NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

Walden University NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

Whether one passes or fails an academic assignment such as the Walden University NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

The introduction for the Walden University NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

After the introduction, move into the main part of the NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

Abdominal problems have adverse effects on the health and wellbeing of the patients. Nurses are expected to utilize their knowledge and skills in comprehensive history taking and patient assessment to develop accurate diagnoses and treatment plans for their patients. Therefore, this paper is an examination of J.R’s case study. J.R is a 47-year-old client that has come to the hospital with generalized abdominal pain for the last three days and nausea. The purpose of this paper is to examine the additional subjective and objective information to be obtained from the client, whether the case study has subjective and objective data, diagnostic investigations, and decision related to the developed diagnosis.  

Analysis of Subjective Portion 

Subjective data relates to that obtained from the patient. It focuses on the experiences of the patient with the health problem. Additional subjective information should be obtained from the patient to come up with an accurate diagnosis and treatment plan. One of the subjective data that should be obtained from the client is quantification of the abdominal pain. Information about the pain rating, severity, character, and relieving, precipitating, and aggravating factors should be obtained. The other aspect of the pain should focus on whether the pain is generalized, radiating to other body parts, or increasing or decreasing in intensity. The pain should also be described in terms of whether it is sudden or gradual. 

Moreover, the nature of diarrhea that the client reports should also be quantified. A focus should be placed on aspects such as the frequency of the diarrhea in a given period to determine if they client is dehydrated or not. The additional information about diarrhea include color of stool, relieving, aggravating, and precipitating factors. The provider should also obtain information about the dietary history of the client. Food poisoning could be a factor to consider in this client’s case. As a result, information about recent dietary habits and perceived hygiene of the foods should be obtained to determine the cause of the problem. The hygiene status and source of water that the client drinks should be obtained to ascertain whether the problem is a water-borne disease. Since the client has history of gastrointestinal bleeding, it would be necessary to ask about recent changes in color, smell, and texture of the stool prior to the current problems (Jarvis & Eckhardt, 2019). Such information will aid in ruling out causes such as ulcers of the gastrointestinal system.  

Analysis of Objective Position 

Healthcare providers obtain objective data using methods such as observation, palpation, percussion, and auscultation. The data is important in confirming or validating the subjective data given by the patient. Additional objective data should be obtained from the client. They include the general appearance of the client during the first encounter with the healthcare provider. The healthcare provider should provide a description of the grooming, energy levels, body weight, and if the patient is dehydrated or not.  The provider should have also assessed the patient for hydration status and jaundice by checking on skin turgor and sclera for jaundice. The patient should have also provided comprehensive abdominal assessment to determine whether there is distention, bowel movements, organomegally, distention of veins, and scars. The provider should have also palpated the abdomen for tenderness, rigidity, or any rebound tenderness. The information could have helped rule out causes such as bowel obstruction and organomegally (Jarvis, 2019). The objective data could have facilitated the development of an accurate diagnosis for the client.  

Analysis of the Assessment 

Objective and subjective data support the assessment of JR. Examples of subjective data that supports the assessment include information about diarrhea, nausea, stomach pains, past medical, medication, allergies, family, and social histories. Examples of objective data include the vitals and heart, lungs, skin, and abdominal findings.  

Diagnostic Tests 

Stool test is the most appropriate diagnostic investigation for JR. Stool analysis should be performed to determine if the client has an infection or the cause could be due to gastrointestinal bleeding. Blood tests such as complete blood count are also recommended to determine if the client has low hemoglobin level due to bleeding or elevated white blood cell count to indicate infection. Since the client has a history of gastrointestinal bleeding, it would be appropriate to perform abdominal ultrasound to determine the actual cause of the problem (Jarvis & Eckhardt, 2019).  

Rejecting/Accepting the Diagnosis 

I would accept the current diagnosis. Patients with gastroenteritis experience symptoms similar to those of JR. The symptoms include abdominal cramps, vomiting, nausea, and diarrhea. The infection is short-term, implying symptom resolution over time. JR reports that the pain severity has declined, implying a potential symptom resolution in gastroenteritis. He also complains of diarrhea, abdominal pain, and nausea, hence, the decision to accept the diagnosis (Bányai et al., 2018). The differential diagnoses to be considered include abdominal obstruction, colon cancer, and inflammatory bowel disease. The above differentials have patients experiencing either nausea, vomiting, diarrhea, or abdominal pains. However, it may not be abdominal obstruction due to the presence of diarrhea and absence of abdominal distention. Diagnostic investigations such as abdominal ultrasound are needed to rule out colon cancer. The patient does not have any predisposition to environmental triggers, hence, ruling out inflammatory bowel disease (Guan, 2019).  

Also Read:

DIGITAL CLINICAL EXPERIENCE: ASSESSING THE HEART, LUNGS, AND PERIPHERAL VASCULAR SYSTEM

ASSESSING MUSCULOSKELETAL PAIN

CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

DIGITAL CLINICAL EXPERIENCE: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM

Conclusion 

Subjective and objective data guide the diagnoses developed for health problems affecting patients. JR is likely to be suffering from gastroenteritis. Additional subjective and objective data is however needed to develop an accurate diagnosis. Diagnostic investigations should be used to develop accurate diagnosis for the patient.  

References 

Bányai, K., Estes, M. K., Martella, V., & Parashar, U. D. (2018). Viral gastroenteritis. The Lancet, 392(10142), 175–186. https://doi.org/10.1016/S0140-6736(18)31128-0 

Guan, Q. (2019). A Comprehensive Review and Update on the Pathogenesis of Inflammatory Bowel Disease. Journal of Immunology Research, 2019, e7247238. https://doi.org/10.1155/2019/7247238 

Jarvis, C. (2019). Physical Examination & Health Assessment Access Code. Elsevier Health Sciences. 

Jarvis, C., & Eckhardt, A. (2019). Physical Examination and Health Assessment. Elsevier. 

Sample Answer 2 for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

Gastrointestinal disorders are common encounters in nursing practice with considerable public health impacts. Nurses and other healthcare providers should perform comprehensive history taking and physical examinations to develop accurate diagnoses and care plans. Therefore, this essay examines J.R.’s case study. J.R. presented to the hospital with complaints of having generalized abdominal pain that began three days ago. He has been experiencing diarrhea that has been unresponsive to any treatments adopted by the patient.  The essay analyzes additional subjective and objective information that should be obtained from the client if subjective and objective data supports the assessment, diagnostic tests, and possible differential diagnoses.

Additional Subjective Information

  Additional subjective information should be obtained to guide the development of an accurate diagnosis. First, information about the things that might have led to the abdominal pain should be obtained. This includes data such as diet, alcohol consumption, or possible trauma that could have led to the symptoms. Information about previous experiences of stomach pain should also be obtained. A previous history of stomach pain will help the nurse determine if the condition is acute or chronic. In addition, the nurse should determine if JR experienced a similar pain when he experienced gastrointestinal bleeding four years ago. Information on previous treatments for the GI bleed should be obtained to guide the current management. The nurse should also seek information about the characteristics of stomach pain (Maret-Ouda et al., 2020). For example, information on whether the pain radiates elsewhere should have been obtained to rule out causes such as pancreatitis.

 Information about the character of the diarrhea should also be obtained. Information such as blood-stained diarrhea would help the nurse to develop a potential diagnosis of gastrointestinal tract bleeding. Associated symptoms such as vomiting should also be obtained. This is important because symptoms such as projectile vomiting will indicate potential problems such as pyloric stenosis. Information about changes in the client’s weight over the past few months should also be obtained. Unintentional weight loss could indicate other health problems such as cancer of the gastrointestinal system. Information on changes in appetite should also be sought. Early satiety could indicate problems such as hypertrophic pyloric stenosis. The nurse should also obtain information about the factors that relieve, precipitate, or worsen the stomach pain. For example, a diagnosis of peptic ulcer disease will be made if the symptoms worsen 15-30 minutes after eating (Sverdén et al., 2019). A diagnosis of gastroesophageal reflux disease will be made if the symptoms worsen when JR lies down and improves with sitting upright.

Additional Objective Information

The nurse should obtain additional objective information from JR to make an informed diagnosis and develop a patient-centered care plan. Firstly, information about JR’s general appearance should be documented. This includes information such as his grooming, weight, alertness, and orientation. A comprehensive review of all the body systems should have also been done. For example, the assessment of the respiratory system is inadequate. Information such as the presence or absence of nasal flaring, wheezes, crackles, rhonchi, and peripheral or central cyanosis should have been documented (Katz et al., 2022). The assessment of the cardiovascular system should have extended to information such as the presence or absence of jugular venous distention or peripheral edema.

The information in the assessment of the gastrointestinal system is inadequate. Additional information such as the presence or absence of abdominal scars, organomegaly, pulsations, ascites, and visible blood vessels should have been documented. This is important because information such as palpable abdominal pulsations would indicate aortic abdominal aneurysm. Information about any abdominal pain on palpation and the location of the pain should have also been obtained and pain rating on a pain rating scale.  The nurse should have also assessed the skin for capillary refill, turgor, cyanosis, and edema (Haque & Bhargava, 2022). Low capillary refill and poor skin turgor could indicate problems with circulation and hydration.

If Subjective and Objective Data Supports the Assessment

Subjective assessment data is the information a patient gives about their health problems. Subjective data supports JR’s assessment. Some of the subjective data include his chief complaints, history of the chief complaints, past medical history, medications, allergies, family, and social history. Objective data refers to the information that the healthcare provider obtains during assessment. Healthcare providers use methods such as inspection, palpation, percussion, and auscultation to obtain objective data (Malik et al., 2023). Objective data supports JR’s case study. Examples of objective data in the case study include vital signs and findings reported in the assessment of the heart, lungs, skin, and abdomen.

Appropriate Diagnostic Tests

Some diagnostic tests should be performed to develop JR’s accurate diagnosis. An occult stool test should be performed to determine if the client’s problem is due to an infection and rule out GI bleeding. A complete blood count test would also be performed to rule out an infection. Stool culture might also be performed to determine the accurate cause of JR’s problem. Antigen tests might also be performed to detect antigens associated with parasites and viruses that cause gastrointestinal problems such as gastroenteritis. A fecal fat test might be needed to rule out malabsorption problems in the client (Chen et al., 2021). Radiological investigations such as abdominal ultrasound and x-rays might be performed to rule out causes such as appendicitis and carcinoma.

Accepting or Rejecting the Current Diagnosis

I will accept the current diagnosis of left lower quadrant pain. The objective findings reveal the presence of left lower quadrant pain. This provisional diagnosis should guide the additional investigations performed to develop an accurate diagnosis. I also accept gastroenteritis as the other diagnosis for JR. Patients with gastroenteritis experience symptoms such as diarrhea, abdominal pain and cramping, nausea, vomiting, and loss of appetite (Chen et al., 2021).  JR has these symptoms; hence, gastroenteritis is his other provisional diagnosis.

Three Possible Differential Diagnoses

Diverticulitis is the first differential diagnosis that should be considered for JR. Diverticulitis is an inflammation of the sigmoid colon that causes left lower quadrant pain. The pain worsens when a patient eats. The accompanying symptoms include diarrhea, constipation, bloating, nausea, and the passage of bloodstained stool (Sugi et al., 2020). Diagnostic investigations will rule in or out diverticulitis as the cause of JR’s problems.

The second differential diagnosis that should be considered for JR is peptic ulcer disease. Peptic ulcer disease is a condition that develops from the destruction of the stomach wall lining by pepsin or gastric acid secretion. It affects the distal duodenum, lower esophagus, or jejunum. Patients often experience epigastric pain 15-30 minutes after a meal. A diagnosis of duodenal ulcer disease is made if the patient reports epigastric pain 2-3 hours after a meal (Malik et al., 2023; Sverdén et al., 2019). The additional symptoms that patients with peptic ulcer disease experience include bloating, abdominal fullness, nausea and vomiting, hematemesis, melena, and changes in body weight.

Gastritis is the last differential diagnosis that should be considered for JR. Gastritis develops from the inflammation of the gastric mucosa. Factors such as infections, smoking, taking too much alcohol, prolonged use of aspirin and non-steroidal anti-inflammatory medications, and immune-mediated reactions might cause gastritis. Patients who are affected by gastritis experience a range of symptoms. They include stomach pain or upset, hiccups, belching, abdominal bleeding, nausea and vomiting, feeling of fullness, loss of appetite, and blood in stool or vomitus (Maret-Ouda et al., 2020; Rugge et al., 2020). Therefore, additional investigations should be performed to develop JR’s accurate diagnosis and treatment plan.

Conclusion

In summary, JR’s subjective and objective data is inadequate. Additional subjective and objective data should be obtained to guide the treatment plan. Subjective and objective data supports JR’s assessment. I accept the current diagnosis of left lower quadrant pain and gastroenteritis.. Different diagnostic investigations should be performed to rule in and out different differential diagnoses in the case study. The three differential diagnoses that should be considered for JR include gastritis, peptic ulcer disease, and diverticulitis.

References

Chen, P. H., Anderson, L., Zhang, K., & Weiss, G. A. (2021). Eosinophilic Gastritis/Gastroenteritis. Current Gastroenterology Reports, 23(8), 13. https://doi.org/10.1007/s11894-021-00809-2

Haque, K., & Bhargava, P. (2022). Abdominal Aortic Aneurysm. American Family Physician, 106(2), 165–172.

Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2022). ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. The American Journal of Gastroenterology, 117(1), 27–56. https://doi.org/10.14309/ajg.0000000000001538

Malik, T. F., Gnanapandithan, K., & Singh, K. (2023). Peptic Ulcer Disease. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK534792/

Maret-Ouda, J., Markar, S. R., & Lagergren, J. (2020). Gastroesophageal Reflux Disease: A Review. JAMA, 324(24), 2536–2547. https://doi.org/10.1001/jama.2020.21360

Rugge, M., Sugano, K., Sacchi, D., Sbaraglia, M., & Malfertheiner, P. (2020). Gastritis: An Update in 2020. Current Treatment Options in Gastroenterology, 18(3), 488–503. https://doi.org/10.1007/s11938-020-00298-8

Sugi, M. D., Sun, D. C., Menias, C. O., Prabhu, V., & Choi, H. H. (2020). Acute diverticulitis: Key features for guiding clinical management. European Journal of Radiology, 128, 109026. https://doi.org/10.1016/j.ejrad.2020.109026

Sverdén, E., Agréus, L., Dunn, J. M., & Lagergren, J. (2019). Peptic ulcer disease. BMJ, 367, l5495. https://doi.org/10.1136/bmj.l5495

Sample Answer 3 for NURS 6512 LAB ASSIGNMENT: ASSESSING THE ABDOMEN

The SOAP note details the history and examination of JR a 47-year-old white male with complains of persistent abdominal pain and diarrhea. Physical examination reveals left lower quadrant and hyperactive bowel movements indicative of a possible gastroenteritis diagnosis. This paper will analyze the subjective and objective details of the SOAP note.

Subjective Portion

JR had two major complains but only one of them (abdominal pain) was discussed in details. The patient was to be probed on the frequency of the diarrhea, the volume and consistency, the color, presence of blood stains and any accompanying symptoms such as thirst, dry mucous membranes and decreased urine output which could be indicative of dehydration(Meisenheimer et al., 2022).Other additional symptoms such as fever, vomiting or nausea should be ruled out. In the past medical history, the year of onset of the chronic illnesses should be included. The social history should quantify the social drinking and the type of alcohol taken. Review of systems could also be essential in ruling out other diseases.

Objective Portion

The objective data given does not reveal the general JR. It should include the patients’ general appearance, if he is in distress, obvious pain, appears dehydrated, pale, cyanosed, jaundiced or edematous. Physical examination of the affected system should have been thorough where examination details on inspection could have included the symmetry, scars, distention or any visible vessels. On palpation masses, organomegally, guarding and tenderness should be ruled out. The percussion should also be noted. It is important to note the rate of bowel sounds (DiLeo Thomas & Henn, 2021).

Assessment Portion

The assessment findings are supported by both objective and subjective data apart from the fact that the abdominal pain was generalized and not specific as opposed to the physical findings.

Diagnostic Test

The patient could have benefited from laboratory tests such stool for ova and cyst, stool for microscopy, culture and sensitivity and a complete blood count. An abdominal ultrasound could have been vital in probing the cause of the abdominal pain and the left lower quadrant pain.

Differential Diagnosis

Pain is not a differential diagnosis but rather a symptom thus the differential diagnosis of left lower quadrant pain does not hold water. It should rather explore some of the conditions that can cause  lower quadrant pain such as diverticulitis(Galgano et al., 2019). Others include inflammatory bowel disease and irritable bowel syndrome. Gastroenteritisis supported by the data provided.

Conclusion

The subjective and objective data provided in the case of JR was not as detailed as it is recommended. The patient could have greatly benefited from several laboratory investigations such as stool analysis, complete blood count and even an abdominal ultrasound. From the history the patient is likely to be suffering from acute gastroenteritis which is mostly infective like bacterial, viral, diverticulitis or inflammatory bowel disease.

References.

DiLeo Thomas, L., & Henn, M. C. (2021). Perfecting the Gastrointestinal Physical Exam. Emergency Medicine Clinics of North America, 39(4), 689–702. https://doi.org/10.1016/j.emc.2021.07.004

Galgano, S. J., McNamara, M. M., Peterson, C. M., Kim, D. H., Fowler, K. J., Camacho, M. A., Cash, B. D., Chang, K. J., Feig, B. W., Gage, K. L., Garcia, E. M., Kambadakone, A. R., Levy, A. D., Liu, P. S., Marin, D., Moreno, C., Pietryga, J. A., Smith, M. P., Weinstein, S., & Carucci, L. R. (2019). ACR Appropriateness Criteria® Left Lower Quadrant Pain-Suspected Diverticulitis. Journal of the American College of Radiology, 16(5), S141–S149. https://doi.org/10.1016/j.jacr.2019.02.015

Meisenheimer, E. S., Epstein, C., & Thiel, D. (2022). Acute Diarrhea in Adults. American Family Physician, 106(1), 72–80.