NR 511 Week 5 iHuman Virtual Patient Encounter Attempt 3751980 - Dorothy Jones

History Notecard by Sophia Scales on case Dorothy Jones 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 Location Duration Characteristics Aggravating Relieving Timing / Treatments Severity Attempt: 3751980 Report generated on 12/1/2025, 1:26:24 PM America/Denver Management Plan by Sophia Scales on case Dorothy Jones Current Treatment Plan for Small Bowel Obstruction 1. Diagnostic Test : ABD x-ray: Small-bowel obstruction CBC: Mild hemoconcentration CMP: Elevated BUN/creatinine ratio. Low-normal potassium consistent with emesis. Lipase: Normal Urinalysis: Specific gravity high end of normal suggesting mild dehydration. Obtain an abdominal CT scan to identify the size of the bowel obstruction to determine the need for emergent surgical intervention. 2. Medications and Procedures: The initial management of SBO begins with fluid resuscitation to address hypovolemia caused by third-spacing of fluids, vomiting, and reduced oral intake. Isotonic intravenous fluids, such as lactated Ringer or normal saline, are administered to restore intravascular volume and correct electrolyte imbalances, particularly hypokalemia and metabolic alkalosis (Schick MA, Kashyap S, Collier SA, et al. Small Bowel Obstruction. [Updated 2025 Jan 19). Pt will requires a Nasogastric tube as well. Decompression the abdominal area of an air or fluid should help decrease pain and bloating. The cornerstone of non-operative management in ASBO has traditionally been the ‘drip and suck’ approach, involving intestinal decompression via a nasogastric (NGT) or nasoenteric tube [7], as recommended by the Bologna Guidelines from the World Journal of Emergency Surgery (Al-Mashat, A., Fareed, A., Senanayake, T., Smith, S. R., & Gani, J. (2025). Nausea/Vomiting control using Zofran or Reglan throughout the day for nausea and vomiting. Pain control with opioids and non-opioid analgesic, which ever combination or medication is more suitable for her pain level. Starting the patient on a broad-spectrum antibiotics, Cephalosporin and Metronidazole and then monitor pt for electrolyte imbalances. 3. Consultations/ Referrals: Patient will now requires referrals for other Emergency department or Direct admission for surgery. Gastroenterology and Med-Surg. 4. Patient Education Until the SBO has resolved there should be nothing by mouth. As previously addressed surgery my be needed. If movement is capable being mobile will help with peristalsis. Individuals, especially those with prior abdominal surgeries, cancer, or chronic gastrointestinal disorders, should understand the symptoms and risk factors. Patients should be taught to recognize signs such as abdominal pain, vomiting, distentsion, and an inability to pass stool or gas and to seek medical attention immediately if these symptoms occur (Schick MA,