Medical Surgical Nursing

 The patient may complain of dull abdominal pain and tenderness in the right

upper quadrant of the abdomen.

 Hepatomegaly, jaundice, anemia, and pleural effusion may develop.

 Sepsis and shock may be severe and life-threatening.

Assessment and Diagnostic Findings

 Blood cultures are obtained but may not identify the organism.

 Aspiration of the liver abscess may be done to assist in diagnosis and to obtain

cultures of the organism.

 Percutaneous drainage of pyogenic abscesses is carried out to evacuate the

abscess material and promote healing.

 A catheter may be left in place for continuous drainage; the patient must be

instructed about its management.

Medical Management

 Treatment includes IV antibiotic therapy; the specific antibiotic used in

treatment depends on the organism identified.

 Continuous supportive care is indicated because of the serious condition of the

patient.

 Open surgical drainage may be required if antibiotic therapy and percutaneous

drainage are ineffective.

Nursing Management

 Depends on the patient‘s physical status and the medical management that is

indicated.

 For patients who undergo evacuation and drainage of the abscess, monitoring of

the drainage and skin care are imperative.

 Strategies must be implemented to contain the drainage and to protect the

patient from other sources of infection.

 Vital signs are monitored to detect changes in the patient‘s physical status.

 Deterioration in vital signs or the onset of new symptoms such as increasing

pain, which may indicate rupture or extension of the abscess, is reported

promptly.