Acute Abdominal Pain Essays

Acute Abdominal Pain Essays Acute Abdominal Pain Essay Acute Abdominal Pain Essay Assessment of the patient with acute abdominal pain Karen DeLawder Chamberlain College of Nursing NR305: Health Assessment Spring 2011 Assessment of the patient with acute abdominal pain Introduction Assessment of the patient with acute abdominal pain is an article published in the Nursing Standard Journal in the June 2006 issue, written by Elaine Cole, Antonia Lynch, and Helen Cugnoni. This article gives an in depth look at common diagnosis associated with abdominal pain. With each diagnosis the article gives common statistics such as occurrence, need for urgent treatment or emergent surgery. It provides a detailed list of signs and symptoms for each diagnosis as well as what test or procedure that needs to be performed to diagnose each. The article provides very useful information on the nursing care that patients with abdominal pain may require. Summary of Article It is very hard to determine the cause of abdominal pain because of the multiplicity of signs and symptoms and all people describe pain differently. It is very important to take a good medical history as this can provide 70 per cent or more of the clues that may lead to the diagnosis. A nurse must familiarize themselves with the anatomy of abdomen. The organs located in the abdomen are: the stomach, spleen, liver, gall bladder, pancreas, kidneys, small intestine and large intestine. The organs in the pelvis are: the bladder, caecum, appendix, sigmoid colon, rectum and female reproductive organs. (Cole, Lynch, Cugnoni, 2006). It is very important for the nurse to also learn the location of each organ, as this will help pin point what actually may be causing the abdominal pain. The right lobe of the liver, duodenum, head of pancreas, gall bladder, and sections of the ascending and transverse colon are located in the right upper quadrant of the abdomen. The left lobe of the liver, spleen, body of pancreas, stomach and sections of the descending and transverse colon, are located in the left upper quadrant of the abdomen. The caecum, appendix and a section of the ascending colon are located in the left lower quadrant to the abdomen. The sigmoid colon and section of the descending colon are located in the left lower quadrant of the abdomen. Cole, Lynch, Cugnoni, 2006). â€Å"Acute surgical emergencies constitute about 50 percent of all general surgical admission. About half of these are for abdominal symptoms, predominantly pain, and half of this group resolve without operation. The rest undergo emergency surgery or a scheduled procedure during the same admission. † Birkitt and Quick 2002. (As cited in Cole, Lynch, Cugnoni, 2006, p. 68). Appendicitis i s the most common cause for emergency surgery. Some other common causes of abdominal pain are biliary colic, cholecystitis, gastrointestinal disease, ectopic pregnancies, pelvic inflammatory disease, hepatitis, abdominal aortic aneurysm, pancreatitis, peritonitis, urinary tract infection or pyelonephritis, which is when the infection in the urinary tract has reached the kidneys. Of course there many, many more disease processes that can cause abdominal pain, but these are the ones that are seen most often. (Cole, Lynch, Cugnoni, 2006). â€Å"A systematic approach to assessment should be used so that vital information is not overlooked. Questions should be asked about: pain, associated symptoms, past medical and medication history and social and family history. † (Cole, Lynch, Cugnoni, 2006, pg. 71). The nurse must ask the patient to point to the area where they are having the pain. They should determine when the pain started, if it is constant, if it is sharp, stabbing pain, dull ache, radiating or burning sensation. They should ask if there is anything in particular that causes the symptoms to worsen or better, such as position changes, certain foods or hot or cold liquids. It should also be determined whether or not the patient has had any changes in appetite or weight loss without dieting, as these symptoms can be caused by abdominal malignancies. (Cole, Lynch, Cugnoni, 2006). The physical assessment would include vital signs. Increased temperature, heart rate, respiratory rate and blood pressure can be indicative of serious conditions such as: infection, hypovalemic shock, septicemia, or dehydration . Patients with increased blood pressure and pulse must have an electrocardiogram to rule out cardiac causes for abdominal pain. Other important test would be blood glucose measurement as high readings in a patient that is not diabetic can indicate pancreatitis, also blood test will be ordered to help in obtaining a diagnoses. Most patients that present with sever abdominal pain will be kept nothing by mouth, in case they need surgery and will require Intravenous fluids, pain medications and anti-emetics. (Cole, Lynch, Cugnoni, 2006). Evaluation of Article This is an excellent article for nurses it provides excellent information for nurses to utilize immediately to sharpen their assessment of patients with acute abdominal pain. With the information provided in this article, the nurse will be able to determine whether or not the patient is suffering from acute or chronic abdominal pain. This article gives detailed information on where to locate all the in the abdominal cavity and within the pelvis, it also details which organ is found in each quadrant of the abdomen. This article gives us list of the most common causes of abdominal pain. The article gives just enough information on each of these causes without overwhelming the nurse. The approach to this article is simplistic and this writer found it enlightening and very easily understood. This article would be an excellent resource for any nurse in any setting that practices patient care, since this topic is one of the most common causes for trips to the emergency room. (Cole, Lynch, Cugnoni, 2006). After reading this article this writer has developed useful knowledge that will help in completing a thorough exam and one that may determine whether the patient requires emergent care. The article also gives detailed information on how to differentiate between the diagnoses which can also help in the process of triaging the patient in the emergency room. The journal author goes on to describe the different types of fluids and why one type of fluids may be the better choice for the patient depending on their symptoms. For example; a patient with acute abdominal would need crystalloid type fluids such as 0. 9% sodium chloride which is usually first choice of doctors. Patients suffering from hypovalemic or septic shock would need colloids which will help increase the patient’s blood pressure. Cole, Lynch, Cugnoni, 2006). The author also explains the importance of administering analgesics to the patient’s suffering with acute abdominal pain and the perception that nurses that if they administer analgesia before the diagnoses is obtained can some how interfere with that process. The author states that this thought process has been unfounded. And diagnoses accuracy was no different between patients who had analgesia and those who did not. (Cole, Lynch, Cugnoni, 2006). Conclusion This article provides practical information for use by nurses in emergency room settings. It gives very detailed information on the location of every organ in the abdomen and pelvic region so the nurse can establish possible diagnoses. This article would be very useful to any level of nurses, new graduates to the experienced nurse. I found this article to be a very useful tool in helping nurses fine tune their assessment skills with the patient suffering from acute or chronic abdominal pain. References Cole, E. , Lynch, A. , Cugnoni, H. , (2006). Assessment of the patient with acute abdominal pain, 20(39), p. 67-75.