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Ch 42 Acute Abdominal Pain, Appendicitis, Peritonitis, Gastroenteritis Exam Questions and Answers
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Ch 42 Acute Abdominal Pain, Appendicitis, Peritonitis, Gastroenteritis Exam Questions and Answers
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Ch 42 Acute Abdominal Pain,Appendicitis, Peritonitis, Gastroenteritis
Exam Questions and Answers
Acute Abdominal pain
Etiology and Pathophysiology - Answer-pain of recent onset
may signal a life-threatening problem requires immediate attention
causes include:
- damage to organs in abdomen and pelvis -> leads to inflammation, infection,
obstruction, bleeding, and perforation
Perforation of GI tract results in irritation of the peritoneum (serous membrane lining the
abdominal cavity) and peritonitis
Hypovolemic shock occurs from bleeding or obstruction and peritonitis causing large
amounts of fluid to move from the vascular space into the abdomen
Clinical Manifestations - Answer-pain is the most common symptom of an acute
abdominal problem
pt may have N/A, diarrhea, constipation, flatulence, fatigue, fever, rebound tenderness,
and bloating
Diagnostic Studies and Interprofessional Care - Answer-Diagnosis begins with complete
history and physical examination
- description of pain (frequency, timing, duration, location), accompanying symptoms,
and sequence of symptoms (pain before or after vomiting) provide vital clues about
origin of the problem
note pt's position
- fetal position = common with peritoneal irritation (appendicitis)
- supine position with outstretched legs with visceral pain, and restlessness with a
seated posture with bowel obstructions or obstruction = kidney stones and gallstones
physical examination includes examination of;
- abd
, - rectum
- pelvis
complete blood count (CBC), urinalysis, abd x-ray, and electrocardiogram are done,
along with ultrasound or CT scan
goal of management is to identify and treat the cause, monitor and treat complications,
especially shock
careful use of pain medications (morphine) provides pain relief without interfering with
diagnostic accuracy when pts have non-traumatic acute abd pain
in pt's with abd pain an immediate - Answer-surgical consult is needed
- surgeon may perform a diagnostic laparoscopy to inspect the surface of abd organs,
obtain biopsy specimens, perform laparoscopic ultrasounds, and remove organs
if cause of acute abd can be surgically removed (inflamed appendix) or surgically
repaired (ex: ruptured abd aneurysm), surgery is considered definitive therapy
Nursing Management: Acute Abd Pain - Nursing Assessment - Answer-Nursing
Assessment
take VS immediately and again at frequent intervals
- increased P and decreased BP indicate impending shock
- elevated temp suggests inflammatory or infectious process
inspect abd for distention, masses, abnormal pulsation, symmetry, hernias, rashes,
scars, and pigmentation changes
apply light pressure when inspecting abd to help determine level of pt's pain
auscultate bowel sounds ; diminished or absent bowel sounds in a quadrant may
indicate a bowel obstruction, acute peritonitis, or paralytic ileus
do OLDCARTS to assess pain
Nursing Management: Acute Abd Pain - Nursing Diagnosis - Answer-Nursing Diagnosis
acute pain r/t inflammation of the peritoneum and abd distention
Planning - Answer-overall goals are that the pt with acute abd pain will have
1) relief of abd pain
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