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Ch. 47

Common causes of abdominal pain

causesigns and symptomsemergency management
bowel obstruction nausea and vomiting, abdominal pain, abdominal distention, inability to pass gas or stool keep pt on NPO status and assist with care as directed, the pt will require hospitalization for further care and possible surgery
cholecystitis colicky epigastric pain that radiates into the RUQ, right shoulder and back; nausea and vomiting, fever, jaundice, tachycardia, light stool and dark urine, pruritus not an emergency although pain maybe severe, test rule out cardiac causes, pt maybe hospitalized for cholecystectomy or lithotripsy
crohn disease chronic diarrhea, fever, weight loss, anorexia, fatigue, abdominal pain, cramping that may be localized to the RLQ not usually an emergency but surgery maybe necessary in cases of perforation or to remove the involved portion of the colon; administer fluids, anticholinergics, and opioids to control pain and reduce bowel motility; antimicrobials for infection
diverticulitis fever, nausea, blood streaked stool, LLQ pain not usually an emergency but surgery may be necessary in cases of bowel perforation; administer antibiotics to treat infection and analgesics for pain
gastroenteritis varies with cause, watery diarrhea, abdominal cramps, anorexia, nausea and vomiting, headache, fever, weakness rarely an emergency, administer fluids and electrolyte replacement, antiemetics, and antibiotics per order
peptic ulcer disease indigestion, heartburn, epigastric pain, uncomfortable fullness, nausea and vomiting, peak of symptom 2 hours after eating not usually an emergency, tests may rule out cardiac causes, treatment includes GI evaluation, anti-ulcer medications, and possibly antibiotics
ulcerative colitis episodic flare-ups with as many as 10-20 episodes of bloody muciod diarrhea per day, pain, cramps, urgency to defecate, weight loss, fever, malaise not usually an emergency but surgery may be necessary in some cases of severe hemorrhage or perforation, give anticholinergic and antidiarrheal medications per order to reduce bowel motility, corticosteroids to reduce inflammation and analgesics for pain
appendicitis classic symptoms of nausea, vomiting, and severe periumbilical pain that eventually localizes to the RLQ, RLQ rebound tenderness to palpation possible, fever, diarrhea or xonstipation keep pt on NPO status, help arrange for appendectomy if directed, administer antibiotics to prevent or resolve infection if ordered
Created by: rewebb
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