Question

Discuss the assessment of patient complaining of moderate abdominal pain and include one usual abnormal findings

Answer 1

Abdominal pain can be due many reasons.

Nursing assessment mainly includes history collection and physical examination.

a) Obtain the history for location and extend of pain.Monitor the pain level,duration,intensity,pattern etc.

b)Collect the history of factors aggravating and relieving pain,eating patterns,regularity,types of food,eating circumstances etc.

c) Take a social history of alcohol consumption and smoking.Ask whether the patient is on any medications like aspirin,steroids etc.Collect the history of loss of apetite,weight loss etc.

d) In case of female at reproductive age collect sexual and menstrual history .

Physical examination

-Inspect the abdomen for any injury,bruises,distension,swelling etc.Determine the location of pain.Auscultate for bowel sounds.On palpation assess for any tenderness in abdomen especially in right quadrant region.Localized pain over McBurneys point.Assess for rebound tenderness in the right lower quadrantas well as reffered rebound when palpating the left lower quadrant.Assess for positive obturator sign by flexing the patients right hip and knee and rotating the leg internally.Hypogastric pain indicates the inflammation of obturator muscle.

If the patient is suspected with appendicitis

Physical examination consistent with clinical manifestations.WBC reveals moderate leukocytosis.Abdominal x ray may visualize shadow consistent with fecalith in appendix.Anorexia,moderate malaise,mild fever,nausea and vomiting are the other clinical manifestations.Usually constipation occurs,occasionally diarrhoea.

Nursing intervention includes

Relieving pain by -comfortable position,restrict the activities that aggravate pain,application of ice bag to abdomen for comfort,give analgesics as per doctors order.

Preventing infection by-frequent monitoring of signs and symptoms to assess the worsening of condition indicating abscess,perforation,peritonitis.Administer antibiotics as ordered.Promptly prepare the patient for surgery.