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In: Nursing

You are the triage nurse in the Emergency Department. Your patient, Mr. Sawyer, is a 48...

You are the triage nurse in the Emergency Department. Your patient, Mr. Sawyer, is a 48 year old man who presents with severe abdominal pain, poor appetite, and fatigue. He states the pain awakened him from sleep and he began vomiting. He denies any relief from the pain and he can’t get comfortable as the pain radiates to his back and right shoulder. He rates his current pain level as 10/10. He denies any previous medical or surgical history. He denies any tobacco or drug use. States he drinks “just a beer or two after work each day” though he reports to “more than usual” alcohol consumption this past weekend after attending a bachelor party. He lives with his wife and 2 children and works fulltime as a construction foreman. Initial vital signs: BP 160/94, resp 24, pulse 100, temp 99.6 orally, pulse ox 99%.

Based on the Review of Systems (ROS) questions for the abdominal system what additional information would you want to elicit from Mr. Sawyer to assist you in analyzing his symptoms?

Solutions

Expert Solution

As a triage nurse, I would assess Mr. sawyer based on the following history.

1. Assess the abdominal pain based on the PQRST.

  • P - Position, provoking factors.
  • Q - Quality of the pain, ( what kind of pain).
  • R - Region( location), and radiation. ( where the pain is located exactly).
  • S - Severity of pain.(whether the pain is bad).
  • T - Time of onset, progression, and intensity.(how it began).

2. Assess the associated symptoms such as nausea, vomiting, anorexia, bowel sounds, diarrhea.

3. Assess for any genitourinary infection or the inflammatory condition such as cholecystitis, appendicitis, and symptoms of dysuria, Pyuria.

4. Collect history of current medications such as steroids, NSAIDS, immunosuppressant agents, narcotics which will affect the gastric mucosa.

5. Alcohol consumption: the amount, frequency and its previous complication.

6. Detailed family history.

7. Complete physical examination to be done which includes inspection, auscultation, and percussion.

Nightingale answered 2 years ago
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