Abdominal Pain Case Study

An emergency department nurse is caring for a 44-year-old woman with LLQ abdominal pain and is brought to the emergency department by her husband. Explain what type of assessment is most critical for this patient, providing a rationale for your response. Discuss the questions the nurse would ask, prioritizing these questions from most concerning to least concerning. Use your Jensen (2014) text to support your rationale.

Since this patient is having acute abdominal pain, a focused acute abdominal assessment needs to be conducted to identify the cause of her pain. For this patient, a quick focused history related to abdominal issues is to be conducted, then a focused abdominal physical exam (Jensen, 2011). Since abdominal pain can be tricky to

This can give the nurse a place to start the focused exam. Where is the pain located, is it localized or does it radiate, is the pain intermittent or continuous. Ask the patient when the pain began. How long have you had this pain? Ask characteristics: Is the pain sharp, stabbing, burning, dull, is there tenderness, or cramping. Determining the type of pain can be used to identify the type of issue. There is visceral pain, tension pain, and inflammatory pain, each of which corresponds to different types of condition. Describe the quality, and intensity; ask about severity on a scale of 1 to 10. What makes the pain better, or worse? Find out if she has had any recent trauma or surgeries. Does food make the pain better or worse and if so, how long after eating? The answers to this question can help to identify if there is an issue in the digestive system and can narrow down a location. Determine if there are associated signs and symptoms such as fever, nausea, vomiting, weight loss, heartburn, rectal bleeding. Determine if she has vomiting and fever. Vomiting associated with the pain, may suggest an infection. Ask the patient if the abdominal pain began before vomiting. Assess for cholecystitis in this patient. Even though the patient reports pain in the LLQ instead of the RUQ, the patient is female and over forty, which are two criteria of cholecystitis (Holcomb, 2009). If she reports nausea and vomiting and bowel changes, ask about recent travel, what she may have eaten while away. The patient could have been exposed to Hepatitis A. Ask about her normal eating habits, have they changed recently, is she dieting. Has there been any recent unexplained weight loss or gain. Ask if the patient is taking new medications that might cause abdominal pain such as NSAIDs, Acetaminophen, aspirin, antibiotics, laxatives, or weight loss drugs. What is her alcohol intake, and is she taking any other