Kayla’s Case Study: Nausea and Lower Abdominal Pain
Kayla’s Case Study: Nausea and Lower Abdominal Pain
Kayla’s Case Study: Nausea and Lower Abdominal Pain
Overview
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Three months after the children’s abdominal illnesses, Kayla, still 26 years old, has come to see you today for complaints of nausea and lower abdominal pain. She has not had a well-woman exam since the birth of her youngest child. The nausea and intermittent abdominal pain have been intermittent for about 2 weeks.
Kayla’s Case Study: Nausea and Lower Abdominal Pain
HPI: There is abdominal pain to the lower quadrants intermittent for 2 weeks. She has not had a fever, diarrhea, dysuria, rash, headache, blurred vision, and no other household members are ill. She is not taking any current medications. She has been able to eat and drink with some limitations. She has vomited on two occasions, once each week of the abdominal pain. Her LNMP was 3 months ago, and she has a history of irregular periods and PCOS, so this pattern is not unusual. She reports she is not currently sexually active and has only been sexually active with her husband whom she is separated from. Her last timing of sexual intercourse was 14 weeks ago, with her estranged husband after an emotional meeting of custody of their children.
Kayla’s Case Study: Nausea and Lower Abdominal Pain
She also has had trouble sleeping and reports continuing anxiety over her living situation and the inability to adequately provide for her family financially.
PMH: G – 3, T-1, P-1, A-1, L-2; cesarean section X 2; no trauma history; 10 year 1PPD smoker, smoking cessation 2 years ago; gestational diabetes with last pregnancy; history of PCOS.
Social History: She continues to live with her parents and is working part time at the children’s school library. She reports her divorce will be final in a matter of a few weeks.
Vital Signs: Weight: 74.5 kilograms, B/P:128/68, T: 98.7, HR: 92, Resp: 16, reg, non-labored, SpO2: 99%
General: Awake, alert, appropriate; well groomed; tearful at times throughout the exam; skin: warm, dry, intact; HEENT: head normocephalic; Conjunctiva clear, non-icteric, PERRLA, EOM’s intact; tympanic membranes intact, unremarkable; nares patent, unremarkable bil; pharynx unremarkable tonsils 2/4 bil; neck supple w/o lymphadenopathy.
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Kayla’s Case Study: Nausea and Lower Abdominal Pain
CARDIOPULMONARY: Heart RRR w/o murmur; lungs CTA throughout; respirations even and unlabored; abdomen, soft, with normoactive bowel sounds throughout; tenderness to palpation in the super-pubic area; no masses or organomegally; peripheral pulses reg., equal; pelvic exam reveals pink vaginal mucosa with a moderate whitish-clear discharge; she is exceedingly tender to palpation and her uterus is enlarged to about the size of a softball.
Urinalysis in the office: Cloudy amber yellow urine, specific gravity 1.010, positive WBCs, nitrites, and leukoesterase; negative for RBCs, glucose, and ketones.
UA Lab Results
Chlamydia and Gonorrhea vaginal cultures sent.
STD Lab Results
Urine Pregnancy Test—Positive
Discussion Questions Part Two:
What is the primary diagnosis for Kayla, with rationale?
What is the differential diagnosis with rationale and support from evidence?
If she were pregnant, she may have some concerns. Education throughout pregnancy is critical. Please choose one common symptom, complaint, question, or concern that a mother might have and briefly review it here. Some examples might be topics such as cord blood banking, Pica, heartburn, varicosities, ptyalism, leucorrhea, exercise, weight gain, and so forth. Please do not choose the same topic as any other classmate, so be sure to go in and read other’s posts. Cite all sources of information. List the following.
Topic
Definition
Specific educational points
Please list a primary diagnosis and at least 2 other differential diagnoses with rationale with support from evidence based articles that are dated no earlier than 2011, preferably the most recent. In addition, I need a complete reference guide. Please write a summary of one of the complications listed above: cord blood banking, Pica, heartburn, varicosities, ptyalism, leucorrhea, exercise, weight gain.
Name: Discussion Rubric
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
0–69 |
|||
| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
||
| Main Posting:
Writing |
6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
||
| Main Posting:
Timely and full participation |
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
7 (7%) – 7 (7%)
Posts main Discussion by due date. |
0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
||
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| First Response:
Writing |
6 (6%) – 6 (6%)
is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| First Response:
Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| Second Response: Writing |
6 (6%) – 6 (6%)
is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| Second Response: Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Total Points: 100 | ||||||
Name: Discussion Rubric
