Esther Park Abdominal Pain Assessment Reflection Paper
Explicitly describe the task you undertook to complete the exam for Esther Park
To complete this exam, I interviewed Ms. Park to establish the history of her presenting illness and discovered that the abdominal discomfort had began almost a week ago and worsened over the last 3 days. Having established that she had no history of GI disorders, I conducted a physical exam on my patient. General physical assessment showed she was stable, though mildly distressed. Cardiovascular, respiratory and HEENT exams all revealed no abnormal finding. A physical exam of her abdomen revealed no discoloration, bruits or friction sounds over the liver and spleen. However, an oblong mass with mild guarding and distension appeared on the left lower quadrant of the abdomen. The exam further revealed no CVA tenderness and no organomegaly.
Explain the clinical reasoning behind your decisions and tasks
With the patient reporting pain in the abdomen, the first action was to examine her bowel sounds in all quadrants to establish the exact pain location. The patient’s bowel sounds were normoactive in all quadrants, with no registered bruits or friction sounds. On percussing the left lower quadrant, a scattered dullness was noted, which is often suggestive of feces in the colon (Setya, Mathew & Cagir, 2020). Further, palpating the abdomen showed that it was soft with mild guarding, and an oblong mass was present, confirming the presence of feces in the colon. To rule out any doubt, I conducted a digital rectal exam, which showed fecal mass in the rectal vault, hence my positive diagnosis of fecal impaction.
Identify and discuss at least 3 things that you learned from completing this assessment and how you can apply to your practice.
Completing this abdominal assessment enabled me to learn pertinent information regarding patient pain assessment. Firstly, prior to this assessment, I had hardly any knowledge on how to conduct abdominal palpations especially when a patient is in pain. Secondly, prior to this assessment, I had difficulty interpreting patient’s facial responses to mild pain during palpations. Finally, this assessment enabled me to learn the basics of abdominal pain assessments that I intend to leverage when assessing patients during my practice.
In what ways did this assignment affect your development into proficiently interviewing and assessing patients?
The Esther Park Abdominal Assessment tests one’s ability to concisely collect a patient’s history of present illness and how to leverage such information in determining the best course of action. Since the assessment requires comprehensive inspection and evaluation, alongside such physical examinations as palpation and percussion, I was able to master how to proceed with these activities, and the vital patient responses to note during the assessment. I believe this experience will help me practice better when handling patients presenting with similar complaints.
Identify how your performance could be improved and how you can apply “lessons learned” within the assignment to your professional practice.
One aspect of my performance during this assessment that needs improvement is time management when collecting subjective data. The need to collect an extensive patient history in relation to the present illness, while at the same time seeking to minimize the time spent interviewing a patient can be particularly challenging. However, I realized that by efficiently documenting patient responses and providing empathic or educative feedback makes the process smoother and faster. This is because such personalized interaction makes it easier for the patient to provide detailed, yet specific responses regarding their problems. I intend to leverage this aspect of patient interviewing into my practice going forward.
Setya, A., Mathew, G. & Cagir, B. (2020). Fecal Impaction. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK448094/