2024 Nrnp 6531 Week
7 i HUMAN Case Study
CC: Abdominal pain
Evita Alonso is a 48-year-old Hispanic American female. She has had abdominal
discomfort for two months off and on that has increased over the last two days and
now is constant. She explained the pain is located in the right side of her upper
abdomen, under her ribs with radiation to right shoulder. She describes the
, character of the pain as crampy, gnawing, and achiness that increases when she
eats a meal and the pain in her shoulder as an ache. She rates her pain at 2-3,
elevates to 6-7. She has also been experiencing nausea and vomiting for the last
two days along with fever and chills for two days, she has not been able to keep
any nutrients down. Over the last 2 months she has noted some bloating, decreased
appetite, and increase in symptoms when she eats fast food. She has tried using
antacids to treat this discomfort with no symptom relief.
Diagnosis: choledocholithiasis
Symptoms
Pain in the right upper or middle upper abdomen for at least 30 minutes. The pain
may be constant and intense. It can be mild or severe. Fever, yellowing of skin and
whites of the eyes (jaundice), loss of appetite, nausea, vomiting, and clay-colored
stools.
Essentials of DX: History of biliary pain, maybe accompanied by jaundice.
Patients sometimes present with painless jaundice. Cholangitis should be suspected
with fever, followed by hypothermia, and gram-negative shock, jaundice, and
leukocytosis. Stones in the bile duct are best detected by EUS or ERCP
Choledocholithiasis refers to the presence of one or more gallstones in the common
bile duct. with the potential development of cholangitis and ascending infections.
Acute common bile duct obstruction produces an acute increase in the lever of
liver enzymes ALP, AST and ALT followed by increased serum bilirubin level.
Evita Alonso had an elevation in ALP, AST, and ALT indicating acute obstruction
along with assessment findings that corelate with choledocholithiasis diagnosis.
Mild scleral icterus was noted during visual inspection if the eyes, this is also
known as jaundice indicating accumulation if bile pigment (bilirubin) in the body.
Diagnostic test of choice is a transabdominal ultrasound, can be performed to look
for dilation of the common bile duct, along with the presence of shadowing if the
gallstone can be seen.
7 i HUMAN Case Study
CC: Abdominal pain
Evita Alonso is a 48-year-old Hispanic American female. She has had abdominal
discomfort for two months off and on that has increased over the last two days and
now is constant. She explained the pain is located in the right side of her upper
abdomen, under her ribs with radiation to right shoulder. She describes the
, character of the pain as crampy, gnawing, and achiness that increases when she
eats a meal and the pain in her shoulder as an ache. She rates her pain at 2-3,
elevates to 6-7. She has also been experiencing nausea and vomiting for the last
two days along with fever and chills for two days, she has not been able to keep
any nutrients down. Over the last 2 months she has noted some bloating, decreased
appetite, and increase in symptoms when she eats fast food. She has tried using
antacids to treat this discomfort with no symptom relief.
Diagnosis: choledocholithiasis
Symptoms
Pain in the right upper or middle upper abdomen for at least 30 minutes. The pain
may be constant and intense. It can be mild or severe. Fever, yellowing of skin and
whites of the eyes (jaundice), loss of appetite, nausea, vomiting, and clay-colored
stools.
Essentials of DX: History of biliary pain, maybe accompanied by jaundice.
Patients sometimes present with painless jaundice. Cholangitis should be suspected
with fever, followed by hypothermia, and gram-negative shock, jaundice, and
leukocytosis. Stones in the bile duct are best detected by EUS or ERCP
Choledocholithiasis refers to the presence of one or more gallstones in the common
bile duct. with the potential development of cholangitis and ascending infections.
Acute common bile duct obstruction produces an acute increase in the lever of
liver enzymes ALP, AST and ALT followed by increased serum bilirubin level.
Evita Alonso had an elevation in ALP, AST, and ALT indicating acute obstruction
along with assessment findings that corelate with choledocholithiasis diagnosis.
Mild scleral icterus was noted during visual inspection if the eyes, this is also
known as jaundice indicating accumulation if bile pigment (bilirubin) in the body.
Diagnostic test of choice is a transabdominal ultrasound, can be performed to look
for dilation of the common bile duct, along with the presence of shadowing if the
gallstone can be seen.
