Which of the following therapies is not included in the medical management of a client with peritonitis?
A. Broad-spectrum antibiotics
B. Electrolyte replacement
C. I.V. fluids
D. Regular diet
Correct Answer: D. Regular diet
The client with peritonitis usually isn’t allowed anything orally until the source of peritonitis is confirmed and treated. In bacterial peritonitis, the type of antibiotic therapy administered depends on the infecting organism. Keep the patient N.P.O., administer supplemental parenteral fluids and electrolytes as prescribed, and administer medication to manage pain as ordered. Insert a nasogastric (NG) tube to decompress the bowel.
Option A: The client also requires broad-spectrum antibiotics to combat the infection. The primary focus of management is the identification and targeted treatment of offending agent(s) via antibiotics and/or surgical intervention. The non-operative measure includes broad-spectrum antibiotic administration with appropriate stewardship, tailoring the regimen to accomplish increased efficacy targeting the identified microorganisms.
Option B: I.V. fluids are given to maintain hydration and hemodynamic stability and to replace electrolytes. Enteral nutrition is preferred to intravenous as soon as possible. The use of low-dose steroids for 7 days is indicated if the state of shock persists despite adequate resuscitation, or if there is poor response to vasopressors or adrenal insufficiency.
Option C: Crystalloids are used, and a patient may easily require three to six liters in the first hours, depending on the state of the patient and the illness. Blood glucose is also closely monitored, aiming to maintain values around 220 mg/dL.
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