Case Study 2 PDF

**[Case Study 2]** **Question 1:** - The nurse should be alert for any concerning alarm symptoms in clients who have acute **abdominal pain** - **Nausea and vomiting** may occur from an obstruction to gastric emptying (e.g., ileus) or an inflammatory or infectious process...

**[Case Study 2]** **Question 1:** - The nurse should be alert for any concerning alarm symptoms in clients who have acute **abdominal pain** - **Nausea and vomiting** may occur from an obstruction to gastric emptying (e.g., ileus) or an inflammatory or infectious process (e.g., cholecystitis, pancreatitis). Persistent **vomiting **can also lead to fluid and electrolyte imbalances. - **Hypoactive bowel sounds** indicate reduced gastric motility, which can be related to an emergent condition such as ileus or peritonitis. - **Presence of blood in the stool **or emesis should concern the nurse for a possible GI bleed**.** - Elevated **temperature (e.g., 100.1 F \[37.8 C\]) **in a client with abdominal pain usually indicates an infectious or inflammatory process (e.g., appendicitis, cholecystitis, diverticulitis). - **Incorrect:** - **Pulse 104 + BP 130/83 mmHg** = Mild tachycardia** **and borderline hypertension most likely represent physiologic responses to the stress and pain of acute illness.  **Question 2** - **Diverticulitis** occurs **more commonly in elderly clients** when sac-like protrusions of the colon wall (i.e., diverticula) become inflamed. The inflammation causes **fever**. Diverticulitis most often affects the sigmoid or descending colon, causing** pain **and **tenderness in the left lower quadrant**. Compression and erosion of vessels adjacent to the diverticulum cause rectal bleeding and **blood in the stool**.  - **Appendicitis** occurs most commonly in adolescents when pressure and bacteria build up in the lumen of an obstructed appendix (e.g., obstructed by stool, mass, etc.). Infection and inflammation cause **fever**. Appendicitis causes *periumbilical *or *right *lower quadrant pain at [McBurney point]. The inflamed appendix irritates the nearby peritoneum, causing severe **abdominal tenderness to palpation**. - **Ulcerative colitis** is a form of inflammatory bowel disease usually presenting in clients under age 30. The innermost layers of the colon repeatedly become inflamed, beginning in the rectum and advancing to the entire colon. This produces **crampy abdominal pain** over the rectum region (i.e., the **left lower quadrant**). Inflammation causes **fever** and **tenderness to palpation**, especially during acute flares. Ulcerative lesions erode into the rectal wall, producing **blood in the stool**. - Diverticulitis, appendicitis, and ulcerative colitis cause fever and abdominal tenderness. - Appendicitis pain localizes to the right lower quadrant and does not cause bloody stools.  - Diverticulitis and ulcerative colitis cause bloody stools.  - Appendicitis and ulcerative colitis occur in younger clients **Question 3** -