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Assessment of the patient with acute abdominal pain

Critical Review Introduction The article being critiqued here is en d “ Assessment of the patient with acute abdominal pain”, published in the journal Nursing Standard. It appeared in Volume 20, Issue 39, which was published June 7, 2006, and authored by Elaine Cole, Antonia Lynch, and Helen Cugnoni. The focus of this article was the treatment of patients who present with abdominal pain and the role of the nurse in meeting the needs of those patients with regards to taking histories, assessing potential causes of their pain, and pain management. Article Summary According to this article, abdominal pain is probably the most common reason for seeking medical treatment, and is experienced by people of all ages and backgrounds. Assessment by the use of a thorough history can determine the cause of up to seventy percent of all abdominal pain cases. The history plan laid out by the authors questions involving the pain itself, what symptoms are co-morbid with the pain, past medical treatment, current medications and medical conditions, and a family and social history. Article Evaluation The guide for the history laid out in this article is very detailed. It even gives notes on how to frame the questions in order to gain the most useful results from the patient, as well as listing nearly a dozen co-morbid disorders that can lead to abdominal pain during serious complications. It also provides an explanation of many of the therapies that are often used to treat and diagnosis abdominal pain. However, most of the diagnostic tools mentioned and all of the treatment methods would require a physician and are outside the scope of traditional nursing care. Despite this, there are no reasons why this assesssment should not be used. While such thorough questioning may be time-consuming, a complex and possibly very serious symptom like abdominal pain does require this level of attention, at least until a reason for the pain can be determined that is not a serious risk to the life or health of the patient. The article reads very dryly, and lacks the ability to hold the reader’s attention. It assumes a very low level of background knowledge, seeming to forget that the audience for the article is nurses in continuing education; that is, people who have already attained a nursing degree. This article even goes so far as to name the abdominal organs! While this article is useful, other similar articles seem unneccessary, as such basic information seems redundant in continuing education. Taking histories, anatomy, and the basics of pain management should be covered in the initial training portion of a nursing degree and not during the continuing education. If this article is necessary to someone who has been a practicing nurse for several years, it would be only as a refresher. Conclusion Abdominal pain is a symptom of many potentially very serious conditions and should be treated accordingly. Patients presenting with this symptom should have a thorough history taken, including the nature of the pain, any other medical conditions they may have, and a family history of possibly related conditions. The article critiqued herein gives a very detailed, if sometimes overly basic, guide to taking such a history, to be used for continuing education purposes. Reference Cole, E., Lynch, A., & Cugnoni, H. (2006). Assessment of the patient with acute abdominal pain. Nursing Standard (Royal College of Nursing (Great Britain): 1987), 20(39), 67-75.

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