PP EE RR II TT O

ONN II TT II SS
Peritonitis is inflammation of the peritoneum — a silk-like membrane that
lines your inner abdominal wall and covers the organs within your
abdomen — that is usually due to a bacterial or fungal infection.
Patients with signs and Patient receiving peritoneal
symptoms of Peritonitis dialysis
Abdominal pain with or without Cloudy dialysis fluid
guarding or rebound white fleck, stands or clumps
fever (fibrin) in the dialysis fluid
leukocytosis
signs of sepsis (hypotension and
tachycardia)

YES Is the peritonitis generalized? NO

- Assess for potential

secondary peritonitis +
YES
Localized peritonitis
Is the patient
hemodynamically NO
stable?
Consider primary
1. Assess the degree 1. Antibiotics
peritonitis
of contamination through 2. Volume resuscitation
imaging tests such as 3. +/- vasopressors
Peritoneal Dialysis
Ascites abdominal ultrasound
2. Antibiotics Failure to clinically
Drain peritoneal
Diagnostic improve
fluid and irrigate Gram staining and culture, cell count
Paracentesis
2-3 times
Exploratory
Antibiotics Laparotomy

Condition tailor antibiotics Monomicrobial Polymicrobial broaden antibiotic

resolved and continue for 7 culture culture coverage
days or more

Condition does Monitor vital signs. A temperature of 37.8C
not resolve to 38.3C can be expected along with an
increased pulse rate.  characteristics.
 Provide tepid sponge bath
Encourage increase of fluid intake
Place the patient in a comfortable position
that maximizes air exchange, such as semi-
Fowler's to high Fowler's position.
Monitor tube drainage every 1 to 2 hours
for color, amount, and other
Provide emotional support to the patient
and his family and teach them which
signs and symptoms to report
immediately, such as changes in pain
characteristics, difficulty breathing,
nausea or vomiting, or light-headedness.