Tuesday, August 21, 2012

Pain related to Distention - Nursing Diagnosis for Abdominal Pain

Pain related to Distention - Nursing Diagnosis for Abdominal Pain

Abdomen is the part of the body between the thorax and the pelvis, which is separated from the thorax by a diaphragm and from the true pelvis by an imaginary plane. Anteriorly the anterior abdominal wall supports it and posteriorly, the spine and back muscles. Skin, superficial fascia, deep fascia, muscles, layers of fascia (Fascia transversalis), extra peritoneal connective tissue and the outer layer of peritoneum form the anterior abdominal wall. The abdominal cavity extends upwards in to the concavity of diaphragm and downwards in to the pelvic cavity. Since there is overlapping by the ribs in the upper part and pelvic bones in the lower part, the exact size of the abdominal cavity is masked.

Abdominal pain can be a sign of a serious condition. Fortunately, minor causes for abdominal pain are much more frequent than major ones. Abdominal pain can come from the esophagus, the stomach, the bowel, the female organs, the rectum, the gallbladder, r from other organs. Appendix pain usually occurs in the right lower quarter, kidney pain involves the back. The gallbladder involves the right upper quarter, the stomach the upper abdomen, and the bladder, colon, or female organs the lower areas. Exceptions to these rules do occur. Pain from hollow organs such as bowel or gallbladder tends to be intermittent and to resemble gas pains or colic. Pain from solid organs such as kidneys, spleen, or liver tends to be more constant. There are exceptions to these rules also.

If the pain eventually proves to be due to a serious problem, and the stomach should be empty to allow the prompt surgery or diagnostic tests. Anticipate this possibility. Sips of water or other clear fluids may be taken, but avoid solid foods. A bowel movement, passage of gas through the rectum, or a good belch may give relief - don't hold back. If you have not had a bowel movement for several days, an enema can sometimes give relief. Be gentle. A warm bath helps some of you. The key is periodic reevaluation. Any persistent pain should be evaluated at the emergency room or the physician's office. This treatment should be reserved for mild pains that resolve within 24 hours or are clearly identifiable as viral gastroenteritis, gas pains, heartburn, or another minor problem.

Nursing Diagnosis for Abdominal Pain : Pain related to Distention

Objective: pain is resolved or controlled

Expected outcomes: the patient revealed a decrease in discomfort; expressed pain at tolerable levels, indicating relaxation.

Intervention:
  1. Maintain bed rest in a comfortable position: do not support the knee.
  2. Assess the location, weight and type of pain
  3. Assess the effectiveness and monitor side effects anlgesik; avoid morphine
  4. Give a planned rest period.
  5. Assess and advise doing Lathan active or passive range of motion every 4 hours.
  6. Change positions frequently and give a back rub and skin care.
  7. Auscultation bowel sounds; noticed increased rigidity or pain.
  8. Provide and encourage alternative pain relief measures.

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