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A 23-year-old female presents to the emergency department with vomiting and abdominal pain. She describes it as “severe pain at her belly button” and is now radiating to the RLQ. The pain is described as cramping that started over 12 hours ago. She has had nausea and decreased appetite. She began vomiting this morning, which she states is mainly fluid because she has not been able to eat anything since yesterday. She denies any fever or changes in her stool.

1.

Based on the description of the patient’s pain and remembering the structures of the abdomen, what organs may be involved?

2.

What are the impaired functions of the abdomen she is experiencing?

3.

The patient asks to use the bathroom. When she returns, she tells you she had a bowel movement. What questions should you ask regarding defecation to add to the comprehensive abdominal assessment?

4.

Is there any medical history you need to be aware of?

5.

How should you approach gathering objective data during the patient exam?

6.

The patient has sunken in eyes, dry lips, and dry mucous membranes. Because of the patient’s history, what do you suspect is happening with the patient and what should you do next?