patient care report for epigastric pain

How is epigastric pain diagnosed and treated?

Pain when you eat, or pain that is relieved when you eat or have a bowel movement How is epigastric pain diagnosed and treated? Your healthcare provider will feel your abdomen to see if it is tender or rigid. He may change or stop any medicine you are taking that is causing your pain.

What happens if you have pain in your epigastric region?

Failure to comply may result in legal action. Epigastric pain is felt in the middle of the upper abdomen, between the ribs and the bellybutton. The pain may be mild or severe. Pain may spread from or to another part of your body. Epigastric pain may be a sign of a serious health problem that needs to be treated.

What causes epigastric pain during pregnancy?

Pregnant women may experience epigastric pain due to increased abdominal pressure and hormonal changes that slow digestion. Epigastric pain can also arise from conditions that impair normal digestion, such as peptic ulcers, hiatal hernias, or gallstones. In these cases, it may occur frequently after meals, and it may become chronic.

Is it possible to evaluate acute abdominal pain in the ER?

Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes.

How do you assess a patient with abdominal pain?

The American College of Radiology has recommended different imaging studies for assessing abdominal pain based on pain location. Ultrasonography is recommended to assess right upper quadrant pain, and computed tomography is recommended for right and left lower quadrant pain.

How do you describe epigastric pain?

Epigastric pain is pain that is localized to the region of the upper abdomen immediately below the ribs. Often, those who experience this type of pain feel it during or right after eating or if they lie down too soon after eating.

What assessment findings might you find in a patient complaining of abdominal pain?

Abdominal assessment may reveal a mass in the right lower quadrant that is tender to palpation, or signs of peritoneal irritation such as rebound, involuntary guarding and abdominal wall muscle spasms. Any movement of the patient (e.g., bumping the stretcher) may elicit severe pain.

What questions should you ask a patient with abdominal pain?

Some other important questions to ask the patient include:Have you ever had this pain before? ... Are there associated symptoms, such as nausea and vomiting and/ or diarrhea?Have you noticed any black stools or blood in your stool? ... Have you noticed blood in your urine?Do you feel as though you have had a fever?More items...

What is the most common cause of epigastric pain?

Gastritis is a common cause of epigastric pain. It is often worse after eating and will generally improve with proton pump inhibitors. Test for the presence of Helicobacter pylori. Peptic ulcer tends to cause acute or chronic gnawing or burning pain.

What are the common causes of epigastric pain?

Epigastric pain risk factors include a history of peptic ulcer disease, consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, heavy alcohol consumption, and overeating.

What should be included in an abdominal assessment?

Assessing your patient's abdomen can provide critical information about his internal organs. Always follow this sequence: inspection, auscultation, percussion, and palpation. Changing the order of these assessment techniques could alter the frequency of bowel sounds and make your findings less accurate.

What is the nursing diagnosis for abdominal pain?

Abdominal Pain Nursing Care Plan 1 Nursing Diagnosis: Acute Abdominal Pain related to stomach spasms, secondary to irritable bowel syndrome (IBS), as evidenced by abdominal pain, high pain score rating, verbalization of pain or discomfort in the abdominal region, abdominal guarding, and cramping.

What should a nurse do when a patient has abdominal pain?

The following tips for managing patients with abdominal pain could be helpful:Do serial assessments. ... Get a rectal temperature. ... At triage, consider MIs. ... Check respiratory rates and blood pressure. ... Consider orthostatics. ... Expedite urinalysis. ... Be proactive to ensure fast test results.More items...•

What information would you want to obtain when taking history on a client with abdominal pain?

Let's discuss the questions to ask your patient when taking a detailed history. These questions should focus on aspects that are most pertinent to abdominal pain or symptoms....How to obtain a detailed patient history for abdominal painPast medical history.Past surgical history.Family history.Social history.

When examining a patient with abdominal pain the nurse in charge should assess?

If the patient is experiencing abdominal pain, the nurse should ascertain its location, duration, intensity, factors that make it worse, and factors that make it better.

What Do I Need to Know About Epigastric Pain?

Epigastric pain is felt in the middle of the upper abdomen, between the ribs and the bellybutton. The pain may be mild or severe. Pain may spread f...

What Causes Epigastric Pain?

The cause of your pain may not be known. The following are common causes: 1. Inflammation of your stomach, liver, pancreas, or intestines 2. Heart...

What Other Signs and Symptoms May I Have With Epigastric Pain?

Signs and symptoms will depend on what is causing your pain. 1. Nausea, vomiting, bloating, constipation, or diarrhea 2. Loss of appetite, weight l...

How Is Epigastric Pain Diagnosed and Treated?

Your healthcare provider will feel your abdomen to see if it is tender or rigid. He may change or stop any medicine you are taking that is causing...

How Can I Manage My Symptoms?

1. Keep a record of your symptoms. Include when the pain starts, how long it lasts, and if it is sharp or dull. Also include any foods you ate or a...

Call 911 For Any of The Following

1. You have any of the following signs of a heart attack: 1. Squeezing, pressure, or pain in your chest 2. and any of the following: 1. Discomfort...

When Should I Seek Immediate Care?

1. You have severe pain that starts suddenly and quickly gets worse. 2. You cannot have a bowel movement and are vomiting. 3. You vomit or cough up...

When Should I Contact My Healthcare Provider?

1. You have a fever or chills. 2. You have yellowing of your skin or the whites of your eyes. 3. You vomit often or several times in a row. 4. You...

Is epigastric pain a differential diagnosis?

Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This ….

Is epigastric pain a common complaint?

Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This …. Epigastric pain is an extremely common ...

Is epigastric pain a diagnosis?

Epigastric pain is an extremely common complaint in the emergency department and has an associated broad differential diagnosis. In the differential it is important to consider cardiac causes that may be mistaken for gastrointestinal disorders as well as various serious intra-abdominal causes. This article highlights the limitations in laboratory testing and guides providers through the appropriate considerations for advanced imaging. Special attention is focused on acute pancreatitis, esophageal emergencies, and peptic ulcer disease/gastritis and their associated complications.

What does it mean when you have epigastric pain?

Pain may spread from or to another part of your body. Epigastric pain may be a sign of a serious health problem that needs to be treated.

What causes pain in the stomach?

Certain foods may cause your pain, such as alcohol or foods that are high in fat. You may need to eat smaller meals and to eat more often than usual. Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Do not have drinks that contain alcohol or caffeine.

How to keep track of pain?

Also include any foods you ate or activities you did before the pain started. Keep track of anything that helped the pain. Eat a variety of healthy foods.

What are the symptoms of a swollen stomach?

Signs and symptoms will depend on what is causing your pain. Nausea, vomiting, bloating, constipation, or diarrhea. Loss of appetite, weight loss, feeling of fullness as you start to eat. Movement relieves the pain or makes it worse, or only certain positions are comfortable.

What does it mean when you have epigastric pain?

Pain may spread from or to another part of your body. Epigastric pain may be a sign of a serious health problem that needs to be treated.

What causes pain in the stomach?

Certain foods may cause your pain, such as alcohol or foods that are high in fat. You may need to eat smaller meals and to eat more often than usual. Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you. Do not have drinks that contain alcohol or caffeine.

How to keep track of pain?

Include when the pain starts, how long it lasts, and if it is sharp or dull. Also include any foods you ate or activities you did before the pain started. Keep track of anything that helped the pain.

Does Gina have allergies to medications?

She states that she tried to walk it off but could not continue walking due to the pain. Gina states that she tried to walk it off but could not continue walking due to the pain. (Photo/WomensHealth.gov) Gina has no medical history and takes birth control regularly. She states that she has no allergies to medications.

Does Gina have a medical history?

Gina has no medical history and takes birth control regularly. She states that she has no allergies to medications. When asked about the possibility of pregnancy, Gina states that she just finished her period. Gina denies any recent trauma or illness. She also reports normal urination and bowel movements.

How long does gallbladder pain last?

Although labeled “colic,” gallbladder pain is generally not paroxysmal, and it almost never lasts less than 1 hour, with an average of 5–16 hours’ duration, and ranging up to 24 hours.13Small bowel obstruction typically progresses from an intermittent (“colicky”) pain to more constant pain when distention occurs.

What organs cause pain in the suprapubic region?

Hindgut structures such as the bladder, and distal two-thirds of the colon, as well as pelvic genitourinary organs usually cause pain in the suprapubic region. Pain is usually reported in the back for retroperitoneal structures such as the aorta and kidneys.5,6. Character .

How to determine if you have peritonitis?

Determining the presence or absence of peritonitis is a primary objective of the abdominal examination; unfortunately, the methods for detecting it are often inaccurate. Traditional rebound testing is performed by gentle depression of the abdominal wall for approximately 15–30 seconds with sudden release. The patient is asked whether the pain was greater with downward pressure or with release. Despite limitations, the test was one of the most useful in a meta-analysis of articles investigating the diagnosis of appendicitis in children.29Cope’s Early Diagnosis of the Acute Abdomenrecommends against this test because it is unnecessarily painful. The authors suggest gentle percussion as more accurate and humane.28When subject to study, traditional rebound testing has a sensitivity for the presence of peritonitis near 80%, yet its specificity is only 40%–50% and it is entirely nondiscriminatory in the identification of cholecystitis.27,33,34The use of indirect tests such as the “cough test,” where one looks for signs of pain such as flinching, grimacing, or moving the hands to the abdomen upon coughing has a similar sensitivity but with a specificity of 79%.35In children, indirect tests would include the “heel drop jarring” test (child rises on toes and drops weight on heels) or asking the child to jump up and down while looking for signs of abdominal pain.29,36

What is abdominal ED?

The ED abdominal exam is directed primarily to the localization of tenderness, the identification of peritonitis, and the detection of certain enlargements such as the abdominal aorta. Various strategies have been advocated to improve the palpation phase of the examination, including progression from nonpainful areas to the location of pain. It may be useful to palpate the abdomen of anxious or less cooperative children with the stethoscope to define areas of tenderness.29Meyerowitz30advocates following up the initial examination with a secondary palpation with a stethoscope while telling the patient one is listening in order to uncover exaggerated symptoms. It is preferable to have the patient flex the knees and hips to allow for relaxation of the abdominal musculature (see below discussion of guarding).

What is acute onset pain?

Acute-onset pain, especially if severe, should prompt immediate concern about a potential intra-abdominal catastrophe. The foremost consideration would be a vascular emergency such as a ruptured abdominal aortic aneurysm (AAA) or aortic dissection. Other considerations for pain of acute onset include a perforated ulcer, volvulus, mesenteric ischemia, and torsion; however, these conditions may also occur without an acute onset. For example, only 47% of elderly patients with a proven perforated ulcer report the acute onset of pain.8Likewise, volvulus, particularly of the sigmoid colon, can present with a gradual onset of pain.9Serious vascular issues such as mesenteric ischemia may present with a gradual onset of pain. Conversely, one would expect a gradual onset in the setting of an infectious or inflammatory process. Pain that awakens the patient from sleep should be considered serious until proven otherwise.10The time of onset establishes the duration of the pain and allows the physician to interpret the current findings in relation to the expected temporal progression of the various causes of abdominal pain.

What is somatic pain?

Somatic pain is transmitted via the spinal nerves from the parietal peritoneum or mesodermal structures of the abdominal wall. Noxious stimuli to the parietal peritoneum may be inflammatory or chemical in nature (eg, blood, infected peritoneal fluid, and gastric contents).5,7

Where does somatic pain come from?

Somatic pain is transmitted via the spinal nerves from the parietal peritoneum or mesodermal structures of the abdominal wall. Noxious stimuli to the parietal peritoneum may be inflammatory or chemical in nature (eg, blood, infected peritoneal fluid, and gastric contents).5,7. Onset .