Question

Concept Map - Choledocholithiasis Mr. Tony Burk is a 60y/o retiree admitted to your unit from the emergency room. Upon arrival, you note that he is trembling and nearly doubled over with severe abdominal pain. The patient states that he has had severe upper right quadrant pain that radiates to his back, and he is more comfortable walking bent forward than lying down in bed. He admits to having bouts of abdominal pain in the past month but "none as bad as this". He states he feels only slightly nauseated but has experienced but has experienced nausea and vomiting during previous episodes. He states that he experienced this latest episode after eating fish and chips at a fast food restaurant. His daughter insisted he go to the hospital and has accompanied him to the floor. Assessment findings are: AAO X 3 and moves all extremities well. Moves restlessly and continuously; complains of notable fatigue. Heart sounds clear bilaterally in both anterior and posterior chest. Heart sounds clear without adventitious sounds, heart rate regular, all pulses +3 bilaterally. Abdominal guarding noted with exquisite tenderness to light palpation over the right side, especially the upper right quadrant. He has sharp respiratory arrest with palpation of the upper right quadrant. Patient reports light colored stools over the past week. Voids medium amber urine; denies pain or discomfort with voiding. Skin and sclera are slightly jaundiced. Vital signs on admission are: B/P 164/100, P 132, R 26, and T. 99.4 1. State the structures that are in the upper right quadrant of the abdomen 2. List two organs that can be palpated in the upper right quadrant 3. Discuss the significance of the vital signs. Revised 9/19

Answer 1

1) Structures that are in the right upper quadrant of the abdomen are right lobe of liver, Gallbladder, Rt kidney , Pancreas,Large and small intestine.

2) Organ palpated in right upper quadrant are liver and kidney.

3) Vital signs are measurements of the body most basic function .The four main vital signs routinely monitored are blood pressure,Pulse rate,Respiration rate and body temperature .

It helps in detecting or monitoring medical problems .