Question

Week 6: Assessment of the Abdomen and Genitourinary System No unread replies. 1 1 reply. This week's graded discussion topic relates to the following Course Outcomes (COs). CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1) CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1) CO3 Utilize effective communication when performing a health assessment. (PO 3) Amira is a 27-year-old Syrian refugee who has been residing in a local homeless shelter since her arrival here in the United States 4 weeks ago. She was brought into the emergency room this morning via squad after being found by a shelter employee sitting in a pool of blood on the bathroom floor crying and holding her abdomen. Due to her limited English speaking abilities, she is unable to provide specific details as to her complaints but the shelter employee states that she has recently stopped eating and has not looked well for the past couple of days. Based on the limited information provided, please answer the following questions. How will you prioritize your care of Amira, what assessments will you complete, and in what order? Please provide rationale for choosing this order. Are there any cultural beliefs/practices that must be taken into consideration when planning her care? Considering her symptoms of abdominal pain and bleeding, is it possible that her status as a homeless refugee is a causative or contributing factor to her illness? Please provide rationale for your response.

Answer 1

How will you prioritize your care of Amira, what assessments will you complete, and in what order? Please provide rationale for choosing this order. Are there any cultural beliefs/practices that must be taken into consideration when planning her care? Considering her symptoms of abdominal pain and bleeding, is it possible that her status as a homeless refugee is a causative or contributing factor to her illness? Please provide rationale for your response.

Foremost thing Amira needs some translation expert to express her needs and explain her condition.

• Introduce myself to her through the translator , I would check the heart rate(vital signs) as she was bleeding profusely.
• Secure a intravenous access and send grouping &cross matching to provide fluids and blood transfusion.
• Connect her to continuous cardiac monitoring
• Complete physical examination especially abdominal examination and detailed history and a stat pregnancy test.
• Look for signs of hypovolemic shock like tachycardia, confusion,pallor, hypotension as she was bleeding and note for sepsis.
• Complete blood count ,emergency pelvic sonogram can be made.
• Intravenous opioid analgesia can be given to relieve pain
• Rectal and vaginal examination should be done to rule out cause and to find out the area of bleeding.Take a consent before doing these examinations.
• She may have a miscarriage, ectopic prenancy , peritonitis, ruptured aneurysm, pyelonephritis and sepsis too. So collect her marriage and sexual history.
• Being a homeless women refugee, she is more vulnerable to sexual assault, reproductive illnesses and any exposure to sexually transmitted diseases.
• As she is homeless she would have lacked access to health care and also nutritious food.
• Being a syrian , she may be a muslim. Muslim in middle east countries donot visit hospitals until they have some serious problems . According to them diseases are punishment of God . So she needs counselling and mental health assistance too.
• She needs to be examined by female only according to her cultural beliefs , so a female physician should be made to take care of Amira.

Thus Amira needs rest and needs nutritious assistance to regain her health both physically and mentally.