Question

A 55-year-old man is transferred to your unit from the intensive care unit following a head injury. During your admission assessment, he complains of a burning sensation in his midepigastric area. On examination, you note a distended abdomen with tenderness in the epigastric area.

• What questions would you ask the patient?

• What diagnostic tests would you anticipate and how would you prepare your patient for these?

• Describe your plan of nursing care for this patient.

Answer 1

Head injury is called when any trauma to your head occurs and it can be by any means and it is severe when it start to cause any other symtom related to digestive system or respiratory system.

The question I will ask from patient suffering from epigastric pain and distension following head trauma is how u get injured,which type of pain in epigastric region he is having either continuously or intermittently,any episode of vomiting,vision change is there to suspect which part of brain is affected.

As patient is suffering from epigastric burning and tenderness following head injury and it might be due to excessive secretion of pancreatic polypeptide which is altered when there is damageto mid brain and head injury indicates vagal nerve increasing activity and pancreatic polypeptide is related to vagus nerve ,so I will suggest patient for endoscopy for checking any erosion in upper GI tract,ultrasonography ,Ct, X-ray and radioimmunoassay for checking any increase gastrin level. I will prepare patient by advicing drink more and more water,be in fasting stage for ultrasound and ct scan ,advice that patient should not wear any metallic things and wear hospital gown.

I will give nursing care to patient for epigastric tenderness and burning sensation by assessing any difficulty in breathing due to distense if yes then provide Fowler's position to him,advice him to take low fat diet and high protein diet,advise him to take small feed to avoid and not to get food just before going to bed,drink plenty of fluids,take pantrapazole for reducing secretions and not to take stress.