How would you structure your assessment of this presentation, give rationale for why you are assessing in the way that you describe?

NURS8751 Principles Of Emergency Nursing
Question:
Gastrointestinal Scenario 1: My Stomach Hurts
A 25 year old woman presents to the department with 7/10 abdominal pain. She has had worsening pain over the past three weeks with multiple episodes of non bloody loose stools every day. She does not feel nauseous and has not vomited. She has lost 4 kilos over the last 3 weeks. She smokes 30 cigarettes a day, she does not take any medications except for NSAIDs for headaches, which she gets every two to three weeks. The right lower quadrant of her abdomen is painful to palpate. No joint effusions or skin lesions are noted. She said she had a blood test done last week because she felt so tired and her Hb was 11gd/L. (110 g/L) She said that the GP was not concerned and that he told her all her other blood results were normal. She said her menstrual cycle is regular and she tells you she is not pregnant. Her vital signs are:

BP 100/60

Pulse 88

Resp rate 17

Sats 98%

Temp 37.5

Discussion:

What triage score would you give this patient?
List the provisional diagnoses/potential problems?
How would you structure your assessment of this presentation, give rationale for why you are assessing in the way that you describe?
What examinations and/or diagnostics would you like to do or have the doctor arrange? Give rationale, what are you trying to rule in or rule out by performing the tests or examinations?
What pain management would you think suitable in this instance, give rationale?
Scenario 2: ‘She Is So Hot, I Am Really Worried!’
A mother brings a 6 week old baby into the emergency department suffering from a high fever, diarrhoea and vomiting. The mother tells you that the baby has not been feeding properly, has been crying and has not slept very well for the last 24 hours. The mother said that her 3 year old son has the same illness but is recovering. You do a quick physical examination of the baby who is slightly blue around the lips, has a sunken fontanelle and is not very responsive to your physical examination.

Discussion:

Answer the following questions and post to the discussion forum as your 3rd post for assignment 1.

What Triage score would you give this patient?
List the provisional diagnosis/potential problems?
Name at least 5 key elements when taking a history for paediatric presentations.
Would antipyretic therapy be recommended why or why not?
What is the most important parameter to be collected for actual and potential fluid and electrolyte imbalances? How do you accurately obtain this data?

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