ACUTE ABDOMEN
Description
Acute abdomen typically refers to a sudden and severe abdominal pain of unclear etiology that is less than 24 hours in duration. Sometimes it may also be referred to as “Peritonitis” due to the inflammation of the peritoneum (abdominal cavity). Abdominal pain can occur due to variety of medical and surgical causes. It is considered as a medical emergency and requires urgent diagnosis by eliciting a detailed clinical history and thereby performing abdominal examination to determine the cause of pain. Several causes may need surgical treatment. In very severe cases, it may be necessary to give treatment before proper history can be obtained or examination is allowed by the patient.
Causes
Abdominal causes
1. Inflammation of peritoneum due
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• Special analysis like serum lead estimations may be needed, if necessary.
2. Radiological investigations include
• Radiographs of abdomen, supine and chest.
• Ultrasound
• Computed tomography
• Special radiological investigations may be done as and when required.
3. Invasive procedures like endoscopy and laparoscopy are done only if indicated.
4. It may be necessary to rush the patient to operation room, if there is suggestion of intra-abdominal haemorrhage along with pain. Any delay for history, examination and investigations can cause more harm to the patient.
Treatment
Treatment of acute abdomen depends upon the cause of pain. The most common medication includes Inj. Diclofenac sodium 75 mg IM for pain relief. Any patient who does not respond to the pain relief, or if pain reappears, then he is referred to a surgeon for further evaluation.
Surgical
Any acute surgical causes of acute abdomen like perforation peritonitis, appendicitis, perforation of ulcer, etc. are treated surgically.
Management
1. Analgesics should not be administered for acute abdomen. This may delay treatment of surgical
Crohn 's is an immune-mediated inflammatory disease that belongs to a larger group of illnesses called inflammatory bowel disease (IBD). It is associated with inflammation of the digestive tract, or gastrointestinal (GI) tract, which runs from the mouth to the anus, and includes the stomach and intestines. It more commonly affects the end of the small intestine and the large intestine. Crohn 's disease symptoms and complications are unpredictable , you may experience almost no symptoms, then have a sudden flare-up. Or you could experience symptoms every day Crohn 's disease is difficult to diagnose, because symptoms vary and because it can be similar to other conditions.
If this means that the patient is in extreme pain and requests for PAS, then the physician should be able to let them do so as long as they are in the correct state of mind to make that decision. Philosophers argue that helping to kill a patient could never be the best option, however in many cases it may be a better option than letting them suffer for more months to come (Gill,
Crohn and his two co-workers, Oppenheimer and Ginzburg, presented a paper on “Terminal Ileitis”, and it was described in the features of Crohn’s disease to the JAMA. It was published later that year as a landmark article in the Journal of the American Medical Association aka “JAMA” and with the title “Regional Ileitis: A Pathologic and Chronic Entity.” The JAMA article was published at a time
Urgent care: Urgent care is a healthcare service that provides prompt treatment for non-life-threatening emergencies. Urgent care clinics offer walk-in appointments and extended hours for patients who require medical attention outside regular business
This is important to remember down the road because instead of waiting uncomfortably, you or your patient could remember the symptoms and suggest to your doctor that you think it might be inflammatory bowel disease. This would save time and discomfort. I was also informed during the discussion how hygiene can have an impact on Crohn’s disease because it will affect the immune system. A fact that I found interesting is that inflammatory bowel disease can be caused by hereditary through your genes, but also because of your smoking status. This is just another reason why people should not smoke.
According to the Mayo Clinic staff (2014), chronic inflammation can create ulcers in the digestive system, located anywhere from the mouth to the anus, and also the genital area. Inflammation to the lining of the stomach, can lead to scars that can spread throughout the bowel wall completely. Mayo Clinic Staff (2014) state that Crohn’s causes the intestinal wall to become thickened as time goes by, which prevents food from digesting properly due to blockage making it hard for stools to pass by. Mucosa is what protects the stomach, by having Crohn’s, excess mucous is being produced which can make an individual feel as if they are always needing to go to the bathroom.
Only to have them reply back with, “Where is it located? Does the pain rebound? I’m just going to press on your stomach in certain areas.” One ultrasound and some awkward questions from my doctor later, my new diagnosis was Mesenteric Lymphadenitis. Mesenteric Lymphadenitis is where lymph nodes in your stomach are inflamed.
People with the disease experience diarrhea, fever, fatigue, abdominal pain, cramping, internal bleeding, mouth sores, reduced appetite and weight loss. Many affected by Crohn’s disease possess a low-grade fever and low energy. Severe abdominal pain and cramping is caused by inflammation clogging the digestive tract. This same inflammation causes a loss of weight and decreased appetite, because of the lack of efficiency in breaking down and absorbing food. In children, a delay in growth or sexual development is possible.
People use many different kinds of biomedical interventions in the instance of stomach discomfort, mostly antacids but in some cases H-2 receptor antagonists, and pro-kinetics. There are a few different antacids out there including: Pepto-Bismol, Alka-Seltzer and Tums. The most common H-2 receptor antagonist is Pepcid and pro-kinetics is the least common route to relief. Pepto-Bismol is one of the more common interventions to defeating dyspepsia and is offered as a liquid, caplet and chewable tablet. It’s active ingredient is bismuth subsalicylate and does many things in order to relieve the stomach of pain.
Sepsis is a systematic inflammatory response by body to microbial infection that leads to organ damage, eventual death, or shock. The purpose of the study is to improve the early detection and treatment of Sepsis. Therefore, this capstone study will identify some aspects that will help people and staff for improving the early detection and treatment of sepsis. Practice Focused Question
Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.
1. Education to nursing staff who cared for Ms. Gadner on shock symptoms 2. Review with nurse Gilbert identification and treatment of infiltrated IV 3. Educate nursing staff who cared for Ms. Gadner on importance of documentation and updating of physicians of patient’s current condition. 4.
The assessment reveals that the patient does not have a life-threatening condition that may put his life in danger (Andersen, Fagerhaug & Beltz, 2009). Some of the medications that the patient had been using previously were also noted. It is important to note the drugs a patient may be using currently before carrying out the expansive medical procedure to minimize cases of negative drug-drug reactions. Root cause analysis eliminates inadequate patient assessment as the possible cause of complications during care delivery. This justifies the fact that whatever happened to the patient did not happen at
Effective perioperative management of medications requires an understanding of the patient and his or her co morbidities so that the risk of perioperative decompensation can be gauged. This understanding stems from a thorough medical history that includes a comprehensive medication history to provide a complete inventory of the all prescription medications, all over-the-counter agents and all herbal medications. Out of 288 cases collected, 88% were in the age group of 41-80 years. Hypertension and diabetes combination was found to be the comorbities in majority of cases. In most of the cases medication use during perioperative settings was as per available literature indicating appropriate medication reconciliation in the hospital settings.