Abdominal Pain Nursing Diagnosis and Nursing Care Plans

Abdominal Pain Nursing Care Plans Diagnosis and Interventions

Abdominal Pain NCLEX Review and Nursing Care Plans

The term “abdominal pain” refers to any discomfort or pain felt in the abdomen. A wide range of factors might contribute to abdominal pain.

The most common causes include bloating, heartburn, or a strained muscle these common complaints are often not a cause for concern.

There are two types of abdominal pain: acute and chronic. In most cases, acute abdominal pain can be alleviated within a span of a few hours to a few days and is occasionally self-limiting.

On the other hand, chronic abdominal pain can linger for months or even years and progressively worsens as time progresses. As a result, the latter sort of abdominal pain may require the need for rapid evaluation and intervention.

Signs and Symptoms of Abdominal Pain

  • Cramping – This sort of pain fluctuates in intensity and location in the abdomen. If the patient is experiencing cramping, it’s likely that he/she may likely be suffering from stomach gas, bowel movements (defecation), or menstruation.
  • Pain that is not specific to one area – when more than half of the abdomen region is painful, it is likely that indigestion, gas, or stomach infections are the source of pain or discomfort.
  • Pain that is localized to one area – This refers to abdominal pain that is concentrated or localized in a specific location of the abdomen. Restricted abdominal pain can be caused by any number of organ-related illnesses (e.g., appendix, gallbladder, stomach). In addition, these organ-related issues are considered to be the source of pain.
  • Colicky pain (affects the digestive or urinary tracts) – similar to cramping, this sort of pain may disappear and reappear. However, its defining characteristic is that the pain is usually intense and occurs abruptly. And gallstones or kidney stones may be linked to this type of pain.

Types of Abdominal Pain

  • Acute pain – manifests itself over a period of hours or days and may be accompanied by other symptoms.
  • Chronic pain – manifests itself for a longer period of time, typically reaching years. This type can subside and may reappear after a while.

Causes of Abdominal Pain

There are many possible causes of abdominal pain, from dull aching to excruciating cramping. A few common causes are constipation, menstruation for women, and indigestion.

Among the other potential causes are:

The presence of ulcers, lactose intolerance, and pelvic inflammatory disease are some causes of abdominal pain that one should be aware of. Other cause includes:

  • Diverticulitis – a condition known to cause inflammation or infection to the diverticula
  • Gallstones – characterized by increasing pain in the upper right abdomen
  • Hernia – This condition occurs when an internal organ pushes through the muscle or tissue wall that normally encloses it. Hernias in the abdominal cavity are the most common.
  • Appendicitis – occurs when the appendix becomes inflamed. Pain is usually experienced in the lower abdominal region.
  • Kidney stones – The presence of kidney stones usually poses a painful sensation in the lower abdomen.
  • Endometriosis – is an incapacitating and chronic illness affecting approximately 10% of women worldwide. Primary endometriosis symptoms include menstrual cramps and pelvic pain, and these are usually grounds for abdominal pain to be experienced.
  • Abdominal aortic aneurysm – can occur anywhere along the aorta; however, they are most common in the abdominal area (abdomen). The most common complications known are aortic tears or aortic dissection and ruptured aneurysm.
  • Malignancies
  • Cysts or malignancy of the ovaries
  • Pancreatitis – pancreatic inflammation
  • Cholecystitis – swelling and inflammation of the gallbladder
  • Irritable bowel syndrome

Risk Factors for Abdominal Pain

These are associated with abdominal pain but not directly responsible for its manifestation.

  • History of gastrointestinal issues
  • Elderly
  • History of abdominal operation
  • Virus infection
  • Immunocompromised patients (e.g., diabetics, AIDS patients, organ transplant recipients, patients with sickle cell anemia)

Diagnosis of Abdominal Pain

Abdominal pain can be diagnosed using physical evaluation of the patient’s symptoms, medical history, physical examination, if necessary, further tests to confirm a diagnosis.

Inquiries from the attending physician may focus on the following characteristics of the patient’s abdominal pain:

  • Level of pain
  • Location – Is the pain all over or just in one spot?
  • Longevity – Exactly how long was the experienced pain?
  • Activities that seem to worsen or improve it – Is there a certain activity or position that exacerbates the pain?
  • Whether it’s fleeting or reemerging – How often does the pain come and go, and how long does each episode last?)
  • When is it most felt or noticed – In what circumstances does it cause pain? Is it always? Is it more common in the early morning or late at night?
  • For women, menstruation or pregnancy
  • Injury – If injured, how long ago was it?

Besides examination and a series of questions, the physician may require more tests to identify the source of pain. There are a variety of tests that can be used to identify the source of abdominal pain, and these include:

  • Urinalysis
  • Fecalysis
  • Blood tests
  • Imaging test (e.g., X-ray, Ultrasound)
  • Computed tomography (CT scan)
  • Endoscopy
  • Procedures such as sigmoidoscopy and colonoscopy

Treatment for Abdominal Pain

It is important to determine the underlying reason for abdominal pain before deciding on a treatment plan. However, the optimal course of treatment may include managing its most common cause by utilizing self-care techniques or, if necessary, medical interventions such as the use of medications or even surgery.

Treatment options for abdominal pain include:

  • Medications for treating gastroesophageal reflux disease (GERD)
  • Targeted therapies for IBD
  • Anti-inflammatory medications
  • Antibiotics for infection treatment

Severe abdominal pain due to a variety of conditions may necessitate surgery. Some of these surgical procedures are:

  • Numbing agent injection or Anesthetics
  • Appendectomy
  • Cortisone shots
  • Hernia repair surgery

Home Remedies for Abdominal Pain

Self-care techniques and lifestyle changes may relieve mild abdominal pain due to digestive upset (indigestion) or stomach gas:

  • Eat slowly and thoroughly before swallowing
  • Avoid eating foods that can cause bloating or indigestion
  • Reduce the amount of alcohol and caffeine consumption
  • Take a quick walk after eating
  • Consume smaller portions of meals (if frequent)
  • Effectively manage stress
  • Immediately sit upright following a meal
  • Maintain a regular physical exercise schedule/regimen
  • ●       Meditation

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.

Desired Outcome: The patient will be able to express relief from discomfort or control of their condition.

Abdominal Pain Nursing InterventionsRationale
Encourage the patient to disclose any discomfort or pain he/she may be experiencing.Instead of asking for painkillers or analgesics, the patient may strive to tolerate his/her discomfort. Encouraging the patient to report their pain could aid in the provision of treatment.
Evaluate the period, location, and magnitude of pain. Ask the patient to rate his/her level of pain on a scale of 0 to 10.To delegate adequate resources for intervention.
Adhere to changes in the patient’s dietary plan in accordance with the guidelines provided. Begin with liquids and progress to solid foods as tolerated by the patient.It allows constipation to subside and promotes bowel rest following abstinence from solid food. Additionally, IBS alleviation and management appear to benefit from diet modifications. Meals that are rich in fiber soften and facilitate the passage of stool.
Assist the patient in managing his/her pain by providing comfort therapy such as:
-Distraction techniques (e.g., deep breathing exercises, guided imagery)
-Hot and cold application
-Music therapy
-Positioning
-Back massage/back rubs        
Non-pharmacologic interventions, particularly comfort measures, promote a sense of well-being. It also helps to redirect the patient’s thoughts and improves his/her ability to cope with stress.  
Assess for abdominal distension. Monitor the patient’s vital signs (e.g., fluctuations in blood pressure and body temperature).Abnormal variations in the patient’s vital signs could point to an impending obstruction of the digestive tract, swelling/edema, inflammation, and scarring.
As necessary, provide a sitz bath.Encourages blood flow around the anal area

Abdominal Pain Nursing Care Plan 2

Nursing Diagnosis: Acute Abdominal Pain related to hyperperistalsis, secondary to Crohn’s disease, as evidenced by verbalized colicky pain, protective/guarding behavior, reports of abdominal pain, cramping, agitation, and expressed pain sensation.

Desired Outcomes:

  • The patient will be able to express relief from discomfort or control of their condition.
  • The patient will be able to sleep and rest comfortably.
Abdominal Pain Nursing InterventionsRationale
Encourage the patient to disclose any discomfort or pain he/she may be experiencing.Instead of asking for painkillers or analgesics, the patient may strive to tolerate his/her discomfort. Encouraging the patient to report their pain could aid in the provision of treatment.
Examine the patient’s complaints of pain. Take note of the area, duration, and degree of intensity of any abdominal cramping or pain the patient may be experiencing. Observe and document changes in its features.   Although both IBS and Crohn’s disease are two distinct diseases, it’s worth noting that both of these conditions share a common symptom: abdominal pain. For patients suffering from Crohn’s disease, sharp, localized pain in the abdomen or urinary tract known as “colic” is most commonly experienced. As a result, assessing the intensity of acute or abdominal pain may aid in identifying and classifying pain characteristics associated with IBS and IBD.
Take note of nonverbal indicators that the patient may be exhibiting (e.g., disengagement, restlessness, abdominal guarding, aversion to moving, despair, and depression. Find out if there are any disparities between what the patient says and what he/she does nonverbally.In order to assess the severity and depth of the patient’s pain, nonverbal cues can be utilized in conjunction with verbal reports of pain. Among the elderly, however, there is a tendency for pain to go unreported.
Assist the patient in assuming a comfortable position (e.g., knees flexion depending on the desired degree of flexion).It reduces stress and tension throughout the body, most importantly relieves abdominal strain, and enhances feelings of control.
Assist the patient in managing his/her pain by providing comfort therapy such as:
-Distraction techniques (e.g., deep breathing exercises)
-Hot and cold application
-Positioning
-Back massage/back rubs
Non-pharmacologic interventions, particularly comfort measures, promote a sense of well-being. It also helps to redirect the patient’s thoughts and improves his/her ability to cope with stress.  
After each bowel movement, assist the patient in cleansing the rectal area using mild soap and water/wipes. Care for the patient’s skin by moisturization using topical creams or petroleum jelly.Skin excoriation is a possibility if stomach secretions leak from the gastrostomy tube. To avoid skin breakdown and promote optimal healing, a skincare routine involving gentle washing and moisturization is needed.
Consider the factors that contribute to the exacerbation or relief of pain.Identification of the potential triggers or exacerbating factors (e.g., stressful situations or a food allergy) is made possible by recognizing the contributing factors that may aggravate or remedy the pain, thus eliminating any viable complications from arising.

Abdominal Pain Nursing Care Plan 3

Nursing Diagnosis: Acute Abdominal Pain related to infections caused by bacterial infection secondary to food poisoning of the pediatric patient, as evidenced by abdominal pain, vomiting, fever, chills, diarrhea, and painful urination

Desired Outcomes:

  • The patient’s skin will exhibit normal turgor.
  • The patient will have a higher nutrient intake and will not experience vomiting.
Abdominal Pain Nursing InterventionsRationale
Determine the quality and characteristic of the patient’s stool, including information on the following:
-Bowel habits
-Frequency
-Type of stool
-Color
-Odor
Examining the stool characteristics helps the nurse identify the presence of gastroenteritis (food poisoning). Loose, watery stools (i.e., diarrhea) are a complication of food poisoning, and recognizing these key characteristics allocates the appropriate intervention.  
Maintain the integrity of the patient’s skin by doing the following care measures:
-Checking and changing diapers regularly
-Use of disposable pads placed under the infant
-Use of ointment
These techniques prevent skin breakdown by regularly improving the patient’s skin integrity. Furthermore, in order to stop the spread of bacteria and pathogens, it is important to practice good hygiene.  
Ensure that the patient’s nutritional needs are met (including adequate hydration).Vomiting, diarrhea, and abdominal pain are all signs of food poisoning, and these symptoms necessitate a brief fast from food and water. Supplication for the necessary nutrients is then made to compensate for nutrient loss.
Document the patient’s daily weight measurements prior to each meal, and monitor his/her intake and output (I&O) ratio.Measurement of the patient’s weight can be useful in determining the level of dehydration the patient is experiencing.
Ensure that the spread of infection is minimized. Store contaminated clothing and linens in designated receptacles. Wear gloves while handling soiled or contaminated articles.This reduces the risk and spread of infection.  

Abdominal Pain Nursing Care Plan 4

Nursing Diagnosis: Acute Abdominal Pain related to pancreatic and bile duct obstruction, secondary to pancreatitis, as evidenced by abdominal pain, expressed or verbalized pain, guarding behavior, diaphoresis, muscle tone changes, tiredness, fatigue, gestures of safety, careful repositioning of the body to avoid discomfort, pacing, lack of energy, lack of vigor and outwardly expressive behavior such as irritability

Desired Outcomes:

  • Relieved or managed discomfort will be reported by the patient following treatment.
  • The patient will adhere to the prescribed pharmaceutical treatment plan.
  • The patient will be able to express relief from discomfort or pain using non-pharmacologic methods.
Abdominal Pain Nursing InterventionsRationale
Examine the patient’s complaints of pain. Take note of the location, duration, and degree of intensity (0-10 scale) of any abdominal cramping or pain the patient may be experiencing. Consider the factors that may contribute to the exacerbation or relief of pain.When pancreatitis is acute or hemorrhagic, the pain is generally widespread and intense. With chronic pancreatitis, pain is generally the most noticeable sign, and the most predominant complication is abdominal pain. If there is any pain in the right upper quadrant (RUQ), it may indicate pancreatic involvement of the pancreatic head. In contrast, pain in the left upper quadrant (LUQ) may indicate pancreatic tail dysfunction. On the other hand, local complications include the presence of abscesses and pseudocysts with a characteristic feature of abdominal pain.
Make sure that the patient is in a comfortable position, upright seated, and in a forward-lean position with his/her knees flexed.It provides the patient with relief from discomfort and pain by reducing pressure and tension in the abdominal region. Assuming an upright position decreases abdominal strain and lower back pain since pain for those with chronic pancreatitis can be worsened by a supine position.
Have the patient stay in bed if he/she is experiencing a debilitating episode of abdominal pain. Provide a calm and serene environment for the patient to rest in.Reduces pancreatic secretion (commonly associated with increasing pain) by lowering metabolic rate and reducing the number of digestive secretions produced.
Assist the patient in managing his/her pain by providing comfort therapy such as:
-Back massage/back rubs
-Visualization
-Guided Imagery techniques
-Distraction techniques/diversional activities (e.g., listening to the radio, watching television)
Comfort measures allow the patient to relax and refocus his/her attention from the pain, helping them cope better.  
Limit the patient’s access to his/her meals and fluids as directed.This reduces the secretion of pancreatic enzymes and their associated discomfort/pain. The patient’s dependence on medication may rise, possibly necessitating increased dosage to alleviate the pain. In addition, higher doses aren’t recommended because they could mask underlying issues and complications and may potentially cause respiratory depression.

Abdominal Pain Nursing Care Plan 5

Nursing Diagnosis: Acute Abdominal Pain related to risk for dissection due to damaged vessel wall, secondary to abdominal aortic aneurysms, as evidenced by abdominal pain, pulsatile abdominal mass, and high pain score

Desired Outcome: The patient will exhibit improved vital signs as evidenced by normal BP, a urinary output of not greater than 30 ml per hour, normal bowel sounds, and normal pulse rate.

Abdominal Pain Nursing InterventionsRationale
Determine the source, location, and features of the patient’s pain. Examine whether it produces pain in the abdomen, lower flank, groin, or back; and whether it puts strain on neighboring structures.Abdominal aortic aneurysm or AAA is characterized by a rapid onset of intense pain that is reported as sharp, shearing, or penetrating in more than 90 percent of patients. The delegation of appropriate intervention can be made possible by examining the sensation of pain and its location. Identifying the specific location is relatively important as treatment can be modified to target its cause.  
Evaluate the patient’s lower limbs for symptoms of ischemia (ischemic colitis). Observe signs of lower limb dysfunction such as poikilothermia, hypothermia, paralysis, paleness, and lack of pulse.There is a higher chance of aortic dissection if the patient has AAA. Observation of the signs and symptoms linked to this condition is typically grounded on the loss of motor function and sensory capacity.  
Perform clinical pulsation and check for a pulsating midline mass.Notifies the nurse and physician that an abdominal aortic aneurysm may be present due to the presence of a pulsatile abdominal mass. Take note: In order to prevent damage to the aneurysm, the pulsing technique must be as soft or gentle as possible.
Observe and record the volume of the patient’s urine output.Observable decreases in the patient’s urine output are typically caused by a range of reasons, including renal artery compression or stenosis, as well as the presence of an aortic cross-clamp (a surgical instrument used in cardiac surgery). The amount of urine produced by the patient can be used to determine the location of an aneurysm in the patient. If the aneurysm is located above the renal artery, it may have little effect on urine flow. However, most renal artery aneurysms are found below the level of the renal artery.  
Assist the patient in managing his/her pain by providing non-pharmacological comfort measures such as:
-Relaxation techniques
-Repositioning
-Hot and cold application
These interventions may alleviate the patient’s pain but based on the severity of the aneurysm; these techniques may become ineffective.
Provide analgesics as prescribed.Consistent acute pain is indicative of a rupture or dissection that hasn’t stopped. In some cases where the pain isn’t subsiding, surgery may be required.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN, BSN, PHN

Anna C. RN, BSN, PHN
Clinical Nurse Instructor

Emergency Room Registered Nurse
Critical Care Transport Nurse
Clinical Nurse Instructor for LVN and BSN students

Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process.

Her experience spans almost 30 years in nursing, starting as an LVN in 1993. She received her RN license in 1997. She has worked in Medical-Surgical, Telemetry, ICU and the ER. She found a passion in the ER and has stayed in this department for 30 years.

She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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