Chapter 24: Abdominal Emergencies

Front 1

Hollow Organs

Back 1

Esophagus

Stomach

Small Intestine

Large Intestine (Colon)

Appendix

Bladder

Gallbladder

Front 2

Solid Organs

Back 2

Liver

Spleen

Pancreas

Kidneys

Front 3

Peritoneum

Back 3

Membrane that lines the abdominal cavity and covers organs within it

Visceral peritoneum covers each organ

Front 4

Retroperitoneal Space

Back 4

The area posterior to the peritoneum between the peritoneum and the back

(Kidneys, pancreas, part of aorta are in retroperitoneal space)

Front 5

Core Concepts

Back 5

Understanding the nature of abdominal pain

Becoming familiar with abdominal conditions that may cause pain or discomfort

How to assess and care for patients with abdominal pain

Front 6

Abdominal Pain:

Visceral Pain

Back 6

Poorly localized, dull, or diffuse pain that arises from the abdominal organs or viscera

Front 7

Abdominal Pain:

Parietal Pain

Back 7

A localized, sharp, intense pain that arised from the parietal peritoneum, the lining of the abdominal cavity

Front 8

Abdominal Pain:

Referred Pain

Back 8

Pain that is felt in a location other than where the pain originates. This happens because the nerve pathways of the abdomen overlap with others and pain sensation is transmitted from one system to another

Front 9

Abdominal Pain:

Tearing Pain

Back 9

Shar pain that feels as if body tissues are being torn apart. Originates in the aorta.

Front 10

Abdominal Conditions:

Appendicitis

Back 10

Infection of Appendix

S & S:

-Persistent RLQ pain

-Referred pain to umbilical region

-Rupture of appendix=sudden severe increase in pain

Front 11

Abdominal Conditions:

Peritonitis

Back 11

Irritation of peritoneum, usually caused by foreign material in peritoneal space (i.e. stomach ruptures and leaks acid)

The irritation causes involuntary contraction of the abdominal muscles

Front 12

Abdominal Conditions:

Cholesystitis

Back 12

Inflammation of the gallbladder, caused by blockage of its outlet by gall stones

S&S:

-Sharp RUG pain

-Referred pain to shoulder

Front 13

Abdominal Conditions:

Pancreatitis

Back 13

Infection of the pancreas

S&S:

-Epigastric pain

-Often referred to shoulder

Front 14

Abdominal Conditions:

GI Bleeding

Back 14

Hemorrhage within the lumen of the GI tract, pain can be minor to severe. Blood exit either mouth or anus and is often painless.

Gastric ulcers can cause severe peritonitis as a result of gastric acid leakage

S&S:

-Dark colored stool

-Frank (red) blood from rectum

-Vomiting coffee ground blood

Front 15

Abdominal Conditions:

AAA (Abdominal aortic aneurysm)

Back 15

Weakening of inner wall or aorta which tears and separates from outer layers-->leading to weak spots in vessel bulging and possibly rupturing

S&S:
-Tearing abdominal pain

-Referred pain to back

-Palpable abdominal mass (DON"T TOUCH)

-Sudden severe increase in pain may indicate rupture

Front 16

Abdominal Conditions:

Hernia

Back 16

Hole in abdominal wall, allowing tissue or organ sections to protrude under skin

Often happens to lifters

S&S:

-Sudden onset of abdominal pain

-Palpable mass or lump on abdominal wall or crease of groin

Front 17

Abdominal Conditions:

Renal Colic (Kidney Stone)

Back 17

Pain caused by kidney stones being lodged in ureter

S&S:

-Severe cramping in flank or back

-Frequently referred to groin

-Nausea, vomiting

Front 18

Abdominal Conditions:

Cardiac Involvement

Back 18

Pain from a heart attack felt as abdominal discomfort

Front 19

HPI For Females

Back 19

Where in your cycle are you?

Is you period late?

Is there a chance you may be pregnant?

Is your flow normal?

Are you on BC?

Have you experienced this pain before?

Front 20

Physical Exam

Back 20

Inspection

-Distension

-Discoloration

-Protrusions

Palpation

-Rigidity

-Pain

-Guarding

Front 21

Pt care

Back 21

Maintain airway

Administer oxygen

Place in position of comfort (LLR for airway protection)