Assessment of patient acute abdominal pain in nursing

Nurses and Abdominal Pain Patient Care

The people that make up a medical setting contribute immensely and provide the professional care they know to patients who visit the place, whether it's a clinic or a hospital. When the patient first walks in, he or she will meet the desk clerk and other people who will help her get settled in. However, none are the most important when it comes to first professional contact than nurses. The role of nurses is important when patients are in tremendous pain and agony. The purpose of this paper is to explore the different things, methods, and strategies nurses are expected to do in situations where patients are presented with abdominal pain. Overall, it is seem that nurses supplement and complement care on behalf of physicians and their patients.

Summary

Most of the people who come through the doors of a clinic, physician's office, emergency room, or going into a surgical room, it is mostly because of abdominal pain. After the patient is admitted and can see the nurse, the healthcare professional will then take down a personal history before assessing the patient's condition. It is important the nurse asks questions pertaining to the pain, associated symptoms, past medical and medication history, and social and family history because they can all contribute and help find out what the is the patient's problem. As noted by Cole (2006), "the history can provide 70 per cent or more of the clues to the diagnosis." Nurses should also delve into certain histories that are associated with acute abdominal pain, for example, diabetes, drug use through intravenous, or pregnancy. As well, nurses should note whether the patient has alcoholic liver disease, heart problems, ingestion of several medications, or prior history of surgical procedures. Family history is significant since certain cancers and diseases can be due to genetics, or if friends have a contagious disease that can be passed on to the patient. Social history is important since finding out where the patient works, the environment, and whether or not stress is part of the equation will impact findings.

After an assessment, the nurse will then ask the patient the location and quality of the pain. For the former, the nurse will investigate which of the quadrants the abdominal pain is coming from. Nurses see the abdominal cavity in four parts, which are the right upper quadrant, left upper quadrant, right lower quadrant, and left lower quadrant. Each of these aforementioned parts capsulate certain organs of the abdominal cavity, which include the liver, gall bladder, parts of the colon and intestines, appendix, stomach, spleen, and pancreas. The right upper quadrant consists part of the ascending and transverse colon, duodenum, head of the pancreas, liver, and gallbladder. The left upper quadrant contains the left lobe of the liver, stomach, spleen, body of pancreas, and ascending and transverse colon. Furthermore, the right lower quadrant has the caecum, appendix, and ascending colon. The left lower quadrant includes the sigmoid and descending colon.

Once the location of the pain is pointed out by the patient and investigated by the nurse, the healthcare professional will then ask the patient to describe the pain, whether it's referred or radiated. The former type of pain is where it hurts in one region, but pain is felt in another part of the body. The latter is pain that travels to anywhere in the body. Furthermore, pain can be parietal or visceral. The former is sharp pain that is pointed out easily, usually due to inflammation of the parietal peritoneum, while the latter is dull and its origins are vague but may be due to a solid or hollow organ. After the type of pain is assessed by the nurse, the patient will then be asked to describe the characteristic of the pain, for example, if it's burning, aching, cramping or tearing. The former is associated with a peptic ulcer while the latter is due to an ectopic pregnancy, appendicitis, or dissecting aneurysm. Aching pain is linked to constipation or chronic hernia, while cramping is because of a bowel obstruction or of bile duct and ureters. In order to further understand the patient's condition, the nurse will ask the patient whether the pain is relieved when he or she does certain things, for example, eat something, vomit, or passes gas. The level of pain should be recorded by the nurse on a scale of zero to ten, with zero being no pain and ten being the most painful. The time the patient experiences the pain should be asked and noted because then the situation can be assessed as to whether it is acute or chronic. At the end, nurses and the physician may make conclusions as to what the patient is experiencing, which include a myriad of conditions, from appendicitis to cholecystitis to pancreatitis.

Evaluation

Cole is informative about the role of nurses in a setting that involves patients and abdominal pain. The author is illustrative and descriptive without overwhelming the reader, but at the same time, painting a picture that is informative and easy to understand. Furthermore, Cole includes a list and description of the possible causes of abdominal pain that is common in patients. One of such is appendicitis, which is "the most common surgical emergency" (Cole, 2006), and it is the inflammation of the appendix where pain is in the right lower quadrant. Biliary Colic, as Cole wrote, is a sudden, severe pain and continuous but then diminishes rapidly, too. Bowel obstruction may be due to impacted feces, tumors, adhesions, or inflammatory bowel disease like Crohn's Disease. A patient may be in pain because of cholecystitis, which is inflammation of the gallbladder where pain is in the right upper quadrant, and hemorrhaging in the gastrointestinal tract is a cause of pain, too. Cole (2006) noted pain is commonly caused by pancreatitis, or inflammation of the pancreas with a "5-10 per cent morality rate," or peritonitis, which is inflammation of the peritoneum, which is at first centralized and then spreads. Patients may be in pain because of pelvic inflammatory disease, which as Cole (2006) wrote, "ninety per cent of cases are sexually transmitted and sexually active women…are at particular risk." Ectopic pregnancies are a cause of pain when the fetus grows outside the uterus, and as Cole (2006) wrote, "one in 100 pregnancies in the UK are ectopic." The author is quite in-depth with the findings but most of the analysis are based on other people's writings, and the years go back as early as 1997. Some of the information Cole presents may be outdated or there might be an alternative way to diagnose some of the causes of pain since medicine is always changing. Nonetheless, Cole's article is a good stepping stone and a window to what nurses must do when presented with a patient and abdominal pain.