Shadow Health Abdominal Pain Esther Park Latest Update 2024, Exams of Nursing

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Shadow Health Abdominal Pain Esther Park Latest Update 2024 chief complaint - Correct Answer-reports abdominal pain -reports difficulty with bowel movement asked about orientation - Correct Answer-oriented to own person -oriented to place -oriented to situation -oriented to time asked about onset, frequency, and duration of pain - Correct Answer-reports discomfort for the past 5 days -reports pain with gradual onset that worsened 2-3 days ago asked about location of pain - Correct Answer-reports pain in lower abdomen -reports pain is not localized asked about pain rating on scale - Correct Answer-reports 6/10 pain asked about characteristics of pain - Correct Answer-describes pain a dull and cramping -pain fluctuates in severity asked about non-pharmacological relieving factors - Correct Answer-denies taking pain medication -denies taking laxatives asked about aggravating factors - Correct Answer-reports pain is aggravated by eating -aggravated by physical activity asked about impact on daily life - Correct Answer-recent difficulty participating in usual activities -reports low energy followed up on constipation - Correct Answer-constipation most of last 5 days -denies any attempt to treat constipation asked about diarrhea - Correct Answerrecent diarrhea followed up about diarrhea - Correct Answer-about 6 months ago -sudden onset -lasted one day -loose and water asked about substances in stool - Correct Answer-denies mucus and blood in stool asked about urination - Correct Answer-recent, slight decrease in frequency of urination -darker urine recently -denies blood in urine asked about fluid intake - Correct Answer-decreased thirst -decreased fluid intake for last few days -typical fluid intake is 1-2 glasses water/day -denies drinking caffeine asked about contact with illnesses - Correct Answer-denies recent travel and exposure to food poisoning asked about history of constipation - Correct Answerdenies history asked about typical bowel movements - Correct Answer-typically has BM almost every day -stools usually brown, formed, soft asked about allergies - Correct Answer-reports latex allergy -denies med allergies -denies food allergies asked about pre-existing health conditions - Correct Answer-reports high BP -diagnosed at 54 asked about relevant history of surgery - Correct Answer-c section at 40 -gall bladder removal at 42 -no post op complications asked about home meds - Correct Answer-meds for high BP -10 mg accupril daily at 8 am -no OTC meds asked about access to healthcare - Correct Answer-annual checkup with HCP -last pap smear over 10 years -level of health and activity is good -denies STI testing -last colonoscopy over 10 years -denies finances as a barrier -denies transportation as a barrier If Mrs. Park has diverticulitis I recommend IV fluids and bowel rest. If she has bowel obstruction, I recommend NPO, IV fluids, and general surgical consult. If she has constipation, I recommend that she increase fluids, increase fiber, and increase activity as tolerated. Nursing Diagnosis - Correct AnswerPatient exhibits constipation related to deficient fiber and fluid intake, as evidenced by abdominal discomfort and tenderness, defecation fewer than two times per week, a distended abdomen, generalized fatigue, and a palpable abdominal mass Short term goal - Correct AnswerTo induce a bowel movement that relieves the patient's constipation, resulting in patient reporting relief and diminished pain, within an emergency department visit. Interventions - Correct Answer1) Administer a mineral oil based enema with physicians order 2) Assess and fulfill patient needs for ambulating to the bathroom 3) Have patient ambulate the length of the hallway with patient care tech assistance 4) Provide patient with 500 ML of fluid and advise to drink over the next two hours 5) Tell patient to leave any outputs unflushed for examination Data Collections - Correct Answer- Ask about pain rating, abdominal cramping, nausea, and dizziness - ask about patient outputs, presence of stool, and sense of constipation - evaluate any store for amount and qualities - evaluate for physical signs of pain and or cramping - perform dehydration tests. Skin turgor, dry mouth, urine hat collection, and follow up as necessary chief complaint - Correct Answer-reports abdominal pain -reports difficulty with bowel movement asked about orientation - Correct Answer-oriented to own person -oriented to place -oriented to situation -oriented to time asked about onset, frequency, and duration of pain - Correct Answer-reports discomfort for the past 5 days -reports pain with gradual onset that worsened 2-3 days ago asked about location of pain - Correct Answer-reports pain in lower abdomen -reports pain is not localized asked about pain rating on scale - Correct Answer-reports 6/10 pain asked about characteristics of pain - Correct Answer-describes pain a dull and cramping -pain fluctuates in severity asked about non-pharmacological relieving factors - Correct Answer-denies taking pain medication -denies taking laxatives asked about aggravating factors - Correct Answer-reports pain is aggravated by eating -aggravated by physical activity asked about impact on daily life - Correct Answer-recent difficulty participating in usual activities -reports low energy followed up on constipation - Correct Answer-constipation most of last 5 days -denies any attempt to treat constipation asked about diarrhea - Correct Answerrecent diarrhea followed up about diarrhea - Correct Answer-about 6 months ago -sudden onset -lasted one day -loose and water asked about substances in stool - Correct Answer-denies mucus and blood in stool asked about urination - Correct Answer-recent, slight decrease in frequency of urination -darker urine recently -denies blood in urine asked about fluid intake - Correct Answer-decreased thirst -decreased fluid intake for last few days -typical fluid intake is 1-2 glasses water/day -denies drinking caffeine asked about contact with illnesses - Correct Answer-denies recent travel and exposure to food poisoning asked about history of constipation - Correct Answerdenies history asked about typical bowel movements - Correct Answer-typically has BM almost every day -stools usually brown, formed, soft asked about allergies - Correct Answer-reports latex allergy -denies med allergies -denies food allergies asked about pre-existing health conditions - Correct Answer-reports high BP -diagnosed at 54 asked about relevant history of surgery - Correct Answer-c section at 40 -gall bladder removal at 42 -no post op complications asked about home meds - Correct Answer-meds for high BP -10 mg accupril daily at 8 am -no OTC meds asked about access to healthcare - Correct Answer-annual checkup with HCP -last pap smear over 10 years -level of health and activity is good -denies STI testing -last colonoscopy over 10 years -denies finances as a barrier -denies transportation as a barrier asked about family and support system - Correct Answer-reports living with daughter and strong family support asked about diet - Correct Answer-last meal was toast at breakfast -typically eats 3 meals a day -denies snacks -typical breakfast is toast -typical lunch is soup -typical dinner is chicken or fish with rice asked about fiber intake - Correct Answer-denies fiber supplements -denies efforts to incorporate fiber in diet -reports eating veggie every 1-2 days -reports eating fruit ever 3-4 days asked about typical activity level - Correct Answer-typically high level of mobility and independence -reports typically having a moderated activity level asked about substance abuse - Correct Answer-denies illicit drug use; smoking -low alcohol consumption