NR 511 Week 5 iHuman Virtual Patient Encounter Attempt 3689162 - Deborah Arnaudin

History Notecard by Glorious Hicks on case Deborah Arnaudin Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Sx Sx Sx Sx Sx = = = = = Onset 2 days ago Location umbilical area Duration intermittent Characteristics at first cramping but now feels like intestine are being squeezed Aggravating eating and pushing down on stomach Relieving throwing up Timing / none Treatments Severity 9/10 pain Attempt: 3689162 Report generated on 9/30/2025, 11:08:41 AM America/Denver Management Plan by Glorious Hicks on case Deborah Arnaudin Diagnostic Testing: CT Abdomen/pelvis with contrast, CBC, CMP, lactic acid, lipase, PT/INR, UA Medication: Analgesic as needed like acetaminophen 500mg 4-6 hours as needed. Antiemetic 4mg every 8 hours as needed for nausea and vomiting Referrals: immediate general surgery consult for evaluation Education: Provide lab and imaging results, current care like staying NPO and need for surgery. Follow up: Once obstruction resolves, initial oral feedings gradually by starting with clears Reference: Gupta, A. (2024). Management of malignant bowel obstruction. The Lancet Gastroenterology & Hepatology, 9(1), 14-15. Attempt: 3689162 Report generated on 9/30/2025, 11:08:41 AM America/Denver Social History Category Data entered by Glorious Hicks Social History Drinks beer socially most nights of the week, works as an analyst and lives with daughter and husband Review of Systems Category Data entered by Glorious Hicks General Reports abdominal pain after eating starting 2 days ago Integumentary / Breast not assessed HEENT / Neck Denies trauma or falls. Eyes–Denies changes in vision, eye redness, or drainage. Ears–Denies pain or drainage. Nose–Denies congestion,rhinorrhea, and sinus pain. Denies sore throat; Denies hoarseness and mouth sores. Neck–Denies swollen neck glands; Denies stiffness, pain, or limited ROM. Cardiovascular Denies chest pain,palpitations and racing heart Respiratory Denies cough, shortness of breath, and wheezing Gastrointestinal Reports not having a bowel movement for two days then water stools before the constipation developed, Reports intermittent nausea Genitourinary Denies urine issues Musculoskeletal Denies muscle or joint pain, stiffness, crepitus, redness and swelling of joints, limited range of motion, and misalignment Allergic / Immunologic no allergies Endocrine not assesses Hematologic / Lymphatic no history of blood disorder Neurologic patient is alert and oriented, Denies headache, dizziness, syncope, seizures, tremors, tingling, numbness, memory loss, balance problems, falls, and speech deficits Psychiatric denies psych history