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A detailed medical examination of a patient presenting with abdominal discomfort and constipation. The examination includes a thorough inspection and palpation of the abdomen, as well as auscultation and percussion to assess the patient's condition. The examiner asks a series of questions to gather more information about the patient's symptoms, medical history, and lifestyle factors that may be contributing to the constipation. The examination findings suggest the patient is experiencing constipation, with a palpable mass in the left lower quadrant of the abdomen. A comprehensive overview of the steps taken by the examiner to evaluate the patient's condition and reach a preliminary diagnosis. This information could be useful for medical students or healthcare professionals studying abdominal examination techniques and the assessment and management of constipation.
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Hello! Question 07/12/20 3:30 PM EDT Hi. I'm Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. Pay close attention to this information as it will help guide your exam. At the end of this prebrief, you will answer a short question about the upcoming assignment. During the simulation, you may return to these instructions at any time by scrolling to the top of your transcript. What are my objectives in this assessment? Question 07/12/ 3:31 PM EDT In your interview with Ms. Park, you will ask about the history of her presenting illness and the functioning of relevant systems in order to obtain subjective data related to her abdominal pain. If you discover any disease states, ask about symptoms and the patient's experiences of them. Your questioning should cover a broad array of the symptoms' characteristics. In addition to collecting subjective data, you will perform a physical exam on Ms. Park to gather objective data about her health and physiology. Throughout the conversation, you should educate and empathize with Ms. Park when appropriate to increase her health literacy and sense of well-being. While you should communicate with patients using accessible, everyday language, it is standard practice to use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes. You may complete the exam activities in any order and move between them as needed.
What is the situation? Question 07/12/ 3:32 PM EDT Your patient is Esther Park, a 78-year-old Korean-American woman presenting with abdominal pain in Shadow General Hospital's Emergency Department. Your role in this simulation is that of a healthcare provider who will conduct a focused history and physical examination of Ms. Park in order to assess her condition and transfer her care. What else will this exam involve? Question 07/12/ 3:33 PM EDT You will complete nursing tasks to protect the patient's safety, privacy, and health. You can document your findings, including vital signs, in the Electronic Health Record. This record provides necessary information for healthcare professionals who will continue patient care. You will then move onto the Care Plan activity, in which you will synthesize your subjective and objective data to complete the nursing process. You will develop a nursing diagnosis for Ms. Park's condition, identify a treatment goal, plan your interventions and evaluations, and finally assess if your goal was achieved. How will I be evaluated? Question 07/12/ 3:34 PM EDT
In this assessment, you will become familiarized with the structure and content of an abdominal focused exam so that with real-life patients, you can: º ask effective and comprehensive questions º obtain and assess objective data º educate and empathize with the patient º develop a nursing diagnosis º create an effective and expedient care plan º and evaluate your results to determine your goal's achievement. In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: In a geriatric patient, what are some common considerations regarding abdominal pain? Common considerations regarding abdominal pain are constipation, immobility, and bed bound, which leads to constipation and obstruction. Statement 07/12/ 3:38 PM EDT
Time to begin. Hi Esther. My name is Tony and I will exam you, Greet 07/12/ 3:38 PM EDT Hello, dear. Measured vitals Exam Action 07/12/ 3:39 PM EDT what brings you in today Question 07/12/ 3:40 PM EDT
im sorry to hear Empathize 07/12/ 3:43 PM EDT I appreciate your saying that. where is the pain Question 07/12/ 3:43 PM EDT The pain and discomfort is down low in my belly. does the pain radiate Question 07/12/ 3:44 PM EDT
I wouldn't say that, no. It's more of a general pain that stays in one place. how would you rate your pain Question 07/12/ 3:44 PM EDT It has its ups and downs. At the moment, I'd say it's a 2. what does the pain feel like Question 07/12/ 3:44 PM EDT I'd say it's cramping and... a dull, cramping feeling, yes.
No. Those over-the-counter medicines... Tylenol--they say it's very bad for the stomach. do you take laxatives Question 07/12/ 3:46 PM EDT No. I can't imagine they are very good for you. how has pain affected your life Question 07/12/ 3:46 PM EDT I can do all of my daily activities.. .it just takes me longer. I'm just tired and in pain.
does eating aggravate pain Question 07/12/ 3:47 PM EDT Yes. The pain is there all the time, but eating can make it worse. do you have constipation Question 07/12/ 3:48 PM EDT It certainly feels that way. i am sorry to hear that Empathize 07/12/ 3:48 PM EDT
sorry to hear that. Empathize 07/12/ 3:48 PM EDT Thank you much. when did you have constipation Question 07/12/ 3:51 PM EDT I don't usually have problems going to the bathroom, but this has been going on for... about five days now. It's taken quite a toll. when did you notice you have constipation (Clarified to Have you been constipated?.) Question 07/12/ 3:51 PM EDT
Absolutely. I feel it now, and it's been like this for five days. (Clarified to if I have been constipated.) was your diarrhea sudden Question 07/12/ 3:52 PM EDT It came on all of a sudden and only lasted a day--a few bouts of it over the course of a day. what does your stool look like Question 07/12/ 3:53 PM EDT My stool? Usually it's brown, not too hard. Solid. Not watery.
I've been going slightly less often because... well, I've been little less thirsty than usual. you should drink more water. Water is healthy for you! Educate 07/12/ 3:55 PM EDT Well, now I know. how does your urine look like Question 07/12/ 3:55 PM EDT Yellow and... maybe a bit darker than usual.
do you have bloody urine (Clarified to Is there blood in your urine?.) Question 07/12/ 3:55 PM EDT No, it seems normal enough to me. Maybe a little darker than usual. (Clarified to if I have blood in my urine.) tell me your name Question 07/12/ 3:55 PM EDT Esther Park. do you know where you are Question 07/12/ 3:55 PM EDT
when did you notice decrease thirst Question 07/12/ 3:56 PM EDT I haven't been as thirsty, so I only had a few sips of warm water today. I heard it helped stomach pain, but it didn't work for me. how often do you drink water Question 07/12/ 3:57 PM EDT A glass or two a day, I'd say. It's been too difficult to drink even that since all this started. do you drink caffeinated drinks Question 07/12/ 3:57 PM EDT
No. I avoid caffeinated drinks altogether. do you drink coffee Question 07/12/ 3:57 PM EDT No, I never do. do you drink soda Question 07/12/ 3:57 PM EDT No, I never do.