Abdominal Assessment in the ER
HA W8 R2
Type of document Essay
1 Page Double Spaced
Subject area Nursing
Academic Level Master
Style APA
References 2
Order description:
Drew Velasco’s Main Post Week 8 Discussion
COLLAPSE
Abdominal Assessment in the ER
Abdominal pain complaints in the Emergency department are common and comprise about 11% of the total visits (Gross, 2018). It is imperative to rule on the side of caution and eliminate medical or surgical emergencies first. The patient’s perception and description of the pain are vital, OLD CHART is a great subjective tool to obtain all the information regarding the pain. The history and physical should yield the diagnosis some 90-95% of the time (Gross, 2018). Additional testing whether lab work, CT, or X-Ray should only be used to confirm the presumptive diagnosis, according to Gross (2018) “it is rare that “fishing” with laboratory tests will yield a diagnosis when the
H&P does not, and this practice should be condemned” (para 3).
Abdominal Pain during Pregnancy
Nausea, vomiting, and abdominal pain are very common in pregnancy, according to McCarthy, Lutomski, Greene (2014) up to 80% of pregnant women experience nausea and vomiting, most commonly in the first trimester. Furthermore, signs and symptoms that may indicate additional concerns would include nausea and vomiting persisting past mid-pregnancy (approximately 20 weeks) and associated abdominal pain, fever, or diarrhea (McCarthy, Lutomski, Greene, 2014). However, due to the physical changes that occur to the women during pregnancy such as, the enlarging uterus and fetal position/movement, abdominal pain is also common in pregnancy (McCarthy, Lutomski, Greene, 2014). Additionally, an investigation into nonpregnancy-related causes is warranted when there is pain that is localized, abrupt, constant, or severe or pain that is associated with nausea and vomiting, vaginal bleeding, or fever (McCarthy, Lutomski, Greene, 2014). A consult with an obstetric specialist is then recommended as soon as possible. In conclusion, appendicitis remains the most common cause of acute abdomen in pregnancy, and a delay in diagnosis increases fetal mortality (McCarthy, Lutomski, Greene, 2014).
Abdominal Pain in Pediatrics
Acute problems like appendicitis are rarely the cause. Many children are healthy and growing with no abnormalities on physical examination or laboratory work-up (D’Alessandro, 2018). According to D’Alessandro (2018) “laboratory and/or radiological evaluations should be guided by the history and physical examination and should be used, especially if there is evidence of infection, inflammation, or anatomic abnormality suspected” (para 4). Routine laboratory testing would include CBC, sedimentation rate, liver function test, and a urinalysis should be completed first and then possibly radiographic evaluation may be indicated and usually starts with a plain abdominal radiograph but may also include fluoroscopy, ultrasound, or CT scan (D’Alessandro, 2018). Acute problems like appendicitis are rarely the cause (D’Alessandro, 2018).
Reference
D’Alessandro, 2018. Pediatric Education; abdominal pain. Retrieved fromhttp://www.pediatriceducation.org/
Evaluation of Abdominal Pain in the Emergency Department Hartmut Gross, M.D., FACEP
Retrieved from http://www.augusta.edu/mcg/clerkships/em/documents/evalabdominalpain.pdf
McCarthy FP, Lutomski JE, Greene RA. Hyperemesis gravidarum: current perspectives. Int J Womens Health. 2014;6:719-725.
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