Clinical Manifestation and Symptoms
- The symptoms of peritonitis depend on the extent and location of the inflammation.
- The most common symptom is abdominal pain, which is usually diffuse at first and then becomes constant, localized, and more intense over the site of the infection.
- The pain is aggravated by movement, coughing, or breathing.
- The abdomen becomes tender, distended, and rigid due to muscle spasms and fluid accumulation.
- Other symptoms include:
- Fever and chills
- Nausea and vomiting
- Anorexia and weight loss
- Diarrhea or constipation
- Decreased urine output
- Tachycardia and hypotension
- Altered mental status

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Questions on Clinical Manifestation and Symptoms
Correct Answer is C
Explanation
Removal of fluid from the spinal canal would be a lumbar puncture, not a paracentesis.
Correct Answer is C
Explanation
Respiratory distress is not directly related to the findings described in the scenario.
Correct Answer is B
Explanation
Chronic lung disease is not directly related to peritonitis.
Correct Answer is A
Explanation
An allergic reaction to the dialysis solution is a possibility but is not the primary reason for an increased risk of peritonitis in clients undergoing peritoneal dialysis.
Correct Answer is B
Explanation
Pancreatitis is inflammation of the pancreas and may cause abdominal pain, but it is not associated with generalized bloating and distension of the abdomen.
Correct Answer is B
Explanation
Restoring fluid balance is a goal of fluid resuscitation, but the primary focus is on preventing circulatory collapse and ensuring adequate tissue perfusion.
Correct Answer is A
Explanation
Bowel rest may be indicated for other conditions but is not the primary intervention for SBP.
Correct Answer is C
Explanation
Diarrhea is not
a common side effect of opioid use in clients with peritonitis.
Correct Answer is C
Explanation
Ultrasonography can provide images of the abdominal organs, but it may not offer the level of detail provided by MRI in assessing peritonitis.
Correct Answer is A
Explanation
Administering bronchodilator medication is not the priority intervention in managing acute respiratory distress unless there is a specific indication for its use.
Correct Answer is B
Explanation
Dehydration may result in elevated blood cell counts due to hemoconcentration, but it is not the primary cause of an elevated white blood cell count in peritonitis.
Correct Answer is B
Explanation
<p>Increased urine output may be a positive finding but does not directly relate to the development of hypovolemic shock.</p>
Correct Answer is C
Explanation
A CBC may show elevated white blood cell count, which is an indication of infection, but it is not a confirmatory test for peritonitis.
Correct Answer is B
Explanation
Administering enteral nutrition may be a secondary purpose of an NG tube in some cases, but it is not the primary goal in clients with peritonitis.
Correct Answer is D
Explanation
Rapid, shallow breathing is a common early sign of septic shock and indicates the body's attempt to compensate for the decreased cardiac output.
Correct Answer is D
Explanation
The finding of a rigid, board-like abdomen upon palpation is known as guarding, which is a protective response of the abdominal muscles in peritonitis to minimize movement and protect the inflamed peritoneum.
Correct Answer is A
Explanation
Constipation may cause abdominal distension, but decreased bowel sounds are not characteristic of constipation.
Correct Answer is B
Explanation
Urinary retention involves the inability to empty the bladder fully and is not related to the findings described in the scenario.
Correct Answer is B
Explanation
Taking a tissue sample from the peritoneal lining is not the purpose of diagnostic paracentesis.
Correct Answer is C
Explanation
Renal failure involves impaired kidney function and may present with specific signs, but it is not directly related to the signs described in the scenario.
Correct Answer is C
Explanation
Gastrointestinal bleeding may present with symptoms such as melena or hematemesis but is not directly associated with hypotension and tachycardia.
Correct Answer is C
Explanation
Bradycardia is not a common side effect of IV antibiotic therapy.
Correct Answer is C
Explanation
Administering prescribed analgesics is essential for managing the client's pain and providing comfort during the treatment of peritonitis.
Correct Answer is D
Explanation
Promoting bowel rest is the main purpose of continuous gastric suction in the management of peritonitis. By reducing the workload of the gastrointestinal tract, the inflamed peritoneum can heal and recover more effectively.
GERD is not a risk factor for peritonitis.
Monitoring intra-abdominal pressure is not the purpose of a paracentesis.
Providing deep breathing exercises is important for preventing respiratory complications, but it is not the highest priority compared to addressing sepsis with antibiotics.
A vegetarian diet is not a risk factor for peritonitis.
Maintaining fluid and electrolyte balance is crucial in managing acute kidney injury in peritonitis. The nurse should closely monitor the client's fluid intake, output, and electrolyte levels and collaborate with the healthcare team to adjust the fluid therapy as needed.
<p>Providing pain medication as needed is important for the client's comfort but does not directly prevent the spread of infection.</p>
Frequent use of antacids may alleviate symptoms of gastric ulcers but is not directly related to an increased risk of peritonitis in clients with perforated gastric ulcers.
Using a heating pad for abdominal pain relief may not be recommended for all clients recovering from peritonitis, as it may exacerbate inflammation or lead to complications. Individualized pain management strategies should be discussed with the healthcare provider.
Oral contraceptives do not increase the risk of developing peritonitis.
Sudden-onset severe abdominal pain and tenderness are classic early signs of peritonitis and indicate the need for immediate medical attention.
Evaluating lung health would involve pulmonary imaging, not the imaging indicated for peritonitis.
Reduced gastrointestinal motility is a normal age-related change but is not directly related to an increased susceptibility to peritonitis in older adults.
Administering the antibiotics through a peripheral IV catheter may not be suitable for the client's condition, as peritonitis may necessitate the use of a central line for administration of IV medications.
Shortness of breath is not a common symptom of peritonitis unless there is an associated respiratory complication.
A history of inflammatory bowel disease is a significant risk factor for peritonitis, especially if there are complications such as bowel perforation.
Mild incisional pain is expected after surgery, but it does not indicate the development of abdominal compartment syndrome.
Implementing fall precautions is important for clients at risk of falls, but it is not directly related to potential complications of peritonitis.
Radiating pain is pain that extends from its source to other areas, and it is not specifically described in the scenario.
An abdominal computed tomography (CT) scan is a valuable diagnostic tool for identifying signs of inflammation and infection in the peritoneal cavity, aiding in the confirmation of peritonitis.
An elevated white blood cell count (WBC) is a common finding in peritonitis, indicating an inflammatory response and possible infection in the peritoneal cavity.
The client's elevated temperature, rapid heart rate, and shallow breathing are indicative of a systemic inflammatory response, which is a characteristic feature of peritonitis.
Encouraging deep breathing and coughing exercises is beneficial for preventing respiratory complications, but it is not the highest priority compared to addressing the infection with antibiotics.
Hyperactive bowel sounds may occur with gastrointestinal disorders but are not specific to peritonitis.
Diverticulitis is inflammation of the diverticula (small pouches) in the colon and is not related to a ruptured appendix.
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