Assessment of patient with acute abdominal pain Calister Dike Chamberlain College of Nursing NR 305 Health Assessments Susan Patterson Summer B Session Introduction Assessment of the patient with acute abdominal pain is an article written by Cole, E. , Lynch, A. , & cugnoni, H. 2006.In this article, Cole, E. , Lynch, & Cugnoni, Provided a systematic approach to be used when assessing a patient with acute abdominal pain so that vital information necessary for the diagnosis and treatment is not overlooked; this includes: the type of pain, associated symptoms, past medical and medication history and the social and family history of the patient.
Summary According to Kelso and kugelmas (1997), abdominal pain is one of the most common reasons why people seek medical care.Due to the diversity of the signs and symptoms of acute abdominal pain, nurses in different levels who are involved in the initial assessment and treatment of these patients are required to follow a systematic approach when assessing and taking the history of any patient with acute abdominal pain. This approach is necessary to make sure that vital information is not missed. Certain questions that should be asked during assessment are: Pain It is necessary to establish the position of the pain.
The pain may be localized, wide spread across the abdomen or radiates to the back as in pancreatic pain.To determine the position of the pain, the patient may be asked to point at the exact position of the pain. This helps to confirm the exact organ that is involved and initiate appropriate treatment. It is also important to note the quality, severity, timing and duration, and the relieving and exacerbation of the pain. It is necessary to find out from the patient the severity of the pain, using the scale of 0(NO pain) to 10(worst pain).
Find out from the patient what makes the pain worse and what relieves the pain.Note also the quality and character of the pain. There are classic description of pain, pay attention to the patient’s language, culture and previous experience of pain which may affect the way the patient describes the pain. The character of the pain such as colicky or cramping is associated with obstruction of the bowel (Talley and O’Connor, 2006). Associated symptoms acute abdominal pain is often associated with anorexia and marked weight loss especially in malignant abdominal disorder (Birkitt and Quick 2002).
The nurse should also note the bowel habit of the patient, such as how often the patient has a bowel movement. Ask also about the color, any presence of blood in the stool; is it old or fresh blood? Fresh blood in the stool may indicate a lower intestinal bleed or inflammation. Ask about nausea and vomiting, determine the time and frequency. Early morning vomiting may be due to pregnancy.
Medical and family history this is important to note, recording details of the patient’s past and present medication is important to help determine the cause of the pain.Note also any allergy, alcohol consumption, and any family or medical history of diabetes, Cohn’s disease or cardiac disease. Social and family history it is important to get information about the patient’s past employment. This is necessary because working with toxic substances may cause liver disease; stressful job can cause gastric ulcer and irritable bowel syndrome and anxiety which can cause pain. Alcohol and cigarette smoking can contribute to abdominal pain.
Ask question to make sure there is no family history of abdominal cancer, inflammatory bowel disease and close contact to family, friends or colleagues with infectious diseases such as hepatitis or gastroenteritis which may have been transmitted to the patient. Find out about recent overseas travels to rule out exposure to hepatitis and parasitic infection. Acute abdominal pain can happen to both women, men, children, older adults and people that are obese. Evaluation The author clearly elaborated on the systematic approach of taking the history of a patient with acute abdominal pain.
This is an interesting article because, as nurses we are the first healthcare professionals that the patients come to for assessment before they get medical consultation. Therefore, educating yourself on the specific approach of how to assess a patient with acute abdominal pain will help the nurse to ask the right question in order to give the appropriate treatment. Having a good knowledge of the cause of abdominal pain, and being able to make a careful and a thorough assessment of the patient through history taking, helps both the nurse and the doctor to make a good decision on the are of the patient. In this article, this is no mention of any kind of strategy for prevention of acute abdominal pain. There is no patient education on what to do to stay healthy after the patient has been treated with acute abdominal pain. Adopting the strategies discussed in the article in my practice will help me to assess my patients better, other than using the traditional assessment of patients which I am used to.
These strategies will also help me to make a difference in the life of my patients by getting them the appropriate treatment they need.The health assessment strategies were well written and in simple terms which made it easy to understand The nursing care of the patient should include: To maintain the privacy and the dignity of the patient while providing their physical and psychological needs. The article also discusses the need to meet the comfort of the patient by controlling the pain with medication. This is contrary to the belief that pain medication will mask the pain, thereby hindering accurate diagnosis.
Labs that are necessary when treating acute abdominal pain include: Electrocardiogram, especially for patients over 40 years to rule out cardiac problems. Urinalysis is also done to rule out infections that can cause abdominal pain. Fluid balance to hydrate the patient when NPO. Blood test to assist with diagnosis is needed. The population to benefit from this is will be the patients because the careful assessment will be helpful in making the diagnosis and providing them adequate treatment on timely manner.
The nurses and doctors will also benefit from this article because it give them a systematic approach to assess the patient making sure no vital information is overlooked. This will also assist them to make a sound clinical diagnosis on the cause of the acute abdominal pain. More research and article should be written on acute abdominal pain to include prevention and the use of alternative medicine to treat and prevent abdominal pain in all age groups. Conclusion In conclusion, the writer reviewed the specific questions that a nurse should ask when a patient presents to the hospital with acute abdominal pain.Abdominal pain has many causes, and this can be from a simple, non-acute as in UTI to acute, life threatening such as leaking abdominal aortic aneurysm. This simply means that the patient with abdominal pain may have complex issues that might need physiological and psychological approach.
Therefore, nurses at all levels play important role in the assessment, history taking and initial management of the patient. This helps to expedite the care of the patients. Reference Cole, E. Lynch, A.
& Cugnoni, H (2006). Assessment of the patient with acute abdominal pain Nursing standard, volume 20, issue 39, pages 67-76
