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Abdominal Assessment for the Correctional Nurse: Lower Abdominal Pain

Abdominal pain is perhaps one of the most frequent complaints listed on a sick call/request to be seen slip in the correctional environment.  Changes to routine and diet, stress, and the “unmasking” of symptoms as patients become “detoxed” from substances like alcohol and drugs may contribute to complaints of abdominal problems. It can be the result of an organic issue or identified as physiologic; it can be chronic or acute. While most abdominal pain is self limiting, there are circumstances when abdominal pain signifies a life threatening condition.   Thus,  it is important that the correctional nurse understand the pathophysiology of the abdomen, and how to conduct a proper assessment of the abdominal areas.  As with all presenting complaints, it is vital that a succinct, yet thorough history be obtained from the patient to include any health problems they were experiencing in the past or prior to their incarceration.  The myriad of conditions that may present with lower abdominal pain include appendicitis, hernia, diverticulitis, nephrolithiasis, and ectopic pregnancy.  While it is not the intention of this class to educate correctional nurses to diagnose the condition of their patient with abdominal pain, it is important that the correctional nurse has a basic understanding of the pathophysiology so that they can identify abnormal symptoms. and determine when a provider needs to be notified.

In this class, the proper way to conduct an abdominal assessment will be reviewed, including appropriate questions to ask of any patient complaining of abdominal pain, how to inspect, auscultate, percuss and palpate the abdomen appropriately, and common signs and symptoms that should prompt a call to a provider.  Red Flags will also be discussed.