American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla Assessment

American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla Assessment American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla Assessment Discussion 4 As you know, abdominal pain can be a challenging patient complaint because it is frequently benign, but can also herald serious acute pathology. The history and physical examination are critical to narrowing the differential diagnosis of abdominal pain and guiding the evaluation. Acute abdominal pain frequently requires urgent investigation and management. Some patients may require the assessment of their airway, breathing, and circulation, followed by appropriate resuscitation. Many patients will require analgesics, which can be administered judiciously without compromising the physical assessment of peritoneal signs. That said, what are the common differential diagnoses of abdominal pain in emergency situations? Also, does your healthcare institution have a specific policy, algorithm and/or protocol on how to assess, manage, and treat abdominal pain? Please share an example of the protocol for abdominal pain from practice or the literature. American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla Assessment Sample Discussion Solution From this week’s readings, we learn that not only is abdominal pain a challenging complaint due to its many potential pathologies, but it also may be referred pain from an area in or outside of the abdomen. Both the general patient history and history of the chief complaint are important aspects in addressing abdominal pain. “The following three processes can produce abdominal pain: (1) tension in the GI tract wall from muscle contraction or distention, (2) ischemia, (3) inflammation of thee peritoneum. Pain can also be referred from within or outside the abdomen (Dains et al., 2016).” In the Lippincott Williams and Wilkins (2013) text, the abdominal pain interviewing process includes asking about the location, quality, onset, duration, frequency, and severity of signs and symptoms as well as what precipitates and relieves these symptoms. They outline interviewing the patient regarding their past health, current health, family health and psychosocial health as well. These factors are important in helping the provider determine possible differential diagnosis. “In adults, acute pain requiring immediate surgical intervention is commonly caused by appendicitis, perforated peptic ulcer, intestinal obstruction, peritonitis, perforate diverticulitis, ectopic pregnancy, or dissection of aortic aneurysm. Other common causes of acute pain include cholelithiasis, gastroenteritis, peptic gastroduodenal syndrome, pancreatitis, pelvic inflammatory disease (PID), or urinary tract infection (UTI) (Dains et al., 2016).” With there being many possible causes of abdominal pain, it is important not to rule options out too quickly or become focused on one sign or symptom without doing a complete history and physical. The acute abdominal pain order set for my hospital auto-populates the following orders: Vital signs Q4 with intake and output Diet: NPO, dietician consult IV Fluids: D5 1/2 Kcl @ 60ml/hr PRN Meds: Zofran 4mg IV Q6, Tylenol 650mg Q6 for temp, Morphine 4mg IV Q3 for severe pain or Dilaudid 1mg Q3 for severe pain Scheduled Meds: Pepcid IV 20mg Q12 Labs: CBC, BMP, Hepatic function, Mag, UA *If patient is over 50 consider EKG Radiology – RA Chest 2 views, RA abdomen series, RA upper GI, RA barium enema (ARMC, 2020). The order set can be adjusted based on the scenario and individualized based on the patient. References AtlantiCare Regional Medical Center (ARMC). (2020). Abdominal Pain Order Set. Retrieved from PowerChart Orders. Dains. J. E., Ciofu Baumann, L., & Scheibel, P. (2016). Advanced Health Assessment and Clinical Diagnosis in Primary Care (5th ed). Elsevier. Lippincott Williams & Wilkins (Ed.). (2013). Assessment Made Incredibly Easy (5th ed.). Wolters Kluwer. 405 words Permalink In reply to Jennifer Re: Discussion 4 – American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla Assessment by Dona – Thursday, October 15, 2020, 3:22 PM Well done. Describe the common signs and symptoms of gastritis. 10 words American Sentinel N522PE Module 4: Gastrointestinal, Breast and Axilla A ssessment Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10