INTRA-Abdominal abscess

Definition

Intra-abdominal abscesses are localized collections of pus that are

confined in the peritoneal cavity by an inflammatory barrier. This barrier
may include the omentum, inflammatory adhesions, or contiguous
viscera. The abscesses usually contain a mixture of aerobic and anaerobic
bacteria from the GI tract.
Although multiple causes of intra-abdominal abscesses exist, the following
are the most common: (1) perforation of a diseased viscus, which includes
peptic ulcer perforation, (2) perforated appendicitis and diverticulitis, (3)
gangrenous cholecystitis, (4) mesenteric ischemia with bowel infarction,
and (5) pancreatitis or pancreatic necrosis progressing to pancreatic
abscess. Microbiology includes a mixture of aerobic and anaerobic
organisms.

S/S
-swelling
-bloating
-lack of appetite
-nausea
-vomiting
-rectal tenderness/fullness
-diarrhea

Nursing interventions

-empty and irrigate drain as ordered

-provide pain medication as ordered on a routine basis
- provide non-medication comfort measures in nursing scope of practice
-practice good hand hygiene before and after working with patient

Complications

Complications include recurrent abscesses, spontaneous rupture of an

abscess, and occasionally, spread of the infection to the blood stream and
widespread infection.
Name: Patient X Age: 1 Gender: Female Birthday:
September 09, 2008

Address: Balagtas Orion Bataan Nationality: Filipino Religion:

Catholic

Date admitted: September 24, 2009 4:45 pm Attending Physician: Dr.

Lopez

Nursing History

A. History of present illness:The mother said that her daughter

which is the patient had a recurrent fever
for 3about a week, that’s why she decided
to bring her daughter to the hospital.

B. Past Health History:

 1. Childhood illness: The patient had measles when she was
eight month old . Sometimes she’s having
coughs , colds and fever, other than that
there were no illnesses experienced

2. Vaccination: The mother said that her daughter

completed
all vaccinations.

3. Allergies: The patient had an allergy on cold

environment or cold foods. When she was
exposed to these cold things, redness
appearance of the skin occur.

4. Accidents: There were no accidents happened to the

patient as a confirmation by her mother.

5. Hospitalizations: The patient was no hospitalization said by

her mother since now.

6. Medications used or
Currently taking: As of now, based on the Hospital record, the
Doctor ordered to gave her Cefazolin 250
mg IV q 8 hours ANST & Metronidazole 125
mg IV q 8 hours ANST.

7. Foreign Travel: The patient is not yet traveled abroad as the

mother said.

C. Family History The patient’s parents said that there

were no reported or known issue of
diseases on both sides of their families
Activities of Daily Living

ADL Before Illness During Illness

Interpretation

1. Nutrition:The patients has a big The Doctor ordered Intra-

abdominal
appetite. She is frequently Milk feeding diet abcess
breast fed by her mother because she’s being
↓
she likes to eat rice meals prepared for for
CT scan two times a day.
Diagnostic test. ↓

restriction of

diet(M/F)

↓
Impaired nutrition

2. Elimination
She has a regular bowel She took her bowel
Restricted diet
Movement of once every movement of once
↓
day. every 2 days.
↓fiber intake

Constipation

3. Exercise
The patient always like She cant walk Keep
rested
to walk . because of limited
↓
movement .
Activity intolernce
 4. Hygiene
Took a bath once a Only TSB is
Always on bed
day. done
↓

Limited way

to take a bath

Poor hygiene

5.Substance Use NO SUBTANCE USED REPORTED

6. Sleep & Rest

She slept 8-10 hrs a day Disturbed
Hospital env.
sleeping pattern
uncomfortability

Prolonged hour

w/o sleep
↓

Sleep deprivation
BODY NORMAL FINDINGS INTERPRETATION
PARTS

A. Head Rounded Normal

Skull Rounded smooth
smooth Skull contour.
Skull contour. Smooth,
Smooth, uniform
uniform Consistency,
Consistency, Absence of
Absence of nodules
nodules or masses
or masses
Scalp White, clean, Always on bed
free ↓
From oily Limited way to take a bath
masses,lumps, ↓
scars, lice, Poor hygiene
Nits, dandruff
and
Lesions, no
areas of
Tenderness
Hair Normal hair is Normal hair is Normal
Evenly Evenly
distributed, distributed,
Thick, silky, Thin, silky,
resilent Hair. resilent Hair.
Amount of hair Amount of hair is
is variable, variable, coarse
Or fine.
coarse Or
fine.
Face Symmetrical Eyes aligned Normal
facial and
movement symmetrical

Eyes Eyes should be Eyes aligned Normal

Aligned, and
Symmetrical symmetrical
Eyebrows Hair evenly Normal
Distributed,
skin
Intact.
Eyebrows
Symmetrically
Aligned, equal
Movement
Eyelashes Equally Equally Normal
distributed distributed
Curled slightly Curled slightly
Outward. Outward
Eyelids Skin intact, no Skin intact, no Normal
Discharged, no Discharged, no
Discoloration discoloration
 PATHOPHYSIOLOGY

INTRA-ABDOMINAL ABSCESS
UNKNOWN

DIAGNOSTIC TEST
EXPLORATORY
LAPAROTOMY

ULTRASOUND/CT SCAN
↓
LIVER ABSCESS
↓ ↓
ENTAMOEBA HYSTOLIITICA PYOGENIC LIVER
ASCESS
↓ ↓
AMEBIC LIVER ABSCESS ADMINISTRATION
OF
↓ ANTIBACTERIAL
DRUGS
ADMINISTRATION OF ↓
AMEBICIDAL DRUG CEFAZOLIN
↓ (250 MG IV q8 ANST)
METRONIDAZOLE
(125 MG IV q8 ANST)
_________________________________
↓
IF NOT EFFECTIVE
↓
REQUIRED OPEN
SURGICAL DRAINAGE
INTRODUCTION
 BIOGRAPHIC
DATA

PATHOPHYSIOLOGY
ACTIVITIES
OF
DAILY
LIVING
 PHYSICAL
ASSESSMENT

ANATOMY
 &
PHYSIOLOGY

N.C.P.
DRUG

STUDY
DISCHARGE

PLANNING