ShadowHealth Abdominal Pain Esther Park Latest Updated 2024/2025 Actual Questions and Answers Fully Solved 100% Guaranteed Success.(Graded A+)

asked about substance abuse - -denies illicit drug use; smoking -low alcohol consumption asked about orientation - -oriented to own person -oriented to place -oriented to situation -oriented to time asked about onset, frequency, and duration of pain - -reports discomfort for the past 5 days -reports pain with gradual onset that worsened 2-3 days ago asked about location of pain - -reports pain in lower abdomen -reports pain is not localized asked about characteristics of pain - -describes pain a dull and cramping -pain fluctuates in severity asked about non-pharmacological relieving factors - -denies taking pain medication -denies taking laxatives asked about aggravating factors - -reports pain is aggravated by eating -aggravated by physical activity asked about impact on daily life - -recent difficulty participating in usual activities-reports low energy followed up on constipation - -constipation most of last 5 days -denies any attempt to treat constipation asked about diarrhea - recent diarrhea followed up about diarrhea - -about 6 months ago -sudden onset -lasted one day -loose and water asked about substances in stool - -denies mucus and blood in stool asked about urination - -recent, slight decrease in frequency of urination -darker urine recently -denies blood in urine asked about fluid intake - -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 - -denies recent travel and exposure to food poisoning asked about history of constipation - denies history asked about typical bowel movements - -typically has BM almost every day-stools usually brown, formed, soft asked about allergies - -reports latex allergy -denies med allergies -denies food allergies asked about pre-existing health conditions - -reports high BP -diagnosed at 54 asked about relevant history of surgery - -c section at 40 -gall bladder removal at 42 -no post op complications asked about home meds - -meds for high BP -10 mg accupril daily at 8 am -no OTC meds chief complaint - -reports abdominal pain -reports difficulty with bowel movement asked about access to healthcare - -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 - -reports living with daughter and strong family supportasked about diet - -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 plan - Mrs. Park should receive diagnostic tests to rule out differentials: CBC to assess for elevated WBCs associated with diverticulitis, electrolyte profile to evaluate electrolyte and fluid status, and a CT scan to assess for obstruction. 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 asked about fiber intake - -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 - -typically high level of mobility and independence -reports typically having a moderated activity level assessment - Mrs. Park's bowel sounds are normoactive in all quadrants, with no bruits or friction sounds. Scattered dullness in LLQ during percussion is suggestive of feces in the colon; otherwise, her abdomen is tympanic. Her abdomen is soft to palpation; mild guarding and oblong mass suggesting feces were discovered in LLQ. No CVA tenderness; liver span 7 cm @ MCL; no splenic dullness. Digital rectal exam revealed a fecal mass in the rectal vault. No abnormalities were noted during the pelvic exam, so pelvic inflammatory disease is not suspected. Ms. Park's urinalysis was normal, which rules out a urinary tract infection. No signs of dehydration or cardiovascular abnormalities. Mrs. Park's symptoms and health history suggest she has constipation. Differential diagnoses are constipation, diverticulitis, and intestinal obstruction. followed up on alcohol - -drinks 1 night a week -drinks 1 drink per sitting -white wine asked about constitutional health - -denies recent weight changes-denies fever, chills, night sweats -short term feeling of exhaustion ROS for GU system - -reports onset of menopause at age 54 -denies history of bladder problems -denies painful urination; burning; incontinence -denies hx of UTIs -denies GYN problems -denies vaginal bleeding/discharge