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NR 509 Gastrointestinal Physical Assessment Assignment Lifespan
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Gastrointestinal Physical Assessment Assignment Results | Turned InAdvanced Health Assessment - Chamberlain, NR509-October-2018
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Your Results Lab Pass
Overview Lifespan Activity Time: 112 min
Transcript
Tina’s 10-year-old neighbor vomits every morning before school. What additional
Subjective Data Collection assessments would you perform, and what might you discuss with her? Why?
Objective Data Collection
Education & Empathy
Student Response:
I would get a thorough GI history including diet, the time she eats, nausea onset, consistency/color of vomitus
Documentation
(stomach acid, undigested food, etc). I would try to rule out any food allergies and obtain lab work including
CBC and BMP to assess for dehydration and infection. I would auscultate her abdomen for bowel sounds and
Lifespan
palpate for any masses or abnormalities. I would also assess for any other symptoms and discuss possible
anxiety related problems since this happens only before school. I would discuss any sources of anxiety
Review Questions
including grades, bullying, difficulty learning and peer pressure. I would probably also obtain a urine drug
screen to rule out any other substances that could be causing this.
Self-Reflection
Model Note: A concise history of symptoms is indicated including diet, time of nausea onset, and presence
of any other symptoms. Her abdomen should be auscultated for bowel sounds, and palpated for masses. If no
other symptoms are present and the vomiting occurs only before school, it is likely that the symptom is anxiety-
related. The provider should ask her about the source of anxiety, with special attention to bullying, abuse, peer
pressure, and difficulty with content comprehension. The anxiety needs to be resolved to avoid trauma to her
esophagus and dentition from stomach acid. A referral for counseling will be helpful.
Tina’s 60-year-old godmother complains of constipation, cramps, and bloody stool. List
your differential diagnosis. What additional assessments would you perform?
Student Response:
Differential diagnosis includes hemorrhoids, diverticulitis, colon cancer, bowel obstruction, fecal impaction, and
anal fissure. Additional assessments include a thorough GI exam and interview including diet, history of
symptoms, bowel habits, the onset of pain, nausea, and vomiting. A thorough medical history including any
previous abdominal surgeries, imaging and diagnoses should be obtained. A rectal exam should be performed
for any external hemorrhoids and digital exam for any internal hemorrhoids, fissures or fecal impaction. The
abdomen should be palpated for masses and a consult to GI specialist for colonoscopy to visualize any polyps
indicating diverticulitis or masses indicating cancer.
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