Case #1: A 64-year-old man presents to the emergency department (Links to an external site.) with abdominal pain and distention, as well as constipation of 8 days’ duration. He denies vomiting, fever, diarrhea, or dysuria. Except for hypertension, he is otherwise healthy with no prior surgeries.
His vital signs are normal except for a borderline pulse of 99 bpm. His physical examination is unremarkable except for his abdomen, which is large, rotund, and tympanitic. There is diffuse tenderness everywhere in the abdomen.
- What history would you want to obtain?
- What differential diagnoses would you consider?
- List and describe the specific diagnostic tests you might order to determine cause of his concern?
Kyle is a 58-year-old man who is experiencing lower abdominal discomfort nausea and diarrhea lasting 2 days. He thought he had eaten something that “disturbed his stomach” but since this has lasted so long, he is afraid it’s something serious.
- As you obtain a history from this patient what differential diagnoses are you considering. Give rational for your choices.
- Discuss the pathophysiologic relationship between nausea and vomiting?
Three days after Kyle’s initial visit his labs confirmed a diagnosis of cirrhosis.
- Discuss the pathophysiologic relationship between cirrhosis and portal hypertension.
Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position and suggestions.