case study

Reason for seeking care: "I have pain in my stomach"

Mrs. KT is a 46 y/o female who comes into your clinic today because she has been experiencing pain in her upper abdomen for the past 3 months. She describes the pain as an "ache" that sometimes radiates into her right upper back and right shoulder. The pain gets worse after eating fatty or greasy foods, so she has eliminated these foods from her diet. She feels nauseated when the pain occurs and sometimes vomits. She denies fever or chills, weight loss, chest pain, diarrhea, constipation, melena, hematochezia, and dysuria. She has not been exposed to anyone who has been sick.

PMH: Denies any chronic illness. Healthy. NKDA. Taking no meds. Does not smoke, drink or use illicit drugs. PSH: Denies. PFH: Mother with gallbladder surgery in mid-40's.

1. What body systems would you assess for this patient and why?
2. What history questions do you need to ask this patient to screen forhealth behaviorsthat put her at risk?
3. What are the leading causes of mortality and morbidity for this gender and age group?

4. What screening tests are recommended for a female patient of this age?

a. Are there conflicting recommendations from different advisory bodies?

i. If so, which ones specifically and WHY do they conflict?

b. How would you, as the primary-care provider, make the appropriate determinations as to what to order based on the existing state of the evidence?

5.What health prevention screeningsare appropriate for this patient?

6.How would your current worldview or use of a nursing theory be utilized in your care for this patient?

7.What health promotion strategies are important for this patient at this point in time?