The client is a female, mature adult who was admitted to the medical/surgical unit with complaints of right upper quadarant abdominal pain, nausea and vomiting for the last 3 hours. Client rates her pain 5/10. Vital signs include heart rate 92 beats/minute, respirations 20 breaths/minute, and blood pressure 132/70 mmHg. The client is accompanied by her spouse.
Fifteen minutes after receiving the antiemetic, the client stops vomiting, appears relaxed, and denies further nausea. She states that she is comfortable enough for the nurse to begin the admission assessment.
The nurse questions the client about what brought her to the hospital. The client states she had right upper quadrant abdominal pain, nausea and vomiting right after she ate lunch. Pain remains at 5/10. The client states her last bowel movement was yesterday
1. For the nurse to learn about the client's bowel patterns, which questions are most important to ask the client? (Select all that apply.)
A. Have you had any recent onset of heartburn?
B. Do you take any prescription or over-the-counter medications?
C. Have you had any changes in your bowel movements?
D. What is the color and consistency of your bowel movements?
E. How often do you have a bowel movement?
The nurse questions the client if there are any foods she cannot eat. The client reports that she doesn't tolerate spicy foods.
2. What questions should the nurse ask next? (Select all that apply.)
A. Can you identify which spicy foods cause a problem?
B. How often do you eat spicy foods?
C. What happens when you eat spicy foods?
D. Does anyone in your family have problems with spicy food?
E. Why do you think spicy foods are a problem?
3. What additional focused interview questions will be important for the nurse to ask the client?
A. Do you have a history of any abdominal conditions or surgeries?
B. Have you experienced any weight gain or weight loss?
C. Are you have any difficulty with urination?
D. Are you experiencing any shortness of breath?
E. Do you have any difficulty swallowing your food?
