Question

A 20-year-old undergraduate female comes to the emergency room complaining of lower abdominal pain, fever, and vaginal discharge for the last five days. 1. Name five items of nursing assessment which are required right now for this client. Which is most important? Item of assessment Priority 1-5 2. The provider writes out a list of possible diagnoses (differential diagnosis), below. How does the nurse's assessment help providers zero in on what's wrong? For each disorder, nae a nursing assessment which would confirm or rule out the diagnosis: Potential diagnosis Nursing assessments to confirm/rule out disorder. Can be a question, observation, subjective or objective. pelvic inflammatory disease (extreme infection of upper GU tract) Ectopic pregnancy (pregnancy not in the uterus) Urinary tract infection Appendicitis (infection in the bowel) Inflammatory or irritable bowel syndromes Psychosomatic pain (conversion of an emotional problem to pain) 3. How would the nurse get a history of the presenting complaint? Write out at least 5 questions to ask (consider PQRST or OLDCART): 4. The nurse asks about sexual behaviors. Is the client's answer to be accepted without question? Why or why not?

Answer 1

1. Item of Assessment: Observation , Auscultation, Palpation, Percussion

1. Obtain History of the patient(age, mensturation history)

2. Asses the level of pain, fever, evalute the vital signs

3. Perfom abdominal and pelvic examination for any abdominal tendeness or mass

4. Asses patient feelings

5. Update the physician with all the accurate details collected from the ptient

2. Pelvic Infalmmatory disease- Transvaginal ultrsound, laproscopic examination, endocervical swabs

Ectopic Pregnancy- Pelvic Ultrsound

Urinary tract infection- Level of pain( Suprapubic pain), Freqency, Urgency, Assess the characteristics of patinet's urine like color,cencentratuon, odor and cloudiness

Appendicitis- Could be both subjective and objective, Abdominal pain and rigidity, poorappetite, Elevated temparature, Nausea/Vomitting, rebound abdomina tenderness

Inflammatory or irritable bowel Syndrome- Observe for fever, chills, abdominal pain, cramping,bloody stools, physical excertion

Psychosomatic pain- Assessment of psychological factors affecting individual vulnerability, early life events,depression and anxiety

3. When taking the history of the patient make sure the communication or questions asked do not include any technical or medical trems, always prefer use the common language as the patient, like- When did the pain start, Where excatly do you feel the pain, How long does it lasts, Does any physical activity affects the pain, on a scale of 1-10 how serve do you rate the pain.

4. Not all the patinets will be comforatable when it comes to questioning of the sexual behaviours. In that case a form with questions related to sexual reintation should be give so that the patinets would find it confortable to fill in the details instead of face to face collection of information. If the client seems to be attentive the answers can be considered if any deviations are noticed in such cases the answer cannot be considered for certain, different methods can be used. Refer the following website for few details -https://cdn.dal.ca/content/dam/dalhousie/pdf/campuslife/studentservices/healthandwellness/LGBTQ/asking_the_right_questions.pdf