KAREN FLOYD ABDOMINAL PAIN LATEST 2023 A+ GRADED, Exams of Nursing

Download KAREN FLOYD ABDOMINAL PAIN LATEST 2023 A+ GRADED and more Exams Nursing in PDF only on Docsity! KAREN FLOYD "ABDOMINAL PAIN" LATEST 2023 A+ GRADED Questions –yields 90% How can I help you? My stomach hurts Do you have any other symptoms or concerns we should discuss? I occasionally feel “bloated” although I’m not sure my belly is actually bigger when I feel that way. I…well pass a lot of gas and… even belch a lot compared to other people I know. Sort of embarrassing for a woman you know. Do you think that’s related to all of this? Is your pain affected by what, when, or how much you eat? It seems to be worse with rich foods. I haven’t really noticed it as associated with when or how much. Do you now or have you ever smoked or chewed tobacco? No, I never have. Are you taking any over the counter or herbal medications? I take a multivitamin daily, and acetaminophen from time to time for stress headaches Are you taking any prescription medications? No prescription medications Do you have any allergies? Not that I know of Have you ever been hospitalized? Just for the c-section and the bike accident thing Any previous medical, surgical, or dental procedures? I had a c-section at 27 without any complications. When I was 17, I had a bike accident and had a complicated fracture of my right tibia. They had to fix that with surgery. Can you tell me about any current or past medical problems you have had? I don’t know really what’s important. The only thing besides this stomach problem is that lately I’ve been getting occasional hot flashes and my skin is sort of dry. I also get headaches now and then which isn’t new and that probably isn’t important anyway. Is that the kind of things you want to know? Do you have diarrhea? Occasionally. Sometimes I’d say my bowel movement is loose and watery. Does that count? Is there any blood in your stools or with your bowel movement? Anything red? Not that I have noticed KAREN FLOYD "ABDOMINAL PAIN" LATEST 2023 A+ GRADED Do you have a problem with constipation? Definitely. For as long as I can recall in my adult life, I have alternating periods of constipation and just the opposite if you know what I mean that lasts several days. When I am constipated, I feel like I cannot get everything out, even after a BM. Have you been having fevers? I don’t think so, can you check that for me How often does this abdominal pain occur? It’s been coming and going for years now. It never really goes away entirely, but then it also doesn’t seem to be getting a lot worse. It’s just there all the time. So frustrating. How severe (1-10 scale) is your abdominal pain? It varies, sometimes it’s just mild and annoying, other times it stops me in my tracks it’s so bad Does the pain in your abdomen radiate someplace else? Where? No, it’s just in my stomach Where more precisely is your abdominal pain? All over, especially in the lower half of my belly. What does the pain/discomfort in your abdomen feel like? (Cramping, burning, stabbing, aching, tingling, squeezing). Usually like a bad cramp but sometimes it can be a stabbing feeling. Does anything make the pain in your abdomen better or worse? “Having a bowel movement sometimes makes it better. Then it starts up again if I’m stressed out or eating the wrong stuff”. When did your abdominal pain start? This problem started at least 10 years ago. It’s really been going on far too long. KAREN FLOYD "ABDOMINAL PAIN" LATEST 2023 A+ GRADED - Nor seizures Test strength Strength 5/5 bilaterally Visual inspection AP chest Chest is symmetrical and the AP diameter is normal. The excursion with respiration is symmetrical and there are no abnormal retractions or use of accessory muscles. No distension, scars, masses, or rashes. Palpate AP chest No tenderness, masses, heaves, thrills, or crepitus Percuss AP chest The anterior lung fields are resonant. The left anterior chest and right lower chest are dull to percussion. The rest of the lung fields are resonant and are not hyper-resonant. MSAP Stomach pain Stabbing/cramping abdominal pain Feels bloated Flatulence worse with rich foods Stress headache C-Section Bike riding accident, right tibia fracture Hot flashes Dry skin Occasional diarrhea Incomplete bowel movements Constipation Pain improved with bowel movements Abdominal swelling Problem statement K.F. is a 45 y/o female that presents with a 10-year history of intermittent chronic lower cramping like abdominal pain that is relieved when she has a bowel movement. She endorses episodes of diarrhea, constipation, and mucus in her stool. She states she works long hours at her job and most days skips meals. She denies any chest pain, worsening of pain with her periods, BRBPR, hematuria, abdominal trauma or increased pain when lifting. PE reveals positive findings of hyperactive bowel sounds and mild tenderness with deep palpation of the lower abdomen on both sides. Rectal exam was unremarkable. DDX – 100%, MNM – 100% Diagnosis Lead Alternate MNM 1 Lactose intolerance X 2 Small intestinal bacterial overgrowth X 3 Laxative abuse X 4 Dyspepsia, functional X 5 GERD X 6 Peptic ulcer disease X 7 Cholelithiasis X 8 Colon cancer X X 9 Biliary colic X 10 Irritable bowel syndrome X 11 Crohn’s Disease X 12 Colitis, ulcerative X 13 Diverticulitis X 14 Large bowel obstruction X X KAREN FLOYD "ABDOMINAL PAIN" LATEST 2023 A+ GRADED 15 Hemorrhoids X 16 Colon neoplasm X 17 Small bowel obstruction X 18 Small bowel neoplasm X 19 Hypothyroidism X 20 Hyperthyroidism X 21 Diabetic neuropathy X 22 Generalized anxiety disorder X 23 Major depressive disorder X 24 Giardiasis X 25 Salmonellosis X 26 Shigellosis X 27 C. Diff X 28 E. Coli X 29 Campylobacteriosis X 30 Pelvic inflammatory disease X 31 Endometriosis X 32 Ovarian neoplasm X 33 Appendicitis X X 34 Microscopic colitis X 35 Colitis, infectious X 36 Lymphoma, non-Hodgkin’s X 37 Stomach cancer X 38 Adrenal insufficiency, primary X 39 DMT1 X 40 DMT2 X 41 Diarrhea, medication associated X 42 Constipation X 43 Tropical sprue X 44 Gastroenteritis X 45 Perforated viscus X 46 Pancreatitis, chronic X 47 Colitis, ischemic X 48 HIV X 49 Somatic symptom disorder X 50 Pancreatic insufficiency X 51 Parkinson’s X 52 MS X 53 Anemia X 54 AAA X 55 Abdominal abscess/infection X 56 Cholecystitis, acute X 57 Celiac X 58 Mesenteric ischemia, chronic X 59 Mesenteric ischemia X 60 Pancreatitis, acute X 61 Colitis, non-infectious X 62 Anemia, lead poisoning X 63 Hypercalcemia X KAREN FLOYD "ABDOMINAL PAIN" LATEST 2023 A+ GRADED 64 Hyperthyroidism, graves X 65 Hyperthyroidism, thyrotoxic crisis X 66 Arthritis, IBD associated X 67 Abdominal neoplasm X 68 Pancreatic cancer X 69 Choledocholithiasis X 70 Somatostatinoma X 71 Gastric ulcer X 72 Colonic ulcer X 73 DKA X 74 Ectopic pregnancy X 75 MI, acute X 76 Ovarian torsion X 78 Nephrolithiasis/kidney calculi X 79 Peritonitis X 80 Peritonitis, spontaneous (NOS) X 81 Splenic rupture X 82 Splenic abscess X 83 Hepatitis, viral X 84 Follicular cyst X 85 Ascending cholangitis X 86 Hepatic venous outflow obstruction X Diagnostic Tests – 100% 1 Tissue glutaminase antibody (IgA-tTG) Negative 2 C Reactive Protein Normal 3 Capsule endoscopy Normal 4 Colon biopsy Normal 5 Colonoscopy Normal 6 Complete blood count Normal 7 CMP Normal 8 CT abdomen Normal 9 CTA, abdomen Normal 10 ESR Normal 11 Sigmoidoscopy Normal 12 Vitamin B12 Normal Diagnosis – 100% Irritable bowel syndrome Exercises – yields 94%, but not graded per rubric Hematochezia Mucous in the stool Chronic, pellet, period, pain, urgency, sensation, acute Stress and eating Blood, significant, anorexia, pain False All of the above CBC, CRP, celiac sprue panel