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Tuesday, November 08, 2005

Nursing Care Plan to the Client with Abdominal Trauma, Acute Abdomen and Peritonitis

Nursing Assessment

1. Assess for history of the injury, onset and progression of the symptoms.
2. Assess presence of signs and symptoms of internal bleeding or acute abdomen (pain, bowel distention, muscle rebound) .
3. Assess abdomen wall for presence of wounds and hematomas.
4. Assess vital signs, CVP, fluid balance and urine output.
5. Assess diagnostic tests and procedures for abnormal values (US, x-ray, CT, etc.).

Nursing Diagnosis

1. Increased risk of hypovolemia and shock related to abdominal trauma and internal bleeding.
2. Increased risk of sepsis related to acute inflammatory process and peritonitis.
3. Increased risk of severe fluid, electrolyte, and metabolic imbalances related to injury or inflammation.
4. Pain and bowel distention , related to diagnosis.
5. Anxiety related to the symptoms of disease and fear of death.


Nursing Plan and Interventions

Goals

1. Promote adequate respiratory and cardiovascular function.
2. Provide measures for prevention of the shock and sepsis.
3. Prevent avoidable injury and complications.
4. If surgical intervention prescribed, prevent postoperative complications.
5. Relief or diminish symptoms.
6. Decreased anxiety with increased knowledge of disease, it treatment, and follow-up.

Interventions

1. Assess, report , and record signs and symptoms and reactions to treatment.
2. Monitor fluids input and output closely, insert urinary catheter and IV catheter.
3. Provide positioning of the client in semi-Fowler position.
4. Monitor client for pain and signs of gastrointestinal decompensation.
5. Administer antibiotics and other medications as prescribed, monitor for side effects.
6. Monitor client’s vital signs and signs of possible hemorrhage, sepsis and shock closely, report immediately.
7. Observe patency of tubes and drains, and drainage characteristics.
8. Monitor client’s laboratory tests results for abnormal values.
9. Keep client NPO as ordered.
10. Administer IV therapy and blood transfusions as prescribed.
11. Prepare client and his family for surgical intervention if required.
12. For client after surgical intervention provide postoperative care and teach about possible postoperative complications.
13. Instruct client for cough and deep breathing to prevent respiratory complications.
14. Provide appropriate skin care to prevent possibility of skin lesions.
15. Provide emotional support to client, explain all procedures to decrease anxiety and to obtain cooperation.
16. Instruct client regarding disease progress, diagnostic procedures, treatment and its complications, home care, daily activities, restrictions and follow-up.

Evaluation

1. Reports decreased pain.
2. Maintain stable vital signs, cardiac function, and fluid balance.
3. No evidence of sepsis or other complications.
4. Reestablished regular pattern of bowel function.
5. Laboratory tests results shows no abnormalities.
6. Demonstration of understanding of disease progress, decreased fear and anxiety.


This information has been published by the International Biopharmaceutical Association www.ibpassociation.org . Please note this information does not give any medical advice.

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