Summary Gastrointestinal Physical Assessment Assignment

Gastrointestinal Physical Assessment Assignment Results | Turned In Advanced Health Assessment - Chamberlain, NR509-October-2018 Return to Assignment Your Results Lab Pass Subjective Data Collection: 30 of 30 (100.0%) Hover To Reveal... Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions. Category Scored Items Experts selected these topics as essential components of a strong, thorough interview with this patient. Indicates an item that you found. Indicates an item that is available to be found. Patient Data Not Scored A combination of open and closed questions will yield better patient data. The following details are facts of the patient's case. Chief Complaint Established chief complaint Reports frequently occurring stomach pain History of Present Illness Asked about onset of pain Reports noticing pain for "at least a month" Reports that pain increased gradually Asked about frequency of pain Reports pain occurs every day Reports 3 to 4 episodes a week that are more severe Asked about duration of pain Pain begins right after finishing a meal Asked about severity of pain on a scale Rates present pain as 1 or 2 out of 10 Rates worst pain after eating as 5 out of 10 Rates pain when supine as a 6 or 7 out of 10 Asked about character of the pain Describes the pain as similar to heartburn Denies crushing pain Denies gnawing pain Denies cramping pain Denies that abdomen is tender to the touch Asked location of the pain Pain is in center of upper stomach, below breastbone Pain does not radiate Denies shoulder pain Denies back pain Denies arm pain Denies flank pain Denies pain on right side of abdomen Asked about aggravating factors Pain occurs after eating Pain worsens with larger meals Reports that spicy foods increase the pain Denies high-fat foods as an aggravating factor Pain worsens when supine Pain worsens when bending over Asked about relieving factors Pain improves between meals Pain improves when upright Asked about effects of pain on diet and appetite Reports decreased appetite Describes not wanting to eat out of anticipation of pain Reports eating smaller meals Reports avoiding spicy foods Asked about increased burping Reports burping Burping occurs after eating Asked about changes in weight Denies recent weight loss Confirmed use of medications Confirms medications (no new medications reported) Reports occasional antacid use Denies frequent Advil (ibuprofen) use Followed up on use of antacids and relieving factors Antacid brand is Tums Takes antacids every few days Takes between 2 and 4 antacid tablets at a time Reports that antacids offer partial relief Confirmed allergies Confirms allergies (no new allergies reported) Asked about past gastrointestinal history Denies gastrointestinal disease Denies past history of GERD Denies past gastrointestinal surgery Denies past history of appendicitis Denies past history of cholecystitis Denies past history of stomach cancer Denies past history of liver disease Denies past history of kidney disease Denies past history of bladder disease Denies past history of ulcers Asked about typical bowel movements Reports bowel movement every 2 days Denies pain during bowel movements Denies bloody or tarry stools Denies mucus in stool Describes consistency of bowel movements