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Nursing Care Plan for Abdominal Pain

Pathophysiology

Abdominal pain can be a very minor issue that is easily resolved, or a medical emergency.  There are many different things that can cause abdominal pain, whose pathophysiology can differ widely. Abdominal pain can be classified as either acute or chronic. When a patient presents to the emergency department or outpatient environment with abdominal pain, it generally constitutes a lengthy workup to determine the cause, and therefore the pathophysiology. Additionally, abdominal pain can be referred pain, which can complicate the clinical picture even further.

Etiology

Abdominal pain can be the result of pregnancy, ectopic pregnancy, trauma, a long list of gastric issues (gastroenteritis, constipation, diarrhea, irritable bowel syndrome, GERD, Chron’s disease, appendicitis, to name a few), hernias, allergic response, endometriosis, gallstones, severe menstrual cramps, hepatitis, miscarriage, and many more. Many disease processes result in abdominal pain, and some may present with abdominal pain even though it is not the typical clinical picture.

Desired Outome

Cease painful stimuli, resolve underlying cause, minimize any subsequent damage.

Abdominal pain Nursing Care Plan

Subjective Data:

Abdominal pain

Decreased appetite

Nausea

Rebound tenderness

Muscle tension

Restlessness

Objective Data:

Constipation

Diarrhea

Electrolyte imbalances

Guarding

Vomiting


Nursing Interventions and Rationales:

  1. Assess pain
    • We must have a detailed baseline so we not only know how to treat appropriately, but also to know if it has changed. (For example, a sudden relief of pain in a patient with appendicitis indicates rupture and an emergency.)
  2. Control pain: repositioning, heat/cold, medications (muscle relaxants, analgesics), and so forth (all as clinically appropriate)
    • Patients who are in pain have trouble participating in care, relaxing, sleeping, and healing. Do what is necessary to proactively treat the patient’s pain, and notify the MD as appropriate of changes or an inability to provide adequate relief.
  3. Assess bowel movements (color, consistency, frequency, amount)
    • This will aid the provider in making clinical decisions significantly. It is essential to report bowel movement characteristics and frequency accurately to aid in this important decision making. This also ensure accurate intake and output recording.
  4. Ensure adequate hydration; may require intravenous fluids
    • Patients with abdominal pain may have a diminished appetite, be NPO, or not want to drink fluids. Assess and promote appropriate fluid balance, which may requiring notifying the provider of a decreased oral intake and need for intravenous fluids to maintain fluid balance.
  5. Assess bowel sounds
    • Essential to know their quality as a baseline and to routinely reassess to detect changes. If a patient had bowel sounds, but now does not, it is essential to detect that and notify the provider, as the patient may not experience any symptoms.
  6. Facilitate normal bowel patterns
    • Abdominal pain can be due to issues with the GI tract. Therefore, it’s essential to proactively address issues like nausea, vomiting, constipation, and diarrhea as clinically appropriate. This can lessen
  7. Record intake and output
    • Patients with abdominal pain may not be taking in appropriate fluids or foods, or their urinary and/or bowel output may be lacking. Accurate I&O is essential for appropriate clinical decision making.
  8. Prevent infection
    • Abdominal pain may have been caused by a pathogen (gastroenteritis, for example). It is essential to promote adequate hand hygiene and infection prevention to prevent the spread to others or preventing the issue from resolving.
  9. Assess abdominal distention, report changes in size and quality as appropriate
    • Patients may be experiencing abdominal distention as part of the underlying disease process

References

Date Published - Jun 29, 2017
Date Modified - Aug 22, 2018