Abdominal pain can be a very minor issue that is easily resolved, or a medical emergency. There are many different things that can cause abdominal pain, whose pathophysiology can differ widely. Abdominal pain can be classified as either acute or chronic. When a patient presents to the emergency department or outpatient environment with abdominal pain, it generally constitutes a lengthy workup to determine the cause, and therefore the pathophysiology. Additionally, abdominal pain can be referred pain, which can complicate the clinical picture even further.
Abdominal pain can be the result of pregnancy, ectopic pregnancy, trauma, a long list of gastric issues (gastroenteritis, constipation, diarrhea, irritable bowel syndrome, GERD, Chron’s disease, appendicitis, to name a few), hernias, allergic response, endometriosis, gallstones, severe menstrual cramps, hepatitis, miscarriage, and many more. Many disease processes result in abdominal pain, and some may present with abdominal pain even though it is not the typical clinical picture.
Cease painful stimuli, resolve underlying cause, minimize any subsequent damage.
Abdominal Pain Nursing Care Plan
Nursing Interventions and Rationales
- We must have a detailed baseline so we not only know how to treat appropriately, but also to know if it has changed. (For example, a sudden relief of pain in a patient with appendicitis indicates rupture and an emergency.)
Control pain: repositioning, heat/cold, medications (muscle relaxants, analgesics), and so forth (all as clinically appropriate)
- Patients who are in pain have trouble participating in care, relaxing, sleeping, and healing. Do what is necessary to proactively treat the patient’s pain, and notify the MD as appropriate of changes or an inability to provide adequate relief.
Assess bowel movements (color, consistency, frequency, amount)
- This will aid the provider in making clinical decisions significantly. It is essential to report bowel movement characteristics and frequency accurately to aid in this important decision making. This also ensure accurate intake and output recording.
Ensure adequate hydration; may require intravenous fluids
- Patients with abdominal pain may have a diminished appetite, be NPO, or not want to drink fluids. Assess and promote appropriate fluid balance, which may requiring notifying the provider of a decreased oral intake and need for intravenous fluids to maintain fluid balance.
- Essential to know their quality as a baseline and to routinely reassess to detect changes. If a patient had bowel sounds, but now does not, it is essential to detect that and notify the provider, as the patient may not experience any symptoms.
Facilitate normal bowel patterns
- Abdominal pain can be due to issues with the GI tract. Therefore, it’s essential to proactively address issues like nausea, vomiting, constipation, and diarrhea as clinically appropriate. This can lessen
- Patients with abdominal pain may not be taking in appropriate fluids or foods, or their urinary and/or bowel output may be lacking. Accurate I&O is essential for appropriate clinical decision making.
- Abdominal pain may have been caused by a pathogen (gastroenteritis, for example). It is essential to promote adequate hand hygiene and infection prevention to prevent the spread to others or preventing the issue from resolving.
Assess abdominal distention, report changes in size and quality as appropriate
- Patients may be experiencing abdominal distention as part of the underlying disease process
- Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nrsng.com/cornell