Chapter 42, Abdominal Pain and Trauma

The nurse is caring for a 68-year-old patient admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture?

High-pitched and hyperactive above the area of obstruction

A patient is suspected to have developed abdominal compartment syndrome. What findings would the nurse expect to assess?

Increased abdominal pressure

The nurse is preparing to administer a soapsuds enema to a patient who is constipated. For what complication should the nurse monitor after completion of the enema?

Inflammation of colon mucosa

A patient with abdominal trauma has a urinalysis that indicates there is blood in the urine. For what condition does the nurse monitor this patient?

Kidney damage

A patient is brought to the emergency department with signs of blunt trauma. What may have caused the patient's injuries?

Motor vehicle accident

A patient is involved in a motor vehicle crash and the nurse is performing a head-to-toe assessment to determine injury. Which clinical manifestation indicates abdominal trauma?

Pain over the scapula

A nurse performs an abdominal assessment and notes that a patient has tenderness over the McBurney point. Identify the area where the nurse elicits this finding.

The McBurney point is the area in the region of the right lower quadrant of the abdomen. It is the landmark for pain associated with appendicitis.

A patient sustained abdominal trauma in a motor vehicle crash and the nurse is administering volume expanders as ordered. What rationale does the nurse provide to the patient for this action?

To increase the blood pressure

The nurse encourages a patient after abdominal surgery to ambulate. What is the rationale provided to the patient by the nurse for the importance of early ambulation?

To restore peristalsis

The nurse recognizes that a patient with acute abdominal pain is experiencing hypovolemic shock. Which finding supports the nurse's conclusion? Select all that apply.

Urine output of 0.2 mL/kg/hr Pulse rate of 58 beats/minute Blood pressure of 90/60 mm Hg

A patient is prescribed medication for the treatment of irritable bowel syndrome (IBS) that reduces peripheral nerve sensitivity. About what type of medication will the nurse educate the patient?

Xifaxan

Which food should the nurse encourage for a patient with abdominal cramps associated with irritable bowel syndrome (IBS)?

Yogurt

A patient comes to the clinic reporting frequent abdominal pain for over 6 months. What conditions does the nurse recognize may contribute to the patient's symptoms? Select all that apply.

peptic ulcer disease Chronic pancreatitis Irritable bowel syndrome

The nurse finds coffee-ground like granules in the nasogastric drainage of a patient. What does the nurse suspect to be the cause of this condition?

Blood modified by acidic gastric secretions

A patient with abdominal pain, constipation, bloating, sleep disturbance, and flatulence is prescribed alosetron. Which questions should the nurse ask the patient to ensure the safety of the medication? Select all that apply.

"Do you have abdominal pain?" "Do you have blood in your stools?" "Are you experiencing severe constipation?"

A 28-year-old woman calls the office nurse and states, "I am having the worst abdominal pain! It just started this afternoon. Is there anything I can take to get relief?" Which answer by the nurse is appropriate?

"Please have someone bring you to the office today so that we can do an examination."

A patient with abdominal pain, severe diarrhea, bloating, and flatulence complaining of constipation is prescribed alosetron. What statement by the nurse would be most beneficial?

"Stop the medication immediately."

A patient with abdominal trauma is at risk for the development of hypovolemic shock. What assessment finding by the nurse would indicate that the patient is developing this condition?

Blood pressure of 80/42 mm Hg

The nurse is caring for a group of patients. Which patient is at the highest risk for the development of septic shock?

A patient with biliary obstruction

The nurse is providing education to patients assigned for the day. Which patient would benefit from being taught the Valsalva maneuver?

A patient with constipation

The nurse is assigned to care for a group of patients. Which patient is at the highest risk for the development of renal failure?

A patient with high abdominal pressure and third spacing

A 92-year-old patient has been admitted with abdominal pain, nausea, and vomiting. The patient has an abdominal mass, and a bowel obstruction is suspected. Which assessment findings are consistent with the patient's clinical picture?

Abdominal distention and high-pitched bowel sounds above the obstruction

The nurse assesses a patient involved in a motor vehicle crash with a possible pelvic fracture. The abdomen is distended and the patient reports pain over the scapula. What is the priority nursing intervention for this patient?

Administering oxygen through non-rebreather mask

A patient is newly diagnosed with irritable bowel syndrome (IBS). When educating the patient about the disorder, what should the nurse be sure to include about exacerbating the illness? Select all that apply.

Anxiety Depression Posttraumatic stress disorder

A patient with abdominal trauma is suspected of having arterial damage. Which assessment finding by the nurse would support this suspicion?

Auscultation of bruits

A patient involved in a motor vehicle crash reports severe abdominal pain and is suspected to have sustained arterial damage. What assessment finding by the nurse would support this conclusion?

Bruit auscultated

What finding should prompt the nurse to immediately notify the primary health care provider about a patient who has undergone laparotomy surgery?

Dark red drainage from the nasogastric tube

The nurse assesses Grey Turner's sign for a patient exhibiting signs of acute pancreatitis. What observation made by the nurse led to this assessment?

Discoloration of skin in the flank region

The nurse is performing an assessment on a patient with abdominal trauma. What assessment finding indicates to the nurse that there is irritation of the phrenic nerve by free blood in the abdomen?

Distended abdomen Correct3 Decreased bowel sounds Guarding and splinting of the abdominal wall

A patient informs the nurse that he or she is chronically constipated. When educating the patient about the effects of complications related to chronic constipation, what should the nurse include?

Diverticulosis

A patient informs the nurse that he or she is having problems with constipation and would like to know what can be done. What interventions can the nurse suggest to help the patient alleviate this problem? Select all that apply.

Doing sit-ups regularly Increasing the fluid intake Avoiding caffeinated products

A patient is brought to the emergency department after a motor vehicle accident. On examination, the nurse finds that the patient has sustained facial trauma and suspects a fractured pelvis. The nurse also notes that a large piece of glass is impaled in the abdomen. What nursing actions are appropriate for this patient?

Ensure a patent airway.

The nurse is reviewing the medication charts of four patients. Which patient's prescription may need correction?

Patient D

A patient underwent a laparotomy and now reports severe abdominal pain and incisional drainage. What action by the patient does the nurse determine may have caused this complication?

Performing weightlifting exercises

A 32-year-old female patient is admitted to the emergency department with acute abdominal pain. In addition to a complete blood count, urinalysis, and abdominal x-ray, the nurse will expect to see a prescription for which diagnostic test?

Pregnancy test

A 68-year-old patient has been admitted with an abdominal mass and suspected bowel obstruction. Which factor in the patient's history places the patient at greatest risk for colorectal cancer?

Recurrent rectal polyps

A patient with abdominal trauma is admitted to the emergency department. Which nursing action should the nurse avoid to prevent complications?

Removing impaled objects

The nurse is performing an assessment on a patient with abdominal trauma. What assessment finding indicates to the nurse that there is irritation of the phrenic nerve by free blood in the abdomen?

Reports of pain over the scapula

The nurse assesses a patient with ecchymosis around the umbilicus and flanks. What does the nurse suspect that this indicates?

Retroperitoneal hemorrhage