nursing diagnosis for abdominal abscess nursing diagnosis for abdominal abscess

Additionally, excessive consumption of dietary fiber promotes stomach distention and gas. Kumar RR, Kim JT, Haukoos JS, et al. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Thank you for the advice! In patients with suspected appendicitis who have equivocal imaging findings, antimicrobial therapy should be initiated in combination with pain medication and antipyretics, if indicated. What is his fluid status? An abscess in the lower abdomen may track down into the thigh or perirectal fossa. medical diagnoses, when accurate, can be supporting documentation for a nursing diagnosis, for example, "activity intolerance related to (because the patient has) congestive heart failure/duchenne's muscular dystrophy/chronic pulmonary insufficiency/amputation with leg prosthesis." Plus clindamycin (Cleocin) or metronidazole. Enzymes and nutritional supplements may also be needed to break down complex carbs in the event of recurrent abdominal distention. Signs of clearance typically include a decrease in abdominal distention, the passage of flatus or stool, and a decrease in NG tube output. Risk for Infection. Its clinical features include AD or tenderness. PID may be sexually transmitted read more , or indeed any condition causing generalized peritonitis Peritonitis Abdominal pain is common and often inconsequential. When I am trying to find a diagnosis, i look at the presenting signs and symptoms because that will be your evidence. Move the patient slowly and deliberately and instruct him/her to splint the abdomen. Large abscesses may be palpable as a mass. An urgent approach also should be taken in hemodynamically stable patients without evidence of acute organ failure. If you have symptoms of an intra-abdominal abscess, your healthcare provider may order tests to look for the presence of infection: Antibiotics may help treat an infection that could lead to an intra-abdominal abscess. Antimicrobial therapy should be started as soon as intra-abdominal infection is diagnosed or suspected. yes, experienced nurses will use a patient's medical diagnosis to give them ideas about what to expect and assess for, but that's part of the nursing assessment, not a consequence of a medical assessment. Acute and severe abdominal pain, however, is almost always a symptom of intra-abdominal disease. If the patient has any of the following: chest pain, exhaustion, decreased pulse rate, systemic blood pressure, increased respiratory response (RR), or pulses that take more than 3-4 minutes to rebound to within 6-7 beats of the resting pulse, the activity should be discontinued or modified. The low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is by far the most significant treatment for abdominal distention. By providing gentle pressure or rocking the newborn, it is possible to alleviate gas and constipation. Stomach (e.g., pyloric stenosis, peptic ulcer), Bowel (e.g., Crohns disease, colorectal carcinoma), Urinary abnormalities (e.g., acute pyelonephritis, acute renal infarction). Diagnosis is by CT. Why is he still in the hospital? Determine etiology (e.g., acute or chronic wound, burn, dermatological lesion, pressure ulcer, leg ulcer ). Exocrine pancreatic insufficiency may also lead to AD due to excessive gas production. Local heat and elevation may hasten resolution of inflammation. Each medical diagnosis has a defined list of symptoms that the patient's illness must match. Intra-abdominal abscess (IAA), also known as intraperitoneal abscess, is an intra-abdominal collection of pus or infected material and is usually due to a localized infection inside the peritoneal cavity. Antibiotics that modify the microbiome and lower gas-producing bacteria may also aid in reducing excessive fermentation and abdominal distention. Changes in characteristics of pain may indicate developing abscess or peritonitis, requiring prompt medical evaluation and intervention. This can provide many cues regarding the patients diagnosis, such as yellowish skin pigmentation or jaundice indicating a possible liver disorder. Drug therapy. Recent intra-abdominal surgery also may pose a diagnostic problem in patients in whom intra-abdominal abscesses are suspected. Packing the cavity loosely with a gauze wick reduces the dead space and prevents formation of a seroma. Those who do not have septic shock should begin antimicrobial therapy in the emergency department. Images may be needed to look for an abscess. Symptoms are malaise, fever, and abdominal pain. An intra-abdominal abscess often will need to be drained of fluid in order to heal. I also want to say there is a difference between Risk for Impaired Skin Integrity and Impaired Tissue Integrity. Please confirm that you are a health care professional. Administer anti-emetic medications as indicated. Benign cutaneous cysts are read more (often incorrectly referred to as sebaceous cysts) rarely become infected; however, rupture releases keratin into the dermis, causing an exuberant inflammatory reaction sometimes clinically resembling infection. Due to their high levels of indigestible carbohydrates and fiber, these vegetables promote gas production. Abscesses may form within 1 week of perforation or significant peritonitis, whereas postoperative abscesses may not occur until 2 to 3 weeks after operation and, rarely, not for several months. Why are they still there? Enter search terms to find related medical topics, multimedia and more. Discuss the need and relevance of preserving nasogastric tube patency postoperatively. All rights reserved. While you are being treated for an intra-abdominal abscess, you may need nutritional support such as a feeding tube. Promote physical exercise within the patients energy levels, and modify activities as needed. LMN has been a member of the speakers' bureau and consultant for Merck, Pfizer, Schering-Plough, Ortho-McNeil, Wyeth, and Astellas Pharma. It can involve any intra-abdominal organ or can be located freely within the abdominal or pelvic cavities, including in between bowel loops. Specific symptoms of abdominal abscesses depend on the location of the abscess, but most people have constant discomfort or pain, feel generally sick (malaise), and often have a fever. Diagnosis is by read more ), Anaerobes (especially Bacteroides fragilis Mixed Anaerobic Infections Anaerobes can infect normal hosts and hosts with compromised resistance or damaged tissues. Rapid restoration of intravascular volume should be undertaken, as should any additional measures necessary to promote physiologic stability. Many intra-abdominal abscesses develop after perforation of a hollow viscus or colonic cancer. Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage. Broccoli, beans, and cabbage are just a few of the vegetables that might cause a bloated stomach. Anxiety-relieving techniques such as deep breathing and relaxing music work effectively. In adults with mild-to-moderate community-acquired infection, the use of ticarcillin/clavulanate (Timentin), cefoxitin, ertapenem (Invanz), moxifloxacin (Avelox), or tigecycline (Tygacil) as a single-agent therapy, or a combination of metronidazole (Flagyl) with cefazolin, cefuroxime, ceftriaxone (Rocephin), cefotaxime (Claforan), levofloxacin (Levaquin), or ciprofloxacin (Cipro) is preferable to regimens with substantial antipseudomonal activity (Table 1). He had a biopsy which revealed that the thought abscesses where actually cancerous tumors in his abdomen. Shifting the patient from prolonged bedrest will avoid muscle deconditioning, assist the patient in relaxing while at rest, and promote appropriate stress management. The patient will usually present with sudden onset of abdominal pain with associated nausea or vomiting. The placement of nasogastric (NG) tubes assists in decompressing the stomach, hence alleviating symptoms. O'Malley GF, Dominici P, Giraldo P, et al: Routine packing of simple cutaneous abscesses is painful and probably unnecessary. Create well-written care plans that meets your patient's health goals. Developing an effective care plan begins with identifying the cause of nausea. Abdominal abscesses can be caused by a bacterial infection. Instills a sense of self-determination and minimizes the patients energy expenditure. Nurses do that too, it's part of step #1 of the nursing process. Abdominal X-ray. Here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan: A care plan is nothing more than the written documentation of the nursing process you use to solve one or more of a patient's nursing problems. Abdominal abscess: An abdominal abscess is a buildup of pus inside your belly (abdomen). o [teenager OR adolescent ], , MD, Hofstra Northwell-Lenox Hill Hospital, New York, (See also Acute Abdominal Pain Acute Abdominal Pain Abdominal pain is common and often inconsequential. Other techniques, such as ultrasound or magnetic resonance imaging or MRI, may be used as well. Occasionally, abscesses cannot be safely drained this way. Grounds for infection include irritated skin, burning pain, a rash surrounding the catheter, and a pungent odor. Abdominal surgery, particularly that involving the digestive or biliary tract, is another significant risk factor: The peritoneum may be contaminated during or after surgery from such events as anastomotic leaks. To decrease metabolic rate and intestinal irritation, hence promoting pain alleviation and healing. The nursing process itself isa problem solving method that was extrapolated from the scientific methods used by the various science disciplines in proving or disproving theories. Specializes in Med nurse in med-surg., float, HH, and PDN. Fluid Resuscitation Rapid. Other tests may include: abdominal x-ray ultrasound of the abdomen Treatment Symptoms and signs are pain and a tender and firm or fluctuant swelling. Antibiotics used for empiric treatment of community-acquired intra-abdominal infection should be active against enteric gram-negative aerobic and facultative bacilli and enteric gram-positive streptococci. Progressively increasing the intensity of the activity prevents overexertion and raises the patients tolerance for the exercise. 1. In addition, 0.5 mL of fluid should be sent to the laboratory for Gram stain testing and, if indicated, fungal cultures. Evaluate the patients fluid intake and take note of his/her hydration status by assessing the following: blood pressure, daily weight, skin turgor, and mucous membranes. Assessment is required to recognize possible problems that may have lead to Impaired Tissue Integrity and identify any episode that may transpire during nursing care. Is there a nursing diagnosis for metastatic cancer? Outcome depends mainly on the patients primary illness or injury and general medical condition rather than on the specific nature and location of the abscess. They vary in size, typically 1 to 3 cm in length, but are sometimes much larger. In order to decompress the abdomen, nasogastric tubes (NG) are placed. Just invest tiny time to get into this on-line notice Lung Abscess Nursing Care Plan as competently as evaluation them wherever you are now. Nursing Diagnosis: Impaired Comfort related to abdominal distention secondary to ascites, as evidenced by crying, guarding of the abdominal area, shallow breathing, frequent grimacing, anxiety, irritability, and restlessness. recent history of surgery, trauma, or intra-abdominal infection, change in bowel habits/abnormal bowel function, recent surgery or trauma, appendicitis, diverticulitis, or perforated ulcer, serum erythrocyte sedimentation rate (ESR). Drainage through catheters (placed with CT or ultrasound guidance) may be appropriate given the following conditions: The drainage route does not traverse bowel or uncontaminated organs, pleura, or peritoneum. Dullness to percussion and decreased breath sounds are typical when basilar atelectasis, pneumonia, or pleural effusion occurs. This content is owned by the AAFP. Antibiotics are ancillary. Nursing diagnosis for acute abdominal pain. Abdominal distention is a condition in which the abdomen swells due to the buildup of gas or fluid, resulting in outward expansion and increased abdominal girth. Used to detect the presence of malignancies, inflammation, blockages, polyps, and diverticula and to evaluate functional abnormalities in the large intestine. Necrotizing enterocolitis in newborns is managed with fluid resuscitation, intravenous broad-spectrum antibiotics (possibly including antifungal agents), and bowel decompression. Initiate patient care by describing procedures and routines related to comfort promotion and anxiety prevention. Evaluate the patients physiological response to physical activity. you will likely have observed something like, "chest pain during physical activity/inability to walk >25 feet due to fatigue/inability to complete am care without frequent rest periods/shortness of breath at rest with desaturation to spo2 85% with turning in bed.". Risk factors for cutaneous abscesses include the following: Antecedent trauma (particularly when a foreign body is present). Complete blood count. Intra-abdominal abscess continues to be an important and serious problem in surgical practice. The trusted provider of medical information since 1899, Last review/revision Feb 2021 | Modified Sep 2022. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. Acad Emerg Med 16(5):470-473, 2009. doi: 10.1111/j.1553-2712.2009.00409.x, 3. Traumatic abdominal injuriesparticularly lacerations and hematomas of the liver, pancreas, spleen, and intestinesmay develop abscesses, whether treated operatively or not. Knowing what to expect might alleviate the patients anxiety and make them feel more at ease. N Engl J Med 374(9):823-832, 2016. doi: 10.1056/NEJMoa1507476. CT is not recommended for use in diagnosing such abscesses until approximately postoperative day 7, by which time postoperative tissue edema is reduced and nonsuppurative fluids (eg, hematoma, seroma, intraoperative irrigation fluid) should be reabsorbed. Parenteral nutrition should begin early if the enteral route is not feasible. By using our website, you consent to our use of cookies. The type of antibiotic will depend on how severe your abscess is, your age, and any other conditions you may have. Complimenting the patients accomplishments provides them a sense of success and boosts their confidence. Irrigation with normal saline is optional. It is caused by homozygous inheritance of genes for hemoglobin read more and malaria Malaria Malaria is infection with Plasmodium species. If left untreated, the bacteria will multiply and cause inflammation and kill healthy tissue. Perineal abscesses may represent cutaneous emergence of a deeper perirectal abscess or drainage resulting from Crohn disease Crohn Disease Crohn disease is a chronic transmural inflammatory bowel disease that usually affects the distal ileum and colon but may occur in any part of the gastrointestinal tract. Causes, symptoms, treatment, preventive measures, and read more . Abscesses in the Douglas cul-de-sac, adjacent to the rectosigmoid junction, may cause diarrhea. All Rights Reserved. Subdiaphragmatic abscesses may extend into the thoracic cavity, causing an empyema, lung abscess Lung Abscess Lung abscess is a necrotizing lung infection characterized by a pus-filled cavitary lesion. The wick is typically removed 24 to 48 hours later. Appropriate treatment is often delayed because of the obscure nature of many conditions resulting in abscess formation, which can make diagnosis and localization difficult. Dis Colon Rectum. The use of agents effective against methicillin-resistant S. aureus (MRSA) or yeast is not recommended unless there is evidence of infection with these organisms. Specific symptoms of abdominal abscesses depend on the location of the abscess, but most people have constant discomfort or pain, feel generally sick (malaise), and often have a fever. but i can't put them in any individual's plan for nursing care until *i* assess for the symptoms that indicate them, the defining characteristics of each. Commonly presents with abdominal pain, fever, and leukocytosis. Treatment of intra-abdominal infections has evolved in recent years because of advances in supportive care, diagnostic imaging, minimally invasive intervention, and antimicrobial therapy. Epidermal cysts Cutaneous Cysts Epidermal inclusion cysts are the most common cutaneous cysts. Lrg incisional hernia. Anaerobic cultures are not necessary in these patients if empiric antimicrobial therapy is provided. they are all things that nursing treats independently of medicine, via the nursing plan of care, regardless of whether a medical plan of care includes measures to ameliorate the physiological cause of some of them. Although manifestations vary, most abscesses cause fever and abdominal discomfort ranging from minimal to severe (usually near the abscess).