NR 511 Week 3_GASTRO CLINICAL CASE

NR 511 Week 3_GASTRO CLINICAL CASEAdvanced Nursing Practice Week 3: Gastroenterology Clinical Case HPI A 60-year-old Italian male presents with acute abdominal pain. He is a retired schoolteacher and still does some teaching on the side. He is complaining of acute onset of umbilical pain that started last evening after eating. He is experiencing a gnawing hunger pain in the umbilical area. The pain is more diffuse now and he feels nauseous, but there is no vomiting. He believes he had fever last night because he felt very warm and sweaty. His symptoms subsided after he sat up for a few hours on a chair, but he is not sure how it went away. The patient has been having these symptoms for the past 24 hours. He has had similar symptoms in the past, but it was not as bad as this. The pace of illness was worse last night and is much better now. In the past, the symptoms would last only an hour or two and resolve spontaneously. In terms of severity, the pain experienced last night, during the “attack,” was a ten. Today, it is a seven. He was awake last night and the pain has been bothering him for the past 24 hours. Last night, the pain was more localized in the periumbilical region. It is more diffuse now. The pain does not radiate to the back; it is mainly generalized in the abdomen now and less intense from what it was last night. He has also been having some heartburn-like symptoms for the past two weeks. The symptoms increased after eating. The heartburn would resolve spontaneously within a few hours and sometimes it was relieved after he took some OTC antacids. The patient thinks he is having a heart attack. The worsening of his symptoms has made him seek medical care today.