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Abdominal Assessment and Its Application to Surgical Ward

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Application to Surgical Ward

The assessment by nurses refers to the data collection, data analysis, and identification of the problem. Nurses are encouraged to obtain the clinical history of patient from the family members and patient which form the foundation of the assessment. The preliminary assessment is done using the interview technique followed by the physical check-up. The assessment is a process needs to be adopted both pre-operation and post-operation in the surgical ward. For the abdominal assessment pre-operation and post-operation is generalized and remains same, they will be discussed simultaneously. The abdominal assessment, both pre-operative and post-operative has their significance. A surgical pre-operative abdominal assessment is important to determine the presence of an abdominal aortic aneurysm (AAA), which is a potential contraindication of the use of an intra-aorta balloon pump. Abdominal palpitation to detect abnormal widening of an aortic pulsation is suggested to be the most effective method to determine presence of AAA (Elliot et al 2007). The width is compared with the intensity of aortic pulsation to establish the presence of an AAA. Findings from palpation, however, are limited in patients with abdominal obesity. Diagnostic evaluation with ultrasound may also be performed (J. 1998).

In recent times, recognizing the significance of the assessment by nurses, they are encouraged to identify the deficiency in their knowledge and to promote its application in their respective wards. Abdominal assessment by nurses in surgical ward both, preoperative and post operative has the potential to increase the comfort of patient along with accurate identification of the problem area. Surgical ward nurses play an important role in abdominal assessment preoperative and postoperative (O'Laughlen 2009). Nurses have to continuously observe and assess the patient's condition closely. For an instance, in the case of non-catheterized patients, nurses should note the time when the patient first passes the urine after surgery. It is possible for retention of urine to occur, particularly in case of abdominal, genitourinary and gynecological surgery procedures have been undertaken. The patients of abdominal surgery are being examined for the palpation of the lower abdomen and the bladder is felt as full and rising up to the umbilicus. Relief of passing a catheter into the bladder and withdrawing it once the bladder is emptied may be required if the patient can't be persuaded to pass urine normally. This all requires the nurse in the surgical ward to be attentive towards the patient and to possess the knowledge to identify this situation. The knowledge of nurses in assessing the abdomen of the patient is sometimes inadequate which may lead to the emergency situations. The skilled and trained nurses are efficient in recognizing the post-operative symptoms of discomfort in patients and to differentiate it from any abnormal symptoms.

The abdominal assessment port operation requires the nurse to carefully observe to ensure that the patient is capable of passing urine in the normal way as soon as possible (Hohenfellner & Santucci 2007). The certain area where the vigilant and trained nurses make a difference are for an instance, an assessment of patient's level of comfort in terms of body temperature, pain and nausea can be made and, where appropriate, treated. Body temperature usually alters significantly as a result of exposure of tissue during surgery and the administration of cold intravenous fluids. Discomfort, pain and nausea are postoperative experiences which skilled nurses can help to significantly alleviate. The observing nurse's interpretation of the patient's experience has an influence on the care given. Research indicates that some nurses overestimate the patient's pain experience whilst others may underestimate the severity of pain. Harrison (1991) suggests that in order to accurately assess patient's pain, nurses need to be self-aware of their own attitude towards the pain and adapt their care accordingly. Research has demonstrated that more experienced a nurse is, the more accurate is her description of the patients comfort level (Harrison 1991). This highlights the importance of the role played by nurses in identifying the accurate reason of discomfort to patient by physical assessment. In surgical ward, nurses with the training in abdominal assessment can increase the chances of speedy recovery of the patient postoperative and also can assess the exact organ of problem with their skills in abdominal assessment.

As the patient recovers from the immediate post-operative period, the nursing care required should be aimed to move the patient towards a maximum state of independence of medical and nursing interventions. Much of the nursing care in this period is still aimed at preventing complications by closely observing the patient's condition so as to take immediate action should a complication occur



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