GI CASE STUDY | PEGGY SCOTT, 48 YEARS OLD |
UPDATE 2026 ASSESSMENT & REASONING GI
SYSTEM
Peggy Scott, 48 years old
Suggested GI/GU Nursing Assessment Skills
GI/GU:
Inspection: skin (coloration, vascularity, striae, scars, lesions, rashes)
• Contour from 2 angles – (flat, rounded, scaphoid, protuberant/distended)
• Note symmetry, color, veins, lesions, scars, hair distribution
• Umbilicus – contour; Note: inguineal or umbilical hernias
• Symmetry (relaxed, supine position)
• Abdominal movement during breathing
• Aortic pulsations
Auscultation: (completed before palpation/percussion to not alter bowel sounds)
• Bowel sounds – 1 minute per quadrant up to 5 minutes with the diaphragm
• Intensity, pitch, frequency
• Vascular sounds – listen for bruits in abdominal aorta with bell. Palpation:
• Light palpation to all quadrants – 1 to 2 cm to detect tenderness
• Deep palpation to all quadrants – 5 to 6 cm for masses (location, size, shape, pulsatility, mobility, tenderness)
• Palpate bladder- light palpation ONLY; you only want to assess to see if it is distended • Check for
costovertebral angle tenderness
Make Learning Active!
, Present Problem:
Peggy Scott is a 48-year old African American woman who came to the emergency department because she is having
severe abdominal pain radiating to the back that started 24 hours ago but has become progressively worse in the last
couple of hours. She is now nauseated and states that she has “puked small amounts of green liquid” five times in the last
four hours. She had two loose stools today that were dark brown or black in color.
Peggy has struggled with ETOH use/abuse most of her adult life but has been sober the past six months. She begins
to cry and tells the nurse that this week was the one-year anniversary of her only son’s death in an automobile accident.
She reports that she has been drinking one liter of vodka daily the past week.
What data from the present problem are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds? (Which
medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Class: Mechanism of Action (own words):
• Depression • Ibuprofen 600 mg
• Low back pain PO three times
daily PRN
• Pancreatitis
• Citalopram 40 mg
(no current meds) •
PO daily
ETOH abuse
(no current meds)
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 100.6 F/38.1 C (oral) Provoking/Palliative: Movement provokes, nothing relieves pain
P: 98 (regular) Quality: Sharp
R: 20 (regular) Region/Radiation: Epigastric area/LUQ
BP: 146/94 Severity: 10/10
O2 sat: 95% room air Timing: Continuous since onset 24 hours ago
What vital signs are abnormal? What is the reason (pathophysiology) for these findings? (Reduction
of Risk Potential/Health Promotion and Maintenance)
UPDATE 2026 ASSESSMENT & REASONING GI
SYSTEM
Peggy Scott, 48 years old
Suggested GI/GU Nursing Assessment Skills
GI/GU:
Inspection: skin (coloration, vascularity, striae, scars, lesions, rashes)
• Contour from 2 angles – (flat, rounded, scaphoid, protuberant/distended)
• Note symmetry, color, veins, lesions, scars, hair distribution
• Umbilicus – contour; Note: inguineal or umbilical hernias
• Symmetry (relaxed, supine position)
• Abdominal movement during breathing
• Aortic pulsations
Auscultation: (completed before palpation/percussion to not alter bowel sounds)
• Bowel sounds – 1 minute per quadrant up to 5 minutes with the diaphragm
• Intensity, pitch, frequency
• Vascular sounds – listen for bruits in abdominal aorta with bell. Palpation:
• Light palpation to all quadrants – 1 to 2 cm to detect tenderness
• Deep palpation to all quadrants – 5 to 6 cm for masses (location, size, shape, pulsatility, mobility, tenderness)
• Palpate bladder- light palpation ONLY; you only want to assess to see if it is distended • Check for
costovertebral angle tenderness
Make Learning Active!
, Present Problem:
Peggy Scott is a 48-year old African American woman who came to the emergency department because she is having
severe abdominal pain radiating to the back that started 24 hours ago but has become progressively worse in the last
couple of hours. She is now nauseated and states that she has “puked small amounts of green liquid” five times in the last
four hours. She had two loose stools today that were dark brown or black in color.
Peggy has struggled with ETOH use/abuse most of her adult life but has been sober the past six months. She begins
to cry and tells the nurse that this week was the one-year anniversary of her only son’s death in an automobile accident.
She reports that she has been drinking one liter of vodka daily the past week.
What data from the present problem are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds? (Which
medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Class: Mechanism of Action (own words):
• Depression • Ibuprofen 600 mg
• Low back pain PO three times
daily PRN
• Pancreatitis
• Citalopram 40 mg
(no current meds) •
PO daily
ETOH abuse
(no current meds)
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 100.6 F/38.1 C (oral) Provoking/Palliative: Movement provokes, nothing relieves pain
P: 98 (regular) Quality: Sharp
R: 20 (regular) Region/Radiation: Epigastric area/LUQ
BP: 146/94 Severity: 10/10
O2 sat: 95% room air Timing: Continuous since onset 24 hours ago
What vital signs are abnormal? What is the reason (pathophysiology) for these findings? (Reduction
of Risk Potential/Health Promotion and Maintenance)
