Determine the location severity and timing of his pain

Reference no: EM133616755

Assignment: Advanced Nurse Practice in Reproductive Health Care

Mr. Max Fisher is an 77-year-old male presenting to the office after having several days of abdominal pain. He lives independently in his home of 45 years. He has been a widow for 3 years and now lives alone.

CC: "I have stomach pain."

HPI: Max started feeling pain in his abdomen 3 days ago. He generally has normal, regular bowel movements. He has been experiencing cramping abdominal pain, nausea and now some vomiting.

PMH: gastroesophageal reflux disease (GERD), hypertension (HTN), and a pacemaker placed 10 years ago for third-degree heart block. He presents today with a complaint of abdominal pain.

You suspect a bowel obstruction in Max, with complaints of cramping abdominal pain, nausea, and vomiting for 3 days.

Describe six ROS questions you would explore further with him to determine the location, severity, and timing of his pain.

PE: The abdomen appears distended; Max has generalized tenderness over the epigastric region on palpation. He is guarding so the exam is limited. Bowel sounds are decreased.

His vital signs are normal. He describes his abdominal pain as 7/10.

As the APRN, you order an abdominal x-ray. RESULTS: The abdominal x-ray is indeterminate. What are your next diagnostic choices to determine a bowel obstruction in this patient?

List at least three differential diagnoses for abdominal pain in your SOAP note.

Reference no: EM133616755

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