NRNP-6531-WEEK-
7 IHIMAN=Ihuman CASE-STUDY-EVITA-
Q
ALONSO ,48YRS OLD FEMALE HISPANIC
Q Q Q Q
AMERICAN FEMALE CC= Abdominal-
Q Q Q
pain 3 Different version
Q Q
]
,CC: 48 y/o F HPI: pertinent s/s; +/- ROS/prior episodes/recent travel/ill contacts
Q Q Q Q Q Q Q
Chief complaint isQ aQ shortQ 1-
2 statementQ orQ wordQ phraseQfromQpatientQandQshouldQbeQ Mrs.QAlonsoQisQaQ48-year-
listed in “quotes” oldQfemaleQpatientQwhoQpresentedQtoQtheQclinicQwithQaQprogressive, intermittent ri
ghtQupperQquadrantQpainQforQtheQpastQ2QweeksQandQwhichQhasQincreased in severit
“My stomachQhasQbeenQhurtingQreallyQbadQove yQinQtheQpastQ2Qdays.QTheQpainQradiatesQtoQtheQrightQshoulder.QSheQalso complains
QofQassociatedQsymptoms QlikeQnausea,Qvomiting,QanorexiaQsinceQthe past 2 days.
rthe past 2 seeks”
SheQhasQhadQpreviousQrecurrentQself-
resolvingQsymptoms overQtheQlastQoneQyear.QPainQusedQtoQbeQprecipitated by fast
food butQnotQoccursQwithQallQfoodsQandQunresponsiveQwithQantacids and NSAIDS.
Onset:Q2 weeksQago, withQsymptomsQbecomingQmoreQdreadfulQ2Qdays ago Locati
on:QRightQupperQquadrantQandQoccasionallyQradiatedQtoQtheQrightQshoulderDuratio
n: PainQhasQbeen constantQsinceQitQstartedQthisQtime;QinQtheQpastQitQonly lasted 1-
2 days.
Character:QCrampy gnawQachiness
Aggravating/alleviatingQfactors:QPainQgets worseQwithQmealsQand unresolved wit
hantacidsQandQNSAIDs
RelatedQsymptoms: Nausea.QVomiting,QanorexiaQwith onsetQofQsymptoms 2 da
ysago.QDenies any recentQexposureQtoQotherQillQcontacts. SheQhasQhad similar sy
mptomsQpreviously
Treatments: Has triedQOTCQantacidsQandQibuprofenQwithoutQrelief Significanc
e:QPainQstartsQwith aQscaleQofQ2-3QandQgets up toQ6-
7.QSheQreportsQpainhas keptQherQhomeQfromQwork.
PMHx child/adultQillness/hospitalizations/immunizatio Surh type/when/why/complications
Q
ns
Negative for anyQ chronicQ illnesses.Q SheQ hasQocc TubalQligation
asional heartburnQandQarthritis
Frequent episodesQofQcommonQcoldsQandQasQchil
dNo hospitalizations,QtraumaQorQotherQinjuries
, Immunizations:QStatesQherQimmunizationsQar
ecurrent. She hadQtheQinfluenzaQvaccineQthis
season and stillQgotQtheQflu.
Fahm TX
Grandparents (ifQknown)/Parents/siblings/children Tobacco/vaping/ETOH/illicitQdrugQuse/occupational/environmental/relationships
Grandparents- SheQreportsQthatQshe drinksQaQglassQofQwineQwithQdinnerQmostQnights; She deni
states no knownQhistoryQFatherQisQ70Qyears- esQany tobaccoQorQrecreationalQdrugQuse
old and still aliveQandQwellQ(70):QheartQdiseas
e, peptic ulcerQdisease
Mother is 69 years-
old and alive: breastQcancerQinQremission;Qcholec
ystectomy for cholelithiasis
ReproductiveQHex AllergiesQ(Food, Drug,QEnvironmental,Qetc.)
Female: Age of menarche/menstruationQcycleQduratio
n/gravida para status/ChildbirthQhex/sexualQhexQandQc No knownQdrug allergies
oncerns/LMP/menopause
Breast/cervical screeningQ(ifQany)
Male: Sexual hexQandQconcerns/issuesQwithQfertilit
y (if any)/TesticularQorQprostateQscreeningQ(ifQappli List of Medications/supplements (prescription, OTC,
cable) ScreeningQforQSTI’sQ(ifQapplicable) complementaryalternativeQtherapies)
Pertinent sexualQhistory:QNotQsexually active an AntacidsQasQneeded forQ"heartburn"
ddenies any sexualQconcerns IbuprofenQ400Qmg threeQtimesQdailyQasQneededQforQkneeQpai
nQMultivitamins
Review of Systems:Q(ROS)QUseQthisQcolumnQt FromQtheQROS: list/highlightQtheQcurrentQsymptoms/complaints to generate
odocument theQROSQbelow. QaQlistQofQ“reported or denied”QsymptomsQbelow:
General: ReportsQsomeQweightQloss,Qfever,Qnigh
tsweats, and difficultyQsleeping PertinentQpositiveQROS:QReportsQsomeQweightQloss,Qfever,QnightQsweats, and d
HEENT: DeniesQheadaches,QchangesQinQvision, ifficultyQsleeping;QRUQQabdominalQthatQworsensQwithQfoodQandQpain scale of 2
-Q3/10QandQprogressesQtoQ6-7/10,Q6/10.QAnorexia,QnauseaQandQvomiting at onset.
7 IHIMAN=Ihuman CASE-STUDY-EVITA-
Q
ALONSO ,48YRS OLD FEMALE HISPANIC
Q Q Q Q
AMERICAN FEMALE CC= Abdominal-
Q Q Q
pain 3 Different version
Q Q
]
,CC: 48 y/o F HPI: pertinent s/s; +/- ROS/prior episodes/recent travel/ill contacts
Q Q Q Q Q Q Q
Chief complaint isQ aQ shortQ 1-
2 statementQ orQ wordQ phraseQfromQpatientQandQshouldQbeQ Mrs.QAlonsoQisQaQ48-year-
listed in “quotes” oldQfemaleQpatientQwhoQpresentedQtoQtheQclinicQwithQaQprogressive, intermittent ri
ghtQupperQquadrantQpainQforQtheQpastQ2QweeksQandQwhichQhasQincreased in severit
“My stomachQhasQbeenQhurtingQreallyQbadQove yQinQtheQpastQ2Qdays.QTheQpainQradiatesQtoQtheQrightQshoulder.QSheQalso complains
QofQassociatedQsymptoms QlikeQnausea,Qvomiting,QanorexiaQsinceQthe past 2 days.
rthe past 2 seeks”
SheQhasQhadQpreviousQrecurrentQself-
resolvingQsymptoms overQtheQlastQoneQyear.QPainQusedQtoQbeQprecipitated by fast
food butQnotQoccursQwithQallQfoodsQandQunresponsiveQwithQantacids and NSAIDS.
Onset:Q2 weeksQago, withQsymptomsQbecomingQmoreQdreadfulQ2Qdays ago Locati
on:QRightQupperQquadrantQandQoccasionallyQradiatedQtoQtheQrightQshoulderDuratio
n: PainQhasQbeen constantQsinceQitQstartedQthisQtime;QinQtheQpastQitQonly lasted 1-
2 days.
Character:QCrampy gnawQachiness
Aggravating/alleviatingQfactors:QPainQgets worseQwithQmealsQand unresolved wit
hantacidsQandQNSAIDs
RelatedQsymptoms: Nausea.QVomiting,QanorexiaQwith onsetQofQsymptoms 2 da
ysago.QDenies any recentQexposureQtoQotherQillQcontacts. SheQhasQhad similar sy
mptomsQpreviously
Treatments: Has triedQOTCQantacidsQandQibuprofenQwithoutQrelief Significanc
e:QPainQstartsQwith aQscaleQofQ2-3QandQgets up toQ6-
7.QSheQreportsQpainhas keptQherQhomeQfromQwork.
PMHx child/adultQillness/hospitalizations/immunizatio Surh type/when/why/complications
Q
ns
Negative for anyQ chronicQ illnesses.Q SheQ hasQocc TubalQligation
asional heartburnQandQarthritis
Frequent episodesQofQcommonQcoldsQandQasQchil
dNo hospitalizations,QtraumaQorQotherQinjuries
, Immunizations:QStatesQherQimmunizationsQar
ecurrent. She hadQtheQinfluenzaQvaccineQthis
season and stillQgotQtheQflu.
Fahm TX
Grandparents (ifQknown)/Parents/siblings/children Tobacco/vaping/ETOH/illicitQdrugQuse/occupational/environmental/relationships
Grandparents- SheQreportsQthatQshe drinksQaQglassQofQwineQwithQdinnerQmostQnights; She deni
states no knownQhistoryQFatherQisQ70Qyears- esQany tobaccoQorQrecreationalQdrugQuse
old and still aliveQandQwellQ(70):QheartQdiseas
e, peptic ulcerQdisease
Mother is 69 years-
old and alive: breastQcancerQinQremission;Qcholec
ystectomy for cholelithiasis
ReproductiveQHex AllergiesQ(Food, Drug,QEnvironmental,Qetc.)
Female: Age of menarche/menstruationQcycleQduratio
n/gravida para status/ChildbirthQhex/sexualQhexQandQc No knownQdrug allergies
oncerns/LMP/menopause
Breast/cervical screeningQ(ifQany)
Male: Sexual hexQandQconcerns/issuesQwithQfertilit
y (if any)/TesticularQorQprostateQscreeningQ(ifQappli List of Medications/supplements (prescription, OTC,
cable) ScreeningQforQSTI’sQ(ifQapplicable) complementaryalternativeQtherapies)
Pertinent sexualQhistory:QNotQsexually active an AntacidsQasQneeded forQ"heartburn"
ddenies any sexualQconcerns IbuprofenQ400Qmg threeQtimesQdailyQasQneededQforQkneeQpai
nQMultivitamins
Review of Systems:Q(ROS)QUseQthisQcolumnQt FromQtheQROS: list/highlightQtheQcurrentQsymptoms/complaints to generate
odocument theQROSQbelow. QaQlistQofQ“reported or denied”QsymptomsQbelow:
General: ReportsQsomeQweightQloss,Qfever,Qnigh
tsweats, and difficultyQsleeping PertinentQpositiveQROS:QReportsQsomeQweightQloss,Qfever,QnightQsweats, and d
HEENT: DeniesQheadaches,QchangesQinQvision, ifficultyQsleeping;QRUQQabdominalQthatQworsensQwithQfoodQandQpain scale of 2
-Q3/10QandQprogressesQtoQ6-7/10,Q6/10.QAnorexia,QnauseaQandQvomiting at onset.
