An adolescent client is seen for abdominal pain in the local ...

[maychende]

An adolescent client is seen for abdominal pain in the local clinic. The client states, The pain is sort of all over my belly. I can't really find one place that hurts more than another area.
 
  Based on the nurse's understanding about disorders of abdomen and associated symptomatology, which nursing diagnoses are appropriate for this client?
  Select all that apply.
  1. Acute pain.
  2. Hypothermia.
  3. Diarrhea.
  4. Altered urinary elimination.
  5. Altered nutrition, less than body requirements.

Question 2

The nurse is assessing the client's abdomen and notes dullness when percussing over the left lower quadrant. Which question is most appropriate for the nurse to ask the client at this time?
 
  1. How much alcohol do you drink?
  2. Do you have pain after eating?
  3. When was your last bowel movement?
  4. Have you ever had splenomegaly?

[raenoj]

Answer to Question 1

Correct Answer: 1, 3, 5
This client is most likely experiencing clinical manifestations associated with ulcerative colitis. Ulcerative colitis is a recurrent inflammatory process causing ulcer formation in the lower portions of the large intestine and rectum. This condition is common in adolescents and young adults. The client is currently experiencing diffuse acute pain. The client will commonly complain of diarrhea, and may experience weight loss. It would be unusual for the client to complain of hypothermia or have a lowered body temperature. The client with ulcerative colitis will not typically experience altered urinary elimination.

Answer to Question 2

Correct Answer: 3
Percussion over the abdomen produces tympany, and dullness is heard over the solid organs such as the liver and spleen. Dullness in the left lower quadrant may indicate the presence of stool in the colon. Dullness may also indicate an enlarged uterus, distended urinary bladder or ascites. Significant alcohol consumption may be associated with possible liver enlargement. The nurse would be able to percuss the liver in the right upper quadrant. Pain after eating is more likely to be associated with an upper gastrointestinal problem. Splenomegaly is associated with dullness while percussing the client's left upper quadrant.

[maychende]

Excellent

[parker125]

TYSM