Podcast
Questions and Answers
Which diagnostic study is LEAST likely to be used for chronic abdominal pain?
Which diagnostic study is LEAST likely to be used for chronic abdominal pain?
Which of the following is a potential consequence of significant fluid loss from the vascular space due to acute abdominal issues?
Which of the following is a potential consequence of significant fluid loss from the vascular space due to acute abdominal issues?
What is the primary cause of acute abdominal pain according to the provided content?
What is the primary cause of acute abdominal pain according to the provided content?
A patient with suspected appendicitis is most likely to assume which position?
A patient with suspected appendicitis is most likely to assume which position?
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What vital sign pattern is LEAST likely to indicate hypovolemic shock?
What vital sign pattern is LEAST likely to indicate hypovolemic shock?
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Peritonitis is most likely to result from which condition?
Peritonitis is most likely to result from which condition?
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Which assessment finding is NOT typically associated with abdominal or gastrointestinal issues?
Which assessment finding is NOT typically associated with abdominal or gastrointestinal issues?
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Which of the following is a chronic cause of abdominal pain?
Which of the following is a chronic cause of abdominal pain?
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A patient experiencing severe abdominal pain sits in a restless and seated position. This is MOST likely indicative of:
A patient experiencing severe abdominal pain sits in a restless and seated position. This is MOST likely indicative of:
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A patient is experiencing nausea, vomiting, and increased abdominal girth. These are most likely considered symptoms of what condition?
A patient is experiencing nausea, vomiting, and increased abdominal girth. These are most likely considered symptoms of what condition?
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When evaluating a female patient of childbearing age presenting with acute abdominal pain, which diagnostic test is crucial to perform?
When evaluating a female patient of childbearing age presenting with acute abdominal pain, which diagnostic test is crucial to perform?
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What does 'rebound tenderness' indicate during an abdominal assessment?
What does 'rebound tenderness' indicate during an abdominal assessment?
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When assessing a patient with abdominal pain, it's important to determine the sequence of symptoms. Which sequence is most helpful to clarify the cause?
When assessing a patient with abdominal pain, it's important to determine the sequence of symptoms. Which sequence is most helpful to clarify the cause?
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What best describes abdominal compartment syndrome?
What best describes abdominal compartment syndrome?
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Which medication type is noted to provide pain relief for patients with acute abdominal pain while not interfering with diagnosis?
Which medication type is noted to provide pain relief for patients with acute abdominal pain while not interfering with diagnosis?
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In a patient with visceral pain, which posture is commonly observed?
In a patient with visceral pain, which posture is commonly observed?
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Flashcards
What is Abdominal Compartment Syndrome?
What is Abdominal Compartment Syndrome?
A condition where there is increased pressure within the abdominal cavity due to a buildup of fluid, gas, or tissue. This can squeeze and damage organs inside the abdomen.
What is the Peritoneum?
What is the Peritoneum?
The serous membrane lining the abdominal cavity. When it gets irritated, it signifies a problem, often due to a perforation or infection.
What's Nausea and Vomiting?
What's Nausea and Vomiting?
A common symptom of acute abdominal pain. It can be caused by various reasons, including irritation or inflammation of the stomach.
What's Diarrhea?
What's Diarrhea?
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What's Constipation?
What's Constipation?
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What's Flatulence?
What's Flatulence?
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What's Fatigue?
What's Fatigue?
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What's Fever?
What's Fever?
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Endoscopy
Endoscopy
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CT scan
CT scan
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MRI
MRI
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Laparoscopy
Laparoscopy
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Barium Studies
Barium Studies
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Fetal Posture
Fetal Posture
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Supine Posture
Supine Posture
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Seated Position
Seated Position
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Study Notes
Abdominal Pain & Trauma
- Presented by Dr. Sibi Peter, PhD, RN, CCRN
- Topic covers etiology, pathophysiology, clinical manifestations, diagnostic studies, nursing assessment, nursing diagnoses, planning, nursing implementation, and evaluation for both acute and chronic abdominal pain, and abdominal trauma
Etiology and Pathophysiology (Acute Abdominal Pain)
- Acute abdominal pain is a symptom associated with tissue damage.
- Can arise from damage to abdominal or pelvic organs and blood vessels.
- Certain causes (e.g., hemorrhage, obstruction, perforation) can be life-threatening.
- Large fluid loss from the vascular space leads to shock and abdominal compartment syndrome.
Etiology and Pathophysiology (Chronic Abdominal Pain)
- Chronic abdominal pain may originate from abdominal structures or be referred from a site with the same or similar nerve supply.
Etiology and Pathophysiology (Abdominal Compartment Syndrome)
- Abdominal Compartment Syndrome is organ dysfunction caused by intra-abdominal hypertension.
- Perforation of the GI tract can irritate the peritoneum (a serous membrane lining the abdominal cavity), leading to peritonitis.
Etiology and Pathophysiology (Common Causes - Acute Abdominal Pain)
- Abdominal compartment syndrome
- Acute pancreatitis
- Appendicitis
- Bowel obstruction
- Cholecystitis
- Diverticulitis
- Perforated gastric or duodenal ulcer
- Ruptured ectopic pregnancy
- Gastroenteritis
Etiology and Pathophysiology (Common Causes - Chronic Abdominal Pain)
- Irritable bowel syndrome (IBS)
- Diverticulosis
- Peptic ulcer disease (PUD)
- Chronic pancreatitis
- Pelvic inflammatory disease (PID)
- Vascular insufficiency
Clinical Manifestations
- Pain (most common symptom)
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Flatulence
- Fatigue
- Fever
- Increased abdominal girth
Diagnostic Studies (Acute Abdominal Pain)
- Complete blood count (CBC)
- Urinalysis
- Abdominal X-ray
- EKG
- Ultrasound or CT scan
- Pregnancy test (in women of childbearing age)
Note: Careful use of pain medications (e.g., morphine) can help with pain relief without interfering with diagnostic accuracy in non-traumatic cases.
Diagnostic Studies (Chronic Abdominal Pain)
- Endoscopy
- CT scan
- MRI
- Laparoscopy
- Barium studies
Nursing Assessment
- Immediately take vital signs (including pulse, blood pressure, and temperature).
- Complete history and physical examination.
- Inspect, auscultate, and palpate the abdomen.
- Describe pain (frequency, timing, duration, location).
- Note relationship of pain to meals, defecation, and activity.
- Note factors that increase or decrease pain.
- Note changes in bowel or bladder habits.
- Note accompanying symptoms and sequencing.
- Note patient position (e.g., fetal, supine with legs outstretched, restless and seated).
Nursing Assessment (Assessment Findings- Abdominal/Gastrointestinal)
- Diffuse, localized, dull, burning, or sharp abdominal pain or tenderness
- Rebound tenderness
- Abdominal distension
- Abdominal rigidity
- Nausea and vomiting
- Diarrhea
- Hematemesis
- Melena
Nursing Assessment (Assessment Findings - Hypovolemic Shock)
- Decreased blood pressure
- Decreased pulse
- Tachycardia
- Cool, clammy skin
- Decreased level of consciousness (LOC)
- Decreased urine output (<0.5 mL/kg/hr)
Nursing Diagnoses
- Acute pain related to inflammation of the peritoneum and abdominal distention.
- Risk for deficient fluid volume related to collection fluid in peritoneal cavity secondary to inflammation or infection.
- Imbalanced nutrition: less than body requirements related to anorexia, nausea, and vomiting.
- Anxiety related to pain and uncertainty of cause or outcome of condition.
Planning (Acute Abdominal Pain)
- Resolution of inflammation
- Relief of abdominal pain
- Freedom from complications
- Normal nutritional status
Planning (Chronic Abdominal Pain)
- Comprehensive treatment directed towards symptom palliation.
- Nonopioid analgesics, antiemetics, and psychological/behavioral therapies (e.g., relaxation therapies)
Nursing Implementation (General Care)
- Management of fluid and electrolyte imbalances, pain, and anxiety.
- Pain assessment at regular intervals and providing comfort measures.
- Maintain a calm environment and provide information to alleviate anxiety.
- Ongoing monitoring of vital signs (VS), input and output (I&O), and level of consciousness (LOC).
Nursing Implementation (Acute Intervention- Pre-Op Care)
- Ensure patent airway
- Administer oxygen (O2)
- Establish IV access with large-bore catheter, infusing NS or LR
- Obtain blood for CBC and electrolyte levels
- Insert indwelling catheter
- Obtain urinalysis
- Insert NG tube as needed
Nursing Implementation (Acute Intervention- Post-Op Care)
- Depends on the type of surgical procedure performed
- Laparoscopic procedures have lower complication rates.
- NG tube (with low suction) in selected patients to empty the stomach.
- Monitor VS, LOC, O2 saturation and I&O's
- Assess quality and amount of pain.
- Keep Nothing by Mouth (NPO).
- Assess amount and character of emesis.
- Use antiemetics (e.g., Ondansetron) as needed.
- Encourage early ambulation to restore peristalsis.
- Metoclopramide (Reglan) if gas pain is severe for stimulation
Evaluation
- Resolution of the cause of the acute abdominal pain
- Relief of abdominal pain and discomfort
- Freedom from complications
- Normal fluid, electrolyte, and nutritional status
Abdominal Trauma -Etiology and Pathophysiology
- Blunt trauma (falls, motor vehicle collisions, pedestrian events, assault with blunt objects, crush injuries, explosions)
- Penetrating trauma (knife, gunshot wounds, other missiles)
- Common injuries: lacerated liver, ruptured spleen, mesenteric artery tears, diaphragm rupture, urinary bladder rupture, great vessel tears, renal or pancreas injury, stomach or intestinal rupture
Abdominal Trauma - Clinical Manifestations
- Guarding and splinting of abdominal wall (peritonitis)
- Hard, distended abdomen (intraabdominal bleeding)
- Decreased or absent bowel sounds
- Contusions, abrasions, or bruising over abdomen
- Abdominal pain
- Pain over scapula (phrenic nerve irritation by free blood in abdomen)
- Hematemesis or hematuria
- Signs of hypovolemic shock
Abdominal Trauma - Diagnostic Studies
- Complete blood count (CBC)
- Urinalysis
- Ultrasound (detects free intra-abdominal fluid)
- Abdominal CT scan (identifies injury sites and retroperitoneal structures)
- Diagnostic peritoneal lavage (diagnoses injuries to hollow organs and mesenteric structures)
Nursing and Collaborative Management (Abdominal Trauma)
- Establishing a patent airway and assuring adequate breathing.
- Administering oxygen via a non-rebreather mask.
- Controlling external bleeding with direct pressure/sterile pressure dressings.
- Establishing IV access with two large-bore catheters, infusing NS or LR (fluid replacement for hypovolemic shock prevention).
- Obtaining blood for type, crossmatch, and CBC.
- Stabilizing a penetrating object with a bulky dressing (DO NOT remove).
- Inserting an NG tube to decompress the stomach and prevent aspiration.
- Covering protruding organs with sterile saline dressing.
NCLEX Questions & Answers
- Question 1: Priority intervention for acute abdominal pain? Answer: Measurement of vital signs is first.
- Question 2: Priority intervention after abdominal surgery with NG tube and nausea/vomiting? Answer: Administering prescribed antiemetics (e.g., Ondansetron)
- Question 3: Nursing diagnosis of pain related to decreased GI motility in post-operative patient? Answer: Ambulate the patient more frequently to increase peristalsis.
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Description
This quiz covers the essential aspects of abdominal pain and trauma, focusing on etiology, pathophysiology, and clinical manifestations. It includes both acute and chronic abdominal pain, along with insights into abdominal compartment syndrome. Ideal for nursing professionals seeking to enhance their understanding in this critical area.
