Acute Abdominal Pain -- Assessment
Nurses are very often the first medical aid providers that most patients see. In today's interprofessional healthcare set up, a nurse's approach in collecting a patient's history and diagnosing if the pain is acute or non-acute would assuredly help in providing the patient with appropriate treatment. It is therefore primary that nurses be fully equipped to diagnose the various ailments and start on the care to be provided. Nurses are also the first information gatherers and it is vital that they acquire the patient's past medical history. The importance of a structured approach in gathering this information is very vital as it forms the basis of analysis and also influences the care provided. Abdominal pain is one of the most common ailments that people complain of and seek medical care for. In most cases the pain's primary cause of pain may be ascertained almost immediately but…...
mlaBiliary Colic: Biliary colic is a result of intermittent cystic duct or bile duct obstruction caused by gall stones. Typically affecting overweight women, pain in this case is usually colicky and localized in the right upper quadrant and in the epigastrium radiating towards the back. Vomiting is an associated symptom and the onset of pain is sudden and severe and it resolves as fast and spontaneously or after administering opiate analgesic.
Bowel Obstruction: Both the large and small intestines can get obstructed. Large intestine obstruction is caused by impacted faeces, tumors or volvulus (a case of the intestine twisting around itself). Obstructions in the small intestines are largely due to Crohn's disease, tumors, swallowed foreign objects or adhesions (Longmore et al. 2004.)The patient may experience colicky pain, vomiting, and will display a distended abdomen. It is also possible that some patients may become constipated as they might not be able to pass stools or gas due to the obstruction (Longmore et al. 2004). An X-ray can display the accurate position of the obstruction and help in finding speedy care.
Cholecystitis: An acute or chronic inflammation of the gall bladder, this is predominantly caused by
Lower Abdominal Pain
Patient: Patient is a 30-year-old female presenting with lower abdominal pain, beginning approximately 48-hour previous to her exam. Over the last few days, her pain has increased, and she reports vaginal bleeding that is scanty. She did have a normal menstrual period that ending two-weeks prior, and she indicates this was normal and lasted about 4 days. She is Gravida 2, Para -0, Miscarriage -- 2, and has been attempting to conceive with her husband. In addition, she denies dysuria or urinary frequency.
Vaginal bleeding after sex; inflammation of cervix from friction during sex, usually harmless and clear up quickly. It is possible that the issue could be something more serious (cervical dysplasia or cancer), but more likely inadequate lubrication or foreplay, possibly injury to the uterine lining. Vaginitis is another possible cause, all of which require a vaginal examination (Mayo Clinic, 2014).
Pseydocyesis (False pregnancy). This is based on…...
mlaREFERENCES
Adams, P.J. (2002). Menstruation in Young Girls: A Clinical Perspective. American College of Obstetricians and Gynecologists, 99(4), 655-662
Boston Children's Hospital (2011). Amenorrhea. Retrieved from: http://www.childrenshospital.org/health-topics/conditions/amenorrhea
Dains, J.E., Baumann, L.C., & Scheibel, P. (2012). Amenorrhea. In J.E. Dains, L.C. Baumann. & P. Scheibel, Advanced Health Assessment & Clinical Diagnosis in Primary Care (4th ed., pp. 46- 60). St. Louis, MO: Mosby.
Master-Hunter, T. & Heiman, D. (2006) Amenorrhea: Evaluation and Management. American Family
Assessing the Abdomen
Abdominal pain has proven to be a major issue facing emergency room doctors since the diagnosis process is relatively complex. Meisel (2011) contends that doctors in emergency rooms do not fancy diagnosing and treating abdominal pain because it entails dealing with bodily fluids, complex internal examinations, and a wide range of diagnostic tests and therapies. This comes at a time when abdominal pain is one of the major reasons American patients visit the emergency room (ER). Caring for abdominal pain is characterized by a high chance of misdiagnosis unlike other health issues. ER doctors are faced with challenging and time-consuming processes when trying to determine the actual cause of abdominal pain. This is a case study of a woman who visited an emergency room for severe abdominal pain and was diagnosed with diverticulitis. The case study entails an analysis of SOAP (Subjective, Objective, Assessment, and Plan) factors in…...
Abdominal AssessmentA 65-year-old African American presents to the emergency department with a two days history of intermittent epigastric abdominal pain radiating from the back. Following an assessment, he was diagnosed with abdominal aortic aneurysm (AAA) but the doctor ordered a CTA scan. However, diagnosis of abdominal pain is a time-consuming and challenging process that can result in misdiagnosis if not conducted properly. The doctors recommendation of a CTA scan is geared towards ensuring a proper diagnosis of the patients condition. In addition to the recommended CTA scan, it is critical to review the patients history, physical exams, and diagnostic tests. This paper examines the patients abdominal assessment presented in the Episodic note case study in order to formulate a differential diagnosis of his condition.Current AssessmentThe Episodic note case study provides subjective and objective data collected from the patient that resulted in the AAA diagnosis. The current assessment is supported by…...
mlaReferences
Cartwright, S.L. & Knudson, M.P. (2008). Evaluation of acute abdominal pain in adults. American Family Physician, 77(7), 971-978.
Macaluso, C.R. & McNamara, R.M. (2012). Evaluation and management of acute abdominal pain in the emergency department. International Journal of General Medicine, 5, 789-797.
Mehta, H. (2016). Abdominal pain. Clinical Pathways in Emergency Medicine, 1, 329-345. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121692/
Patient: 66-Year-Old Black / African-American Female With Complaint of Sudden Onset of Mid Upper Epigastric Pain
Pertinent PMH
During the initial medical exam, it is critical to gauge the severity of the pain. The healthcare practitioner should inquire as to the presence of previous medical conditions such as colitis, Crohn's disease, and IBS which could be the cause of the sudden onset. In the instance of abdominal pain, the provider should determine the precise location of pain as much as is possible even though referent pain is often an issue. Even though the pain is located in the upper abdominal quadrant, greater specificity is needed to eliminate possible causes. For example, "pain in the patient's right-upper abdomen can indicate gallstones or inflammation" or "duodenal ulcers, acute pancreatitis, acute cholecystitis, and acute hepatitis" (Lipman 2009; Karnath & Mileski, 2002, p. 46). In contrast, pain in the right mid-upper abdomen, may indicate "stomach or…...
mlaReferences
Karnath, B. & Mileski, W. (2002). Acute abdominal pain. Review of Clinical Signs.
Retrieved from: http://www.turner-white.com/pdf/hp_nov02_pain.pdf
Lipman, M. (2009). When your belly hurts. Consumer Reports. Retrieved from:
http://www.consumerreports.org/cro/2012/05/when-your-belly-hurts/index.htm
Exploring Patient History, Assessment, and TreatmentIn clinical practice, the intricate patient assessment and management process stands as the cornerstone of healthcare provision. This case study delves into a profound exploration of a patient encounter witnessed within the context of a recent practicum site visit. Drawing upon the essential components of the SOAP (Subjective, Objective, Assessment, Plan) note template, we embark on a journey through the patients intricate web of subjective experiences, objective manifestations, differential diagnoses, treatment strategy, and reflective insights. The overarching aim of this investigation is to vividly illustrate the seamless amalgamation of clinical reasoning, evidence-based practices, and the invaluable art of thoughtful contemplation in the realm of patient-centered care. Through examining this case study, a profound understanding of the dynamic interplay between medical science and compassionate care is sought, fostering a deeper appreciation for the multifaceted nature of healthcare provision.Patient InformationInitials: J.D.Age: 45Sex: FemaleRace: CaucasianChief Complaint (CC): Persistent…...
mlaReferences
El-Salhy, M., Hatlebakk, J. G., & Hausken, T. (2019). Diet in irritable bowel syndrome (IBS): interaction with gut microbiota and gut hormones. Nutrients, 11(8), 1824. https://doi.org/10.3390/nu11081824
Natarajan, A., Zlitni, S., Brooks, E. F., Vance, S. E., Dahlen, A., Hedlin, H., Park, R. M., Han, A., Schmidtke, D. T., & Verma, R. (2022). Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection. Med, 3(6), 371-387. e379. https://doi.org/10.1016/j.medj.2022.04.001
Rao, S. S., & Bhagatwala, J. (2019). Small intestinal bacterial overgrowth: clinical features and therapeutic management. Clinical and translational gastroenterology, 10(10). https://doi.org/10.14309/ctg.0000000000000078
InterestInterview Coding & Reaction
There is little doubt that the experience, events and quality of care that surround expecting and new mothers is extremely important (Berrien, Olledorff & Menard, 2015). The reduction or mitigation of things like excessive pain before and after birth, any sort of disconnect between patient and providers in terms of communication and an explanation of what is and shall be going on and so forth are all important (Taavoni, Abdolahian, Neisani & Hamid, 2016). This research deigns to cover a number of things. First, it is asked of the interviewee what went well, what did not, what perhaps could or should be compared and contrasted between this or prior birthing experiences (and one did exist in the case of this research), what could have been done better, what was done well, whether proper and full options were made available and so on.
The setting and meeting of…...
Assessing the Abdomen
The chief complaint of JR is that his “stomach hurts” and he is experiencing diarrhea, from which he has been unable to obtain any relief. His pain in his abdomen started 3 days earlier and he has taken no medication for it. The pain is midrange, though it was very high today when it began. He ate but experienced nausea afterwards. JR is 47, suffers from hypertension, diabetes and had an issue of gastrointestinal bleeding four years ago. He is on a number of medications to address his high blood pressure and diabetes. He has no known drug allergies, no history of colon cancer. His father and mother both had hypertension; his father has type 2 diabetes; his mother suffered from Gastroesophageal reflux disease and high fatty concentration in the blood (hyperlipidemia).
JR occasionally imbibed alcohol. He is overweight at 248 lbs with a 5’10” height. He has a…...
This strength, however, comes at the price of an explanation of the detailed mechanisms by which abdominal pain is created by each of the identified illnesses. The article's primary strength is found in its directness and its effective summary of necessary information, in the brevity through which this is achieved necessarily limits the scope of the article. Though the article would perhaps have been more interesting with more in depth explanations, it was still a highly interesting read and provided an effective and concise review of some knowledge already obtained as well as presenting new knowledge.
The health assessment strategies described in this article would be highly beneficially in any practice not already using similar assessment methods. The efficiency and reliability of the methods the authors describe would be of great benefit to patients and staff alike, saving abundant time, energy, and resources that can then be devoted to treatment…...
mlaReferences
Cole, E.; Lynch, a. & Cugnoni, H. (2006). Assessment of the patient with acute abdominal pain. Nursing standard 20(38), 56-61.
Nursing Case Study
Managing a possible Case of Gastroenteritis: A Nursing Case Study
The effective delivery of optimal nursing care requires a comprehensive treatment plan that addresses both the patient's symptoms and the security of the immediate environment. This report presents a case study of appropriate evidence-based nursing practices in treating an elderly female patient presenting with abdominal discomfort in a residential care setting.
The client presents with new onset faecal incontinence, diarrhoea and increasing abdominal discomfort and cramps. These symptoms suggest a possible gastrointestinal disturbance (Crisp & Taylor, 2009) and present a number of possible diagnoses. While the client's nursing care plan indicates that she is normally continent, her confidential disclosure to the nurse suggests that her symptoms may be more prolonged. Another relevant client characteristic is her advanced age of 85 years.
The client's proximity to the dirty utility room in the aged care facility and the report of similar symptoms from…...
mlaReferences:
1. Crisp J, Taylor C. (2010). Potter & Perry's fundaments of nursing (3rd ed.). Chatswood, N.S.W.: Elsevier, Australia.
2. Kirk MD, Hall GV, Veitch MGK, Becker N. (2010). Assessing the ?incidence of gastroenteritis among elderly people living in long-term care facilities. Journal of Hospital Infection, 76, 12.
3. Australian Government: Department of Health and Ageing. (2007). Retrieved from- http://www.health.gov.au/internet/main/publishing.nsf/content/icg-guidelinesindex.htm .
4. Andrew E, Simor MVD. (2010). Diagnosis, Management, and Prevention of Clostridium difficile Infection in Long-Term Care Facilities: A Review. The-Americans Geriatric Societ, 58(8), 1557-1593.
Participants filled out a Short-Form McGill Questionnaire, an Arthritis Self-Efficacy Scale, and Fibromyalgia Impact Questionnaire in order to measure their levels of pain over the past few weeks. What the researchers found through statistical analysis was self-management strategies that reduced pain over time were most effective in the group that was exposed to guided imagery techniques. The level of guided imagery therapy was not itself significant, but more of the fact of whether or not it was present in the patient's therapy or not. This helps illustrate the effectiveness of guided imagery in managing long-term chronic pain when there are no fundamental cures present within traditional therapeutic practices. Pain management symptoms improved, but the symptoms overall remained. This shows that guided imagery is not a cure in and of itself, but rather an effective way to reduce and manage the pain that is present in chronic conditions like fibromyalgia.
Weydert,…...
mlaReferences
Ferrell, Betty R., et al. "Pain management for elderly patients with cancer at home." CANCER-PHILADELPHIA- 74 (1994): 2139-2139.
Menzies, V., Taylor, a.G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. Journal of Alternative & Complementary Medicine, 12(1), 23-30.
Weydert, J.A., Shapiro, D.E., Acra, S.A., Monheim, C.J., Chambers, a.S., & Ball, T.M. (2006). Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC pediatrics, 6(1), 29.
In order to assess Yvonne and her symptoms, the nurse practitioner must show patience and understanding. In the treatment of the symptoms, whether to relieve the fevers or perform scans and tests to find the source of the abdominal pain, the nurse practitioner must give Yvonne and her relatives significant input into the management of the illness. Optimal outcomes can be achieved by providing information to the patient that decreases fear, timely involvement of the doctor in the administration of pain medications and emotional support (McGrath, P. 2006).
eflective practices can have considerable effectiveness in the care of Yvonne. In a paper discussing the benefits of reflective care, Ben Hannigan (2001) argues that reliance on practical knowledge alone is insufficient to solving medical problems as they are rarely abstract in nature. eflection by the nurse practitioner embeds the medical problem into the social context and allows the practitioner to engage…...
mlaReferences:
1. Mununggirritj, D. Yolngu Healer's Medicine: Plants used by the women healers of North-East Arnhem Land. [Online] Available at: [Accessed 3 September 2011].http://www.atec.net.au/djapirri_muunggirritj_atec_h_w_presentation.pdf
2. McGrath P., 2006. 'The biggest worry..': research findings on pain management for Aboriginal peoples in Northern Territory, Australia. Rural Remote Health 6(3), p.549
3. Aboriginal Resource and Development Services (ARDS) [Online] Available at: [Accessed 3 September 2011].http://www.ards.com.au/default.html .
4. Cass A, Lowell A, Christie M, Snelling PL, Flack M, Marmganyin B, Brown I., 2002. Sharing the true stories: improving communication between Aboriginal patients and healthcare workers. Mad J. Aust 176(10), pp.466-70
Endocrine Pancreas
eview of Symptoms and Lab esults
The reported nausea, vomiting, and abdominal pain may indicate a GI disorder, but combined with the patient's diabetes, unusual thirst, constant urination, and fatigue, the symptoms are more indicative of an endocrine disorder (Lippincott Williams & Wilkins, 2006).
Some of the patient's lab results fall into the normal range: BUN of 16 mg/dl (normal is 8 -- 25 mg/dl); creatinine of 1.3 (normal is 0.5 -- 1.7 mg/dl); sodium of 139 mEq/L (normal is 135 -- 145 mEq/L); blood pressure of 90/60 (normal is less than 120/80); and temperature of 99 .1°F (Chernecky & Berger, 2001; Pagana & Pagana, 2003).
Other lab results fall outside of the normal range: glucose of 420 mg/dl is very high (normal is 60 to 110 mg/dl); 4+ glucose and 3+ ketones are very high (normal is no glucose or ketones present in the urine); pH of 7.12 is low (normal…...
mlaReferences
Chernecky, C.C., & Berger, B.J. (Eds.). (2001). Laboratory tests and diagnostic procedures. Philadelphia: Saunders.
Haber, M.H., & Ward, P.C.J. (2002). Urine. In K. McClatchey (Ed.), Clinical laboratory medicine. Philadelphia: Lippincott Williams & Wilkins.
Kitabchi, A.E., Umpierrez, G.E., Miles, J.M., & Fisher, J.N. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7): 1335 -- 1343. doi: 10.2337/dc09-9032.
Lee-Lewandrowski, E., Burnett, R.W., & Lewandrowski, K. (2002). Electrolytes and acid-base balance. In K. McClatchey (Ed.), Clinical laboratory medicine. Philadelphia: Lippincott Williams & Wilkins.
The nursing professional must be adept at dealing ith these kinds of conversations, and ithout increasing the guilt that the family member or patient might be experiencing, and keeping in mind the patient's probable depression; it is the responsibility of the nursing professional to take the conversation back to the treatment and therapies that ithin the realm of the legal and ethical practices in delivering medical nursing care.
Jacquie Peden, Darlene Grantham, and Marie-Josee Paquin (2005) say that nursing standards in palliative care are based on the values of the nursing profession, and are developed by provincial and territorial regulatory bodies in Canada to guide the professional practice of nursing professionals (p. 2). The hospice palliative nurse, they rite:
Believes in the intrinsic orth of others, the value of life, and that death is a natural process.
Establishes a therapeutic connection (relationship) ith the person and family through making, sustaining, and closing…...
mlaworks cited here support the need for continued and expanded research involving the different specialties in nursing and oncology to better serve patients and their families. Also, there is little nursing information that is found in the professional peer reviewed journals that speak directly to the issue of pancreatic patients and depression. There is much more literature on the subject from the physician and researcher perspectives, but there is a void in nursing literature. At this point in time, the depression of pancreatic patients as it concerns nursing, has received little attention. Both the nursing profession and pancreatic patients would benefit from further research in this area.
The conclusion from the study of the literature available is that not only is pancreatic patient depression not well understood, it is also lacking in research that would help professionals to address depression in these patients. Also, because it is directly linked to pancreatic cancer, and because the research does support the fact that patients suffering depression and pancreatic cancer do not enjoy the quality of life as those patients who do not suffer from depression, then pancreatic cancer patients and depression should be a distinct and separate therapeutic intervention from other groups of depression.
References
Adali, E., Merkouris a., Manoussou, E., and Priami, M. (2004). The Attitudes of General and Oncological Hospital Personnel toward Euthanasia, ICUS and Nursing Web Journal, 17:1-9, found online at retrieved 7 October 2009.http://www.nursing.gr/index1.html ,
Canadian Nurses Association (2008). Position Statement: Providing Nursing Care at the End of Life, Canadian Nurses Association.
On the part of his fellow scientists, Snow's research was resisted because it was conducted with intellectual 'leaps' of logic in his determination to find the cause, as opposed to Farr's more technical and methodological approach. Farr had the more comprehensive health surveillance program, but Snow's hypothesis and instincts were correct. Snow drew upon past studies involving smallpox, cowpox, and syphilis, to extrapolate parallel examples of how the disease was transmitted, while Farr clung to the airborne model of disease transmission popular at the time even after reviewing such studies. Farr stated that non-living or zymotic material was transmitted through the air, and hence the closer the quarters of the affected, the more apt the material would be transmitted through the air.
The commonly-held belief was that fecalized air and water were the primary conduits of the disease. Farr believed primarily that the transmission was "miasmatic" and the prevalence in…...
1. The Impact of Crohn's Disease on Quality of Life
Explore the physical, emotional, and social challenges faced by individuals living with Crohn's disease.
Discuss the impact of symptoms such as abdominal pain, diarrhea, fatigue, and weight loss on daily life.
Examine the role of social stigma, isolation, and anxiety in reducing quality of life.
2. The Role of Diet and Nutrition in Managing Crohn's Disease
Describe the dietary and nutritional challenges faced by patients with Crohn's disease.
Discuss the efficacy of elimination diets, low-FODMAP diets, and specific nutrient supplementation in managing symptoms.
Explore the importance of individualized dietary plans and....
Physiological Symptoms of Anxiety: Manifestations in the Body
Anxiety is a normal human emotion characterized by feelings of unease, nervousness, or worry. However, when anxiety becomes excessive or chronic, it can manifest as a range of physical symptoms that can significantly impact daily life. Understanding these physiological manifestations is crucial for effectively managing and treating anxiety disorders.
Cardiovascular Symptoms
Increased heart rate: Anxiety triggers the release of adrenaline and noradrenaline, which cause the heart to beat faster and more strongly.
Palpitations: Rapid, irregular heartbeats can be a common symptom of anxiety, often accompanied by chest discomfort or shortness of breath.
High....
## The Impact of Proper Nutrition and Lifestyle Choices on Digestive Health
The digestive system plays a pivotal role in overall well-being, responsible for extracting nutrients from food and eliminating waste products. Maintaining a healthy digestive system is crucial for optimal physical and mental health. Proper nutrition and lifestyle choices can significantly impact the health of the digestive tract.
### Role of Nutrition in Digestive Health
Dietary Fiber: Fiber is an indigestible carbohydrate that promotes bowel regularity and prevents constipation. Soluble fiber, found in fruits, vegetables, and beans, absorbs water and forms a gel-like substance that slows digestion and helps regulate blood sugar....
I. Physical Effects of Miscarriage
II. Emotional Effects of Miscarriage
Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now