Abdominal Pain Case Study

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Abdominal Pain Case Study #1 Mr. G is a 49-year-old white male who presents to the E.D. with a chief complaint of "abdominal pain." You are the admitting nurse. What assessments will you perform ... first? Perform a focused abdominal assessmentstarting with interview and inspection - OPQRSTU VITAL SIGNS FIRST You obtain the following objective information: Weight 89kg Height 64” T 100.4 oral P 94 R 18 O2 sat 95% on RA BP 132/68 on L arm sitting What questions will you ask regarding his abdominal pain? What is the rationale for asking any of these questions? OPQRSTU Where did itstart - Previoussurgery. Better when you eat or on an empty stomach - Any othersymptoms - Ask about medications - Family history - Smoking or alcohol use Could have issues with gastric Duodenal food helps it Where does it hurt, what makes it better or worse Use questions to guide When was your last bowel movement and what did it look like? Past medical history Mr. G points to hisright side under the costal margin and states that the pain is worse after eating, often “sharp” and it started 2 weeks ago. There is a constant “ache” in his abdomen. The pain radiates to the right shoulder area and is accompanied by nausea. He says Tums are not helping. He rates his pain 6/10. What are the components of your physical exam? I: Inspect A: auscultate P: Palpation P: percussion With diarrhea, what bowelsounds will you expect? Hyperactive Upon palpation of the right upper quadrant, the client grimaces and holds his breath. What will you document? + Murphy sign Based on this diagnosis, what is a proactive nursing intervention? What provider orders do you anticipate? Keep pt NPO Order labs and imaging Tell patient to continue with a low fat diet If you need a professional to complete your college homework at a small fee, then reach out to amazingclasshelp.com Ms. D, a 60-year-old woman, was admitted with vomiting and abdominal pain. HPI reveals that the pain is generalized but worse in the middle of the abdomen, it started yesterday, it is "sharp" and rated 7/10. She has been unable to eat because of the pain and over the counter pain relievers have not helped. VS: 99.9-108-24-100/60-95% on RA Weight: 58 kg What other questions should you ask Mrs. D? HPI, any surgeries or procedures? Last BM? Any medications? What were the OTC meds you were taking? What type of food were you eating? What does vomit look like? How often are you vomiting? What medications are you taking? Any new medications? Anyone in your house has had these symptoms? She has not had a BM in 2 days. Your examination reveals a distended, hard abdomen with a subtle pulsation in between the umbilicus and xiphoid process. There are no lesions present. The RN also notices wavy movements in the upper part of the abdomen. Using the stethoscope, the RN hears very frequent loud, rushing sounds above the umbilicus and very soft, infrequent sounds in the areas below the umbilicus. Percussion reveals a muffled thud in most areas. The patient grimaces when the nurse touches the abdomen. [Show More]

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