Assignment: Mrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days.

Assignment: Mrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days.

Assignment: Mrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days.

Module 3 Discussion
Additional Subjective Data
I will ask Mrs. Deer to describe the characteristics of her pain. This includes if the pain radiates to other body parts, burning, or stinging pain. I will also ask her to identify the factors that worsen, relieve, or exacerbate the pain. I will also obtain information about the color and amount of the vomitus. Information about the color will help rule out causes such as gastrointestinal bleeding. I will also ask her to rate her pain on the pain rating scale to determine its severity.

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Additional Objective Data
I will obtain objective data from Mrs. Deers. The data will include abdominal inspection for abnormal findings such as distention or visible pulsations. I will also look for any signs of organomegaly. I will also auscultate the abdomen for abnormal bowel movements and pulsations. I will also palpate it for any abdominal masses or organomegaly. I will also percuss the abdomen for abnormal findings such as rebound tenderness.
Differential Diagnoses
The differential diagnoses that should be considered for Mrs. Deers include gallbladder and liver disorders, inflammatory bowel disease, diverticular disease, nephrolithiasis, pyelonephritis, pancreatic disorders, malignancy, and pulmonary disorders (Sharma et al., 2020).
Laboratory Tests
Several laboratory tests should be done. A complete blood count should be done to rule out infections and anemia. A metabolic panel should be done to rule out problems such as fluid and electrolyte imbalances. Liver function tests should be done to determine the levels of liver enzymes and rule out liver problems (Mohy-ud-din & Morrissey, 2024). Blood glucose and pancreatic enzyme tests should be tested to rule out pancreatic problems.
Radiological Examinations
Radiological examinations should be ordered for the patient. They include an abdominal ultrasound, computed tomography scan, magnetic resonance cholangiopancreatography, and endoscopic ultrasound (Sharma et al., 2020).
Treatment and Specific Information
Aggressive fluid resuscitation is the first treatment approach to Mrs. Deers’s problem. Intravenous hydration with fluids such as ringers lactate is recommended. Ringers lactate is superior in reducing inflammatory markers in conditions such as pancreatitis. The patient would be started on an insulin drip if she were found to have hypertriglyceridemia. Fibrates can be considered if the patient is to undergo apheresis. Antibiotics should be administered if the patient is found at risk of infectious complications (Mohy-ud-din & Morrissey, 2024). Oral feeding can resume immediately should there be no contraindications.
Potential Complications of the Ordered Treatment
The ordered treatment might result in some complications. For example, an insulin drip might cause hypoglycemia. Hypoglycemia develops from a high dose of insulin or inadequate dietary intake. The other complication that might develop from the treatment is exacerbation of symptoms with oral intake of foods. Antibiotic administration is only recommended if there are signs of infectious complications. Delayed antibiotic initiation could result in septicemia.
Additional Laboratory Tests
A serum lipase test should be ordered. An elevated serum lipase level indicates pancreatitis. Serum triglycerides, lactase, and c-reactive protein levels should also be assessed. Blood urea nitrogen levels should also be assessed since its rise is associated with pancreatitis. An HbA1c can also be done to determine blood glucose levels over the last three months. This will rule out pancreatitis.
Additional Patient Teaching
The additional patient teaching needed includes treatment adherence, avoidance of fatty foods, and symptoms of a worsening condition. The patient should also be educated on the importance of avoiding smoking and alcohol abuse, weight reduction, and engaging in regular physical activity (Mohy-ud-din & Morrissey, 2024).
Consultation
Consultations with surgeons, gastroenterologists, and dieticians are needed in Mrs. Deer’s case. Interprofessional collaboration between these specialists is needed for safety and quality outcomes (Mohy-ud-din & Morrissey, 2024).
References
Mohy-ud-din, N., & Morrissey, S. (2024). Pancreatitis. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK538337/
Sharma, P., Hegde, R., Kulkarni, A., Soin, P., Kochar, P., & Rotem, E. (2020). Imaging right lower quadrant pain: Not always appendicitis. Clinical Imaging, 63, 65–82. https://doi.org/10.1016/j.clinimag.2020.02.012

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Case 3

Mrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days. She would have come sooner, but she lacked transportation and waited until her son could drive her. She states that she has not been sleeping very much because of the pain. She has been nauseous and vomited a couple of times two days ago but has only been drinking fluids. She states that she has not been around anyone else that had an upset stomach. She recalls prior to the onset of pain she had been at a church supper that included meats, refried beans, and many desserts which she sampled. She described the fried pies that she brought to the supper and ate the extras that afternoon.

Vital Signs: BP 130/80, HR 85, RR 20, Temp 99.0°F.

Discuss the following:

1) What additional subjective data are you seeking to include past medical history, social, and relevant family history?

2) What additional objective data will you be assessing for?

3) What are the differential diagnoses that you are considering?

4) What laboratory tests will help you rule out some of the differential diagnoses?

5) What radiological examinations or additional diagnostic studies would you order?

6) What treatment and specific information about the prescription that you will give this patient?

7) What are the potential complications from the treatment ordered?

8) What additional laboratory tests might you consider ordering?

9) What additional patient teaching may be needed?

10) Will you be looking for a consult?

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.