Q

QuestionNursing

Before beginning the focused history and physical examination, it is important to introduce yourself to the patient, Mrs. Esther Park, and obtain her consent. Explain the process and your role as a healthcare provider in Shadow General Hospital's emergency department. Wash your hands and put on appropriate personal protective equipment (PPE) to ensure a clean and safe environment.

Begin by asking Mrs. Park about her current abdominal pain, including: - Onset: When did the pain start? - Character: What does the pain feel like (sharp, dull, cramping, etc.)? - Location: Where is the pain located? Does it radiate to any other areas? - Duration: How long has the pain lasted? - Severity: Rate the pain on a scale of 1 - 10. - Exacerbating/Alleviating factors: What makes the pain better or worse? Additionally, ask about any associated symptoms such as nausea, vomiting, fever, chills, changes in bowel movements, or urinary symptoms. Inquire about her past medical history, surgical history, medications, allergies, and social history (smoking, alcohol, and drug use).

Perform a general inspection of Mrs. Park, observing her overall appearance, level of distress, and any visible abnormalities. Then, proceed with the focused physical examination: A. Vital signs - Measure blood pressure, heart rate, respiratory rate, temperature, and oxygen saturation. B. Head, Eyes, Ears, Nose, Throat (HEENT) examination - Inspect the head for trauma, swelling, or asymmetry. - Examine the eyes for redness, discharge, or pupil reactivity. - Check ear canals and tympanic membranes. - Inspect the nose for any obstruction or discharge. - Examine the oral cavity for lesions, dental issues, or signs of dehydration. C. Neck examination - Inspect the neck for swelling, tenderness, or deformities. - Palpate the thyroid gland and lymph nodes. - Perform active range of motion (ROM) testing. D. Chest examination - Inspect the chest for symmetry, deformities, or scars. - Palpate for tenderness, crepitus, or heaves. - Percuss for any dullness or hyperresonance. - Auscultate for breath sounds, wheezes, or crackles. E. Cardiovascular examination - Inspect the heart for any visible pulsations or deformities. - Palpate the apical pulse and peripheral pulses. - Auscultate for heart sounds, murmurs, or rubs. F. Abdominal examination - Inspect the abdomen for distention, scars, or visible masses. - Auscultate for bowel sounds. - Percuss for liver size and any areas of dullness or hyperresonance. - Palpate for tenderness, guarding, rigidity, or palpable masses. G. Musculoskeletal examination - Inspect the spine for any deformities, tenderness, or scoliosis. - Test active ROM of the spine, hips, and shoulders. H. Neurological examination - Test mental status, cranial nerves, motor function, sensory function, and reflexes.

Document all findings from the focused history and physical examination in Mrs. Park's medical record. Communicate your findings with the healthcare team and determine the appropriate course of action for her care.