Get Answer: Year White Woman Question Guide

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Original Question

SN is a 32-year-old white woman who presents with symptoms of recurrent abdominal pain and loose stools. She states that she has experienced these symptoms since adolescence, with periods of improvement and worsening over the years. She notes that her symptoms were most pronounced when she was in college, and they improved during her pregnancy with her first child 4 years ago. Over the past year, her symptoms have been occurring more frequently and with greater severity. She also has been increasingly bothered by bloating and distention over the past 6 months. The bloating seems to worsen with food intake, while the distention progresses throughout the day. When questioned about abdominal pain, she describes it as 7 (on a scale of 10) at its worst and seemingly related to defecation, with acute worsening immediately prior to defecation and significant improvement after defecation. She has loose stools approximately one-third of the time and often will have 2-3 bowel movements per day. Other than her gastrointestinal symptoms, she considers herself healthy. She has no chronic illnesses or prior surgeries. She had an uncomplicated pregnancy and a vaginal delivery 4 years ago (gravida 1, para 1). She has no family history of organic gastrointestinal diseases such as inflammatory bowel disease, malignancy, or celiac disease. SN is employed part time at an accounting firm. She jogs 2-3 miles 3-4 times a week, tries to eat 4-6 servings of fruits and vegetables daily, and takes a daily multivitamin, which she has taken for many years. Her weight and other vital signs are within normal limits: height 5’6″, weight 120 lb, blood pressure 108/64 mm Hg, pulse 60 beats per minute, and respiratory rate 12 breaths per minute. On physical examination, she is a well-developed, well-nourished woman in no acute distress. Her physical examination is notable for mild tenderness to palpation in the left lower quadrant, but there is no rebound tenderness, guarding, or other peritoneal signs. The remainder of the physical examination is unremarkable. Discuss what is probably be happening to the patient? What Diagnostic exams will be necessary? What are the possible medications be given? As a nurse make individualized NCP for this patient please include Rationale.

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