How to Answer Tereza Svoboda Woman Questions (Complete Guide)
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Original Question
Mrs Tereza Svoboda is a 52 yo woman who has been admitted to the emergency department. For the last couple of days, she has been vomiting small amounts, and has had abdominal pain which has become more severe in the last 8 hours. She expresses surprise at her vomiting because she has eaten and drunk very little. She has not had a bowel movement in 2 days. Her medical history shows abdominal surgery for a hysterectomy twelve months ago, on a background of severe endometriosis. Collect cues: Vital Signs • RR = 14 bpm • SpO2 = 99% • BP = 110/60 mmHg (MAP 77 mmHg) • HR = 118 bpm • Temp = 37 oC Pain Assessment • P = upon movement and at rest • Q = aching with occasional stabbing pain • R = peri umbilical (central abdomen) • S = 8/10 • T = Constant for last 48 hours Abdominal Assessment • Inspection – distension, midline scar. • Auscultation – absent bowel sounds • Palpation – general tenderness and guarding • Percussion – gas-induced tympany, Fluid Status Assessment • Weak pulses • Pale and cool to the touch • Cap refill > 3secs • Reduced skin turgor – tongue furrowed • Dry mucous membranes • Last voided – last night. What is the alternations of digestive system health in this case study?
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