an intra-abdominal abscess is a pocket of infected fluid and pus located inside the belly (abdominal cavity). there may be more than one abscess.
causes, incidence, and risk factors
an intra-abdominal abscess can be caused by a ruptured appendix, ruptured intestinal diverticulum, inflammatory bowel disease, parasite infection in the intestines (entamoeba histolytica
), or other condition.
risk factors include a history of appendicitis, diverticulitis, perforated ulcer disease, or any surgery that may have infected the abdominal cavity.
depending on the location, symptoms may include:
signs and tests
- abdominal pain and distention
- lack of appetite
- rectal tenderness and fullness
a complete blood count may show a higher than normal white blood count. a comprehensive metabolic panel may show liver, kidney, or blood chemistry problems.
a ct scan of the abdomen will usually reveal an intra-abdominal abscess. after the ct scan is done, a needle may be placed through the skin into the abscess cavity to confirm the diagnosis and treat the abscess.
other tests may include:
- abdominal x-ray
- ultrasound of the abdomen
treatment of an intra-abdominal abscess requires antibiotics (given by an iv) and drainage. drainage involves placing a needle through the skin in the abscess, usually under x-ray guidance. the drain is then left in place for days or weeks until the abscess goes away.
occasionally, abscesses cannot be safely drained this way. in such cases, surgery must be done while the patient is under general anesthesia (unconscious and pain-free). a cut is made in the belly area (abdomen), and the abscess is drained and cleaned. a drain is left in the abscess cavity, and remains in place until the infection goes away.
it is always important to identify and treat the cause of the abscess.
the outlook depends on the original cause of the abscess and how bad the infection is. generally, drainage is successful in treating intra-abdominal abscesses that have not spread.
- return of the abscess
- rupture of an abscess
- spread of the infection to the bloodstream
- widespread infection in the abdomen
what is he complaining of, what antibiotics is he on? why is he still there? (check the progress notes)care plan basics:
every single nursing diagnosis has its own set of symptoms, or defining characteristics. they are listed in the nanda taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. you need to have access to these books when you are working on care plans. there are currently 188 nursing diagnoses that nanda has defined and given related factors and defining characteristics for. what you need to do is get this information to help you in writing care plans so you diagnose your patients correctly.
don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. these will become their symptoms, or what nanda calls defining characteristics
how does a doctor diagnose? he/she does (hopefully) a thorough medical history and physical examination first. surprise! we do that too! it's part of step #1 of the nursing process. only then, does he use "medical decision making" to ferret out the symptoms the patient is having and determine which medical diagnosis applies in that particular case. each medical diagnosis has a defined list of symptoms that the patient's illness must match. another surprise! we do that too! we call it "critical thinking and it's part of step #2 of the nursing process. the nanda taxonomy lists the symptoms that go with each nursing diagnosis.
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:
- assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
- determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
- planning (write measurable goals/outcomes and nursing interventions)
- implementation (initiate the care plan)
- evaluation (determine if goals/outcomes have been met)
now, listen up, because what i am telling you next is very important information and is probably going to change your whole attitude about care plans and the nursing process. . .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. the nursing process itself is
a problem solving method that was extrapolated from the scientific method used by the various science disciplines in proving or disproving theories.