Severe Abdominal Cramping Essay

Severe Abdominal Cramping Essay

A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, as a precaution, the doctor ordered a CT scan. The CT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping.Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen.In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.To PrepareReview the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.· With regard to the Episodic note case study provided:o Review this week’s Learning Resources, and consider the insights they provide about the case study.o Consider what history would be necessary to collect from the patient in the case study.o Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?o Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.The Assignment1.  Severe Abdominal Cramping Essay.Analyze the subjective portion of the note. List additional information that should be included in the documentation.2. Analyze the objective portion of the note. List additional information that should be included in the documentation.3. Is the assessment supported by the subjective and objective information? Why or why not?4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. Remember you MUST complete a FULL abdominal exam. Please write this up as a narrative so that you are able to correctly explain your analysis.REQUIRED READINGSBall, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Chapter 6, “Vital Signs and Pain Assessment”This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment.Chapter 18, “Abdomen”In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen.Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Chapter 3, “Abdominal Pain”This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis.Chapter 10, “Constipation”The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests.Chapter 12, “Diarrhea”In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform.Chapter 29, “Rectal Pain, Itching, and Bleeding”This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies.Colyar, M. R. (2015). Advanced practice nursing procedures. Severe Abdominal Cramping Essay. Philadelphia, PA: F. A. Davis.Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.These sections below explain the procedural knowledge needed to perform gastrointestinal procedures.Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487)Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520)Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.


Fast facts on abdominal pain:

Digestive problems are the most common cause of abdominal pain. Most cases resolve by home remedies without medical attention. Sudden or intense pain need immediate medical check-up.What is abdominal pain? Abdominal pain is pain that you feel anywhere between your chest and groin. Most cases of abdominal pain are mild and have a variety of common causes, such as indigestion or muscle strain. Abdominal pain, also called as a stomach ache, is a symptom related with both non-serious and serious medical issues.

Causes of abdominal pain:

Causes of symptoms of abdominal pain vary and may include gallbladder disease, ulcers of the stomach, food poisoning, diverticulitis, appendicitis, cancers, gynecologic (for example, fibroids, cysts, sexually transmitted diseases – STDs, and vascular problems. Some women experience abdominal pain during pregnancy. Sometimes, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause has been found – at least not yet.Severe Abdominal Cramping Essay.

What exams and tests help diagnose the cause of abdominal pain?

Physical examination: Examining the patient will provide the doctor with additional clues to the cause of the pain. The doctor will determine: The presence of sounds coming from the intestines that occur when there is obstruction of the intestines, The presence of signs of inflammation (by special maneuvers during the examination), The location of any tenderness The presence of a mass within the abdomen that suggests a tumor, enlarged organ, or abscess (a collection of infected pus) The presence of blood in the stool that may signify an intestinal problem such as an ulcer, colon cancer, colitis, or ischemia.

Laboratory tests

Laboratory tests such as the complete blood count (CBC), liver enzymes, pancreatic enzymes (amylase and lipase), pregnancy test and urinalysis are frequently ordered. An elevated white count suggests inflammation or infection (as with appendicitis, pancreatitis, diverticulitis, or colitis). A low red blood cell count may indicate a bleed in the intestines. Amylase and lipase (enzymes produced by the pancreas) commonly are elevated in pancreatitis. Liver enzymes may be elevated with gallstone attacks or acute hepatitis. Blood in the urine suggests kidney stones. When there is diarrhea, white blood cells in the stool suggest intestinal inflammation or infection. A positive pregnancy test may indicate an ectopic pregnancy (a pregnancy in the fallopian tube instead of the uterus).

Plain X-rays of the abdomen

Plain X-rays of the abdomen also are referred to as a KUB (because they include the kidney, ureter, and bladder). The KUB may show enlarged loops of intestines filled with copious amounts of fluid and air when there is intestinal obstruction. Patients with a perforated ulcer may have air escape from the stomach into the abdominal cavity. The escaped air often can be seen on a KUB on the underside of the diaphragm. Sometimes a KUB may reveal a calcified kidney stone that has passed into the ureter and resulted in referred abdominal pain or calcifications in the pancreas that suggests chronic pancreatitis.

Radiographic studies

Ultrasound is useful in diagnosing gallstones, cholecystitis appendicitis, or ruptured ovarian cysts as the cause of the pain. Computerized tomography (CT) of the abdomen is useful in diagnosing pancreatitis, pancreatic cancer, appendicitis, and diverticulitis, as well as in diagnosing abscesses in the abdomen. Special CT scans of the abdominal blood vessels can detect diseases of the arteries that block the flow of blood to the abdominal organs. Magnetic resonance imaging (MRI) is useful in diagnosing many of the same conditions as CT tomography. Severe Abdominal Cramping Essay. Barium X-rays of the stomach and the intestines (upper gastrointestinal series or UGI with a small bowel follow-through) can be helpful in diagnosing ulcers, inflammation, and blockage in the intestines. Computerized tomography (CT) of the small intestine can be helpful in diagnosing diseases in the small bowel such as Crohn’s disease. Capsule enteroscopy, uses a small camera the size of a pill swallowed by the patient, which can take pictures of the entire small bowel and transmit the pictures onto a portable receiver. The small bowel images can be downloaded from the receiver onto a computer to be inspected by a doctor later. Capsule enteroscopy can be helpful in diagnosing Crohn’s disease, small bowel tumors, and bleeding lesions not seen on x-rays or CT scans.

Endoscopic procedures

Esophagogastroduodenoscopy or EGD is useful for detecting ulcers, gastritis (inflammation of the stomach), or stomach cancer. Colonoscopy or flexible sigmoidoscopy is useful for diagnosing infectious colitis, ulcerative colitis, or colon cancer. Endoscopic ultrasound (EUS) is useful for diagnosing pancreatic cancer or gallstones if the standard ultrasound or CT or MRI scans fail to detect them. Balloon enteroscopy, the newest technique allows endoscopes to be passed through the mouth or anus and into the small intestine where small intestinal causes of pain or bleeding can be diagnosed, biopsied, and treated.Surgery. Sometimes, diagnosis requires examination of the abdominal cavity either by laparoscopy or surgery.


How to Treat Stomach Pain in Adults?

    1. Over-the-Counter Medications For gas pain, medicine that has the ingredient simethicone (Mylanta, Gas-X) can help get rid of it. For heartburn from gastroesophageal reflux disease (GERD), try an antacid or acid reducer (Pepcid AC, Zantac 75). For constipation, a mild stool softener or laxative may help get things moving again. For cramping from diarrhea, medicines that have loperamide (Imodium) or bismuth subsalicylate (Kaopectate or Pepto-Bismol) might make you feel better. For other types of pain, acetaminophen (Aspirin Free Anacin, Liquiprin, Panadol, Tylenol) might be helpful. But stay away from non-steroidal anti-inflammatories (NSAIDs) like aspirin, ibuprofen (Advil, Midol, Motrin), or naproxen (Naprosyn, Aleve, Anaprox, Naprelan). They can irritate your stomach. Severe Abdominal Cramping Essay.
    2. Home Remedies You might try a heating pad to ease belly pain. Chamomile or peppermint tea may help with gas. Be sure to drink plenty of clear fluids so your body has enough water. You also can do things to make stomach pain less likely. It can help to:

Eat several smaller meals instead of three big ones

Chew your food slowly and well Stay away from foods that bother you (spicy or fried foods, for example)

Ease stress with exercise, meditation, or yoga

    1. When to See a DoctorIt’s time to get medical help if:

You have severe belly pain or the pain lasts several days;

You have nausea and fever and can’t keep food down for several days;

You have bloody stools;

It hurts to pee;

You have blood in your urine;

You cannot pass stools, especially if you’re also vomiting;

You had an injury to your belly in the days before the pain started;

You have heartburn that doesn’t get better with over-the-counter drugs or lasts longer than 2. Severe Abdominal Cramping Essay.