Abdominal Pain Critique

‘Assessment of the patient with acute abdominal pain’ is an article published in Standard Nursing in 2006, written by Elaine Cole, Antonia Lynch, and Helen Cugnoni. In this article, Elaine Cole, Antonia Lynch, and Helen Cugnoni provide an overview of how nurses can thoroughly perform an assessment of abdominal pain in adults. For this reason, it is important that nurses obtain an accurate comprehensive patient history and assessment. This article also provides an overview of the anatomy and physiology of the abdomen, the various causes associated, and vital questions to properly perform an assessment of the abdominal pain. Summary of Article Abdominal pain is the one of the most common reasons that people seek help for medical care (Cole, Lynch, & Cugnoni, 2006). The abdomen is the largest cavity in the body and contains many organs and structures. The abdomen consists of the stomach, liver, spleen, gallbladder, pancreas, kidneys, small intestine, and large intestine. For assessment purposes the abdomen is divided into four quadrants: left upper quadrant, left lower quadrant, right upper quadrant, and right lower quadrant. Abdominal pain has many causes, from simple to complex presentations (Cole et al. , 2006). Therefore, it is essential for nurses to understand the anatomy of the abdomen and be able to distinguish between acute and non-acute conditions to provide an effective treatment plan. According to Cole, Lynch, and Cugnoni (2006), It may be difficult to establish the cause of the abdominal pain because of the diversity of clinical signs and symptoms. A brief description of the common causes of abdominal pain and related symptoms are further discussed. Just to name a few causes, for example, appendicitis is an inflammation of the appendix that often has a colicky pain around the umbilicus or epigastrium; symptoms include vomiting, constipation, loss of appetite, or occasional diarrhea (Cole et al. , 2006). Another, cholesystitis is an inflammation of the gallbladder with a constant colicky pain in the right upper quadrant; symptoms include anorexia, nausea, vomiting and fever (Cole et al. , 2006). In addition, hepatitis is an infectious disease affecting the liver. There are several different types of hepatitis but the most common is hepatitis A; the pain is usually in the right upper quadrant with anorexia, jaundice, dark urine and pale stools, hepatomegaly and splenomegaly, pyrexia, and urticaria (Cole et al. , 2006). Furthermore, a urinary tract infection (UTI) is also a very common cause associated with abdominal pain. Women are most prone in developing this infection. UTI’s are often characterized by suprapubic discomfort, dysuria (pain or burning during micturition), frequency, hematuria, urgency and cloudy urine (Cole et al. , 2006). In order for a patient to receive the appropriate care needed for the abdominal pain, nurses must complete an accurate and detailed history and assessment. According to Cole et al. (2006) a systemic approach to perform an assessment should be used so that vital information is not overlooked. Questions should be asked concerning: pain, associated symptoms, past medical history, medication history, family history, and a social history. Questions regarding pain should include the position, radiation, quality, character, relieving and exacerbating factors, severity, timing and duration. Additionally, other questions to ask would be pertaining to appetite or weight change, bowel habits, and nausea and vomiting, and urinary symptoms. As well as, a complete past medical history, current medications, social and family history should be included. Regardless of the symptoms or diagnosis, all patients should have nothing to eat or drink in case any operative interventions are needed. The physical assessment should present the patient’s vital signs: temperature, heart rate, blood pressure, and respiratory rate. Further, diagnostics should consist of an electrocardiogram, urinalysis, lab test, and fluids. Patients may benefit from non-pharmacological methods of pain control such as positioning, warm compresses, and anxiety reduction through reassurance; nevertheless, analgesia will be prescribed to relieve pain and distress (Cole et al. , 2006). Also, anti-emetics are usually accompanying the pain medication to relieve any nausea and vomiting. Evaluation of the Article This is an interesting article, presenting an outline of an assessment of a patient with abdominal pain. The title clearly defines what the article is all about. The focused population, the major outcome being measured, and a brief description of the possible causes are all included in the title. The focused population here is adults experiencing abdominal pain. The major outcome being measured is the nurses overall understanding of anatomy and physiology and a thorough history taking and a brief description pointing out the most common causes of abdominal pain in a clinical setting. The author emphasizes on the most common causes of abdominal pain, as well as to assist nurses in the history taking and physical assessment. The article provides valuable knowledge of the assessment strategy in an organized fashion and a clear manner. However, the authors did not present any evidence, such as real cases or statistics. The purpose of this article is practical, interesting, and relevant. Practical since the assessment tools can most definitely be useful in the everyday use of health providers, so it can be easily adopted into nursing practice. Interesting as it goes into detail about the numerous possible causes and symptoms of abdominal pain. Relevant since it applies to nurses and other health providers in an acute clinical setting. The content discussed in the article will benefit nurses and practitioners. The summary in this article was able to provide me with an excellent overview of the topic encouraging me to want to read on and on. Also, the summary was short and concise. After reading this article, a deeper insight into understanding the anatomy and physiology of the abdomen is developed. The authors did a great job providing a table displaying the organs in the abdominal cavity, which was refreshing to one’s memory while reading about each possible cause of abdominal pain, thus allowing the article to be easily read. Additionally, the pneumonic used for the causes of pancreatitis is a great tool to have for future reference. The research in this article is sufficient in providing information on the health assessment and does not need additional research. Lastly, many terms mentioned in the article were well defined, but there were spelling errors in the article, pointing out a few words such as localized, generalized, feces, characterized, and summarized. Overall the article was good, yet, it could benefit from some improvement. Conclusion  This article provides a practical overview of the many abdominal pain causes, from acute to non-acute conditions. Nurses play a key role in collecting an accurate patient history and assessment of a patient presenting with abdominal pain. Abdominal pain is the most common reason people seek medical help and can reflect physical discomfort. Therefore knowledge of the many causes of abdominal pain and management is vital. Furthermore, it is essential that nurses understand the anatomy and physiology plus the symptoms related to abdominal pain.