Summary NR667 / NR 667 VISE STUDY GUIDE (LATEST UPDATE)

hepatomegaly. Tympanic “drum-like” sounds heard upon percussion. Abdomen/femoral arteries intact. GU/Rectal Rectal inspection: No visible fissures, induration, or lesions. Rectal exam: Normal. No masses or stools on the rectal exam. Heme-occultnegative. No palpable masses e. ROM intact spineand extremities. No joint Large bowel obstruction erythema or tenderness. Normal muscular development. Normal gaiX X t. Ne throughout. X X Skin Abdominal Aortic Aneurysm Several small dark patches on the dorsal aspect of both hands otherwise, skin X X of normal color, texture and turgor; no lesions oreruptions. Mesenteric Ischemia X X Lymph No pathological lymph nodes in the cervical, supraclavicular, axillary orRetroperitoneal Hemorrhage X X clavicular chains. Small Bowel Obstruction X X Psych The mental examination revealed the patient was oriented to person, place,and time. The patient was able to demonstrate good judgment and reason, without hallucinations, abnormal affect or abnormal HIGH FLYER behaviors during the examination. Patient is not suicidal Key Findings History of diverticulitis Abdominal pain x3 daysAbsence of gas Periumbilical pain No blood in stoolNo stool x 2 days History of abdominal surgery Nausea Vomitin g Weakne ss Tachyca rdia Inability to urinate Pro m St Mr. Orlander is a 50 y/o African American male that presents to the clinic with a 3-day history of intermittent abdominal pain, nausea and vomitingthat has been progressively getting worse. PMH: diverticulitis. Currently on no medications. Deniesany hematochezia, hematuria, hematemesis, fever, chills, or night sweats. Physical exam reveals hyperactive bowel sounds, tenderness to palpationon abdomen and “drum” like sounds heard on percussion