Pain after an abdominal operation is expected, but poor control makes patients breathe shallowly, avoid moving and recover more slowly. Good care uses regular assessment and several drug types together while watching for pain that signals a complication.
Key symptoms
- Incision pain worse with coughing and moving
- Shallow breathing and reluctance to get out of bed
- Shoulder tip pain from gas after laparoscopy
- Nausea, bloating and poor sleep
What you find on exam
- Pain score with a numeric or behavioral scale
- Vital signs, sedation level and respiratory rate
- Wound for redness, discharge or swelling
- Abdomen for distension, bowel sounds and rigidity
Tests
- Mostly clinical; repeat pain and sedation scores after each dose
- Blood count, lactate and electrolytes if pain is out of proportion
- CT abdomen if a leak, abscess or bleeding is suspected
Treatment basics
- Scheduled acetaminophen plus an NSAID such as ketorolac if safe
- Opioids such as oxycodone or hydromorphone for breakthrough pain, at the lowest effective dose
- Epidural, nerve blocks or patient-controlled analgesia
- Early walking, incentive spirometry and splinting the wound with a pillow
- Treat the nausea and constipation that come with opioids
Red flags
- Pain out of proportion with fever or a rigid abdomen
- Respiratory rate below 10 or very hard to wake
- Falling blood pressure with a rising heart rate
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Related guides
Sources: NCCPA PANCE Content Blueprint; NCSBN 2026 NCLEX-RN Test Plan; Open RN, Nursing Pharmacology 2e. Written by Making Synapses. Making Synapses is not affiliated with these organizations.