College of Nursing & Midwifery,

Fatima Jinnah Medical University, Lahore

BS. Nursing (2 Years)
1st Prof
Session 2022-2024

PORT FOLIO
Subject: Advance Concept of Nursing-1

Submitted to: Madam Shamim Akhtar

Submitted by: Abida Nasreen
Roll No:
Submission Date:
Student Cover Letter
Name of Student: Abida Nasreen

Roll No:

Class: BS. Nursing (Post Rn – 1st Year)

Teacher Name: Madam Shamim Akhtar

Respected Madam,

I would like to submit my portfolio for your

kind and expert guidelines. I hope that you consider my little bit

effort of regarding objectives, is understandable. I look forward

of my portfolio with you soon.

Thank you for paying your special attention.

Yours Sincerely,

Abida Nasreen
Acknowledgment

I express my thanks and gratitude to all those who have

collaborated with me in compiling this compendium of the

medical knowledge. They give their though, time and interest.

I am thankful to my honorable Principal Madam --- and my

honorable teacher Madam Shamim Akhtar (College of Nursing

and Midwifery, Fatima Jinnah Medical University Lahore) who

helped me for choosing books for the selective topics, which

helped me in the preparation of this portfolio.

Student Signature:
Health Assessment of Patient

Patient Name: M. Sohail

Age & Gender: 48 Years/Male
Medical Diagnosis: Peritonitis
Reg No: 11155
Unit: MSW-1
DOA: 28-03-2023
Ph No: 03014954142
Address: H#49 Street#67 Taj Din Saman Abad Lhr
Hospital: Sir Gangaram Hospital Lahore
CONTENTS
 Sr # Contents

1 Definition

2 Etiology

3 Clinical Manifestation

4 Investigation

5 Complication

6 Medical Management

7 Surgical Management

8 Nursing Care Plan

9 References

Peritonitis
Peritonitis
Definition
Inflammation or swelling of peritoneum typically caused by
bacterial infection.
Brunner and
Suddarth 1299

It is the inflammation of the peritoneum, which is the serious

membrane lining the abdominal cavity and covers the viscera.
Lakhwinder Kaur Sukhminder Kaur 340

Classification of peritonitis
Primary peritonitis
Spontaneous bacterial peritonitis occurs as a spontaneous
bacterial infection of ascetic fluid.

Secondary peritonitis
Occurs secondary to perforation of abdominal organ with
spillage that infects the serious peritoneum. e.g perforated
appendix or perforated peptic ulcer.

Tertiary peritonitis
Occurs as a result of super infection in a patient who is
immunocompromised. Tuberculosis peritonitis In-patient with
AIDS is example.

Etiology
  Acute cholecystitis
 Perforated Peptic Ulcer
 Acute pancreatitis
 Acute perforation of appendix
 Hernia constriction
 Inflammatory bowel disease
 Injury trauma (gun shot)
 Diverticular disease
 Peritoneal dialysis

Clinical manifestations
  Abdominal Pain
 Tenderness over the involved area
 Loss of appetite
 Nausea and vomiting
 Upset stomach (diarrhea, constipation,
 bloating)
 Reduced urine
 Fever and chills

Brunner and Suddarth 1300

Diagnostic evaluation
  Complete blood count (TLC raised, HB and HCT
decreased)
 Serum electrolytes (sodium, potassium, chloride decreased)
 Abdominal x ray
 Ultra sound abdomen
 CT abdomen
 MRI may be required

Brunner and Suddarth 1300

Complications
  Hypovolemia
 Hypokalemia, hyponatremia
 Shock
 Sepsis
 Death

Brunner and Suddarth 1300

Management
Medical management
  Oxygen therapy
 Replacement of fluid and electrolytes
 Analgesics (inj tramadol)
 Antiemetics (inj onset)
 Intestinal intubation and suctioning(NG tube)
 Broad spectrum antibiotics (imipenem, pipercilline,
tazobactam, cefipime)
 Remove peritoneal dialysis catheter, if present and
peritonitis not responded to antibiotic for 5 days.

Brunner and Suddharth 1300

Surgical management
  Surgical treatment includes removing the infectious
material and correcting the cause. E.g. Excision for
appendicitis, resuction with or without anastomosis for
intestinal obstruction and repair for perforation.

 With extensive sepsis, a fecal diversion may need to be

created.

 In some instances, ultrasound or CT guided drainage of

abdominal and extra peritoneal abscess can be done

 Exploratory laparotomy

Nursing Care Plan

Assessment Diagnosis Planning Implementati Evaluation Rationale
on
Subjective Deficient After 8  Monitor After 8  Aids in
Data: fluid hours vital signs hours of evaluating
 Abdomi volume patient noting nursing the degree
nal Pain may be will presence interventio of fluid
 Nausea related to demonstra of ns, the deficits
 Fever fluid shifts te hypertensi patient was  Effectiven
from improve on able to ess of
Objective extracellula fluid as  Maintain demonstrat fluid
Data: r and evidenced accurate e improve replaceme
 Dry interstitial by intake and fluid nt therapy
Mucous compartme adequate output balanced as  Reflects
Membra nts into urine  Measure evidenced hydration
ne peritoneal output urine by status.
 Poor space. with specific adequate
Skin specific gravity urine
turgor gravity  Measure output with
 Vital and stable skin color. normal
Sign as vital specific
follows: signs. gravity and
T: 36.5°C stable vital
P: 49 sign.
R: 14
BP: 110/80

REFERENCES
  Brunner and Suddarth (Medical & Surgical Nursing)

 Edition 18th Page No 1299 to 1300

 Lakhwinder Kaur Sukhminder Kaur Textbook of Medical

Surgical Nursing

 Edition 2nd Page No 340 to 342

Lesson Plan
Student Name: Abida Nasreen Topic: Peritonitis

Class: BSN (Post RN 2 Years) 1st Prof Duration: 45 Minutes

Group: 03 Students: 49

Subject: ACN-1 Date: 28-03-2023

Venue: Class Room

Purpose: To enhance the knowledge of the learners about Peritonitis, its causes,
symptoms and management.

Objectives Contents Time Teaching Resources Method of

Allocate Strategies Evaluation
By reading this Brain Multimedia Cross
portfolio learners Storming Questions
will be able to

 Define Definition 05 Mins Discussion White Board Oral Quiz

Peritonitis Method & Marker

 Explain the Causes and 15 Mins Lecture Handouts Assignments

causes, sign sign symptoms Method
symptoms

 Elaborate the Medication 10 Mins Explanation Flip Charts

medical and precaution
treatment used to treat

 Discuss Discussion 15 Mins Discussion Multimedia Oral Quiz

Nursing care Method
plan and
discharge plan