{"id":19093,"date":"2020-12-05T12:46:07","date_gmt":"2020-12-05T12:46:07","guid":{"rendered":"http:\/\/onlineclassesguru.com\/?p=19093"},"modified":"2020-12-05T12:46:07","modified_gmt":"2020-12-05T12:46:07","slug":"joshua-phelps-37-arrives-at-the-ed-complaining-of-right-lower-quadrant-abdominal-pain-you-obtain-his-vital-signs-and-find-out-that-he-has-no-known-allergies-and-takes-no-medications","status":"publish","type":"post","link":"https:\/\/onlineclassesguru.com\/index.php\/2020\/12\/05\/joshua-phelps-37-arrives-at-the-ed-complaining-of-right-lower-quadrant-abdominal-pain-you-obtain-his-vital-signs-and-find-out-that-he-has-no-known-allergies-and-takes-no-medications\/","title":{"rendered":"Joshua Phelps, 37, arrives at the ED complaining of right lower quadrant abdominal pain. You obtain his vital signs and find out that he has no known allergies and takes no medications."},"content":{"rendered":"<style type=\"text\/css\"><\/style><p>Caring for Clients with common Digestive\/ Gastrointestinal Health Challenges.<\/p>\n<p>Select any three (3) questions from Case Study # 1 or from Case Study # 2, and discuss the rationale by posting\/ responding in the online learning activity\/ discussion forum. Please identify the case study selected and copy the three questions chosen directly into the post. Include and properly reference information taken from the course readings to support your ideas.<\/p>\n<p>CASE STUDY #2<\/p>\n<p>(must be 3 pages with at least 5 references no older than 5 years)<\/p>\n<p>Joshua Phelps, 37, arrives at the ED complaining of right lower quadrant abdominal pain. You obtain his vital signs and find out that he has no known allergies and takes no medications. His BP is 156\/ 94; pulse, 100 and regular; respirations, 20; and temperature, 99.6 F (37.6 C).<\/p>\n<p>What is the next step in investigating his problem?<br \/>\nMr. Phelps\u2019 pain began last evening and is associated with nausea, but he hasn\u2019t vomited. Eating doesn\u2019t seem to affect the pain, and he hasn\u2019t had any bowel or bladder changes.<\/p>\n<p>In assessing Mr. Phelps\u2019s pain, what information should you obtain?<br \/>\nMr. Phelps describes his pain as constant, deep and achy, and worse with movement. On a pain scale of 0- to 10, with 10 being the worst pain he has ever experienced, he rates the pain at a 7. He doesn\u2019t want to lie supine and is guarding his right lower quadrant.<\/p>\n<p>When assessing Mr. Phelps\u2019 abdomen, describe the order and specifics associated with the assessment?<br \/>\nAbdominal assessment shows a normal inspection, normoactive bowel sounds, and no masses, enlargement, or tenderness of the liver or spleen. However, Mr. Phelps did display rebound tenderness and positive obturator and iliopsoas signs. Based on his history and physical assessment, the healthcare provider orders a complete blood cell count and urinalysis. The results indicate a total white blood cell (WBC) count elevation with 96% neutrophils. The urinalysis is normal.<\/p>\n<p>Mr. Phelps\u2019 signs and symptoms, history, physical assessment, and lab findings suggest which diagnosis? Explain your rationale.<br \/>\nAbdominal aortic dissection.<br \/>\nAcute appendicitis.<br \/>\nRenal calculi.<br \/>\nAcute Cholecystitis.<\/p>\n<p>ONE PAGE OF SELF REFLECTION on<br \/>\nWhat is my knowledge concerning providing care for and with clients experiencing digestive and gastrointestinal challenges? (i am a community rpn)<\/p>\n<p>ONE PAGE OF REFLECTION ON MY PEER WORK ( TWO REFERENCES)<br \/>\nCase Study #2<br \/>\n1) In assessing Mr. Phelps\u2019s pain, what information should you obtain?The information that should be obtained about Mr. Phelps\u2019s pain include:<br \/>\nCharacter of the pain: deep and achy<br \/>\nDuration: States it\u2019s constant<br \/>\nFrequency<br \/>\nWhat makes the pain worse or better: movement makes it worse, lying supine<br \/>\nLocation: right lower quadrant<br \/>\nDistribution of referred pain<br \/>\nTime pain started: last evening<\/p>\n<p>2) When assessing Mr. Phelps\u2019 abdomen, describe the order and specifics associated with the assessment?<\/p>\n<p>Start with inspecting the abdomen noting colour, contour, symmetry, the umbilicus is midline etc.<br \/>\nNext we would auscultate because \u201cpercussion and palpation can increase peristalsis which would give a false interpretation of bowel sounds\u201d (Jarvis, 2014). During auscultation we listen for bowel sounds(character and frequency) and vascular sounds.<br \/>\nPercussion comes next \u201cto assess the relative density of abdominal contents, to locate organs, and to screen for abdominal fluid or masses\u201d(Jarvis, 2014).<br \/>\nPalpation is last. You note whether their is tenderness, masses, involuntary rigidity, guarding etc.<\/p>\n<p>3) Mr. Phelps\u2019 signs and symptoms, history, physical assessment, and lab findings suggest which diagnosis? Explain your rationale.<\/p>\n<p>Mr. Phelps\u2019s assessments suggest acute appendicitis based on the following findings:positive obturator and iliopsoas sign, pain in RLQ. \u201cwhen the iliopsoas muscle is inflamed (which occurs with an inflamed or perforated appendix) pain is felt in the RLQ\u201d (Jarvis, 2014)<br \/>\nRebound tenderness<br \/>\nPain aggravated by movement<br \/>\nNausea<br \/>\nFever<br \/>\nTotal white blood cell count elevation with 96% neutrophils<\/p>\n<p>References<\/p>\n<p>Jarvis, C. (2014). The Abdomen, Physical Examination and Health Assessment (2nd CanadIan ed., pp 557-569). Toronto, ON: Elsevier Canada.<\/p>\n<p>ALSO SEND ME A COPY OF THE REFERENCES THAT YOU WILL USE<\/p>\n<p><center><a href=\"http:\/\/onlineclassesguru.com\/orders\/ordernow\"><img decoding=\"async\" src=\"https:\/\/encrypted-tbn0.gstatic.com\/images?q=tbn:ANd9GcTyj99p60XCLyLk1htB7-1neRt8-2QdnenNlQ&usqp=CAU\"target=\"_http:\/\/onlineclassesguru.com\/orders\/ordernow\"\/><\/center><p>","protected":false},"excerpt":{"rendered":"<p>Caring for Clients with common Digestive\/ Gastrointestinal Health Challenges. Select any three (3) questions from Case Study # 1 or from Case Study # 2, and discuss the rationale by posting\/ responding in the online learning activity\/ discussion forum. Please identify the case study selected and copy the three questions chosen directly into the post&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-19093","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v17.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Joshua Phelps, 37, arrives at the ED complaining of right lower quadrant abdominal pain. You obtain his vital signs and find out that he has no known allergies and takes no medications. - onlineclassesguru<\/title>\n<meta name=\"description\" content=\"Joshua Phelps, 37, arrives at the ED complaining of right lower quadrant abdominal pain. 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