The patient presented with abdominal pain, diarrhea, and fever. A physical exam found a low-grade fever, hyperactive bowel sounds, and left lower quadrant pain. Based on the subjective report and objective findings, the diagnosis of gastroenteritis was made and supported. Additional diagnostic testing like a stool analysis was recommended to confirm the diagnosis and determine the specific cause. Differential diagnoses that should be considered included appendicitis, UTI, and IBD. More detailed documentation of symptoms, risk factors, physical exam findings, and diagnostic results was needed for a full assessment.

1. Advanced Health Assessment.
Advanced Health Assessment. The AssignmentAnalyze the subjective portion of the note.
List additional information that should be included in the documentation.Analyze the
objective portion of the note. List additional information that should be included in the
documentation.Is the assessment supported by the subjective and objective information?
Why or why not?Advanced Health Assessment.ORDER A PLAGIARISM-FREE PAPER
HEREWhat diagnostic tests would be appropriate for this case, and how would the results
be used to make a diagnosis?Would you reject/accept the current diagnosis? Why or why
not? Identify three possible conditions that may be considered as a differential diagnosis for
this patient. Explain your reasoning using at least three different references from current
evidence-based literature.Advanced Health Assessment.Additional Subjective DataIt is
essential to include more details on the nature of the abdominal pain with reference to
where the pain radiates to, originates from, nature of its onset, aggravating and relieving
factors. Gastroenteritis usually begins as an acute infectious condition with a sudden onset
(Jansen, et al., 2015). The onset of the patient’s diarrhea should also be stated including the
color, episodes in a day, if its mucoid, bloody or watery. Gastroenteritis can occur due to a
parasitic, viral or bacterial infection. Bacterial infections usually cause a bloody diarrhea
and viral infections cause watery diarrhea (Oude & Van der Hoek, 2016). By obtaining more
details regarding the nature of the stool, it will be possible to make a more specific
diagnosis that would guide management.It will also be necessary to know and document
how the patient tolerates liquid and solid foods, her procedure of obtaining groceries and
method of preparation. As highlighted by Jansen, et al. (2015), gastroenteritis often occurs
from ingestion of contaminated food or water or inadequately prepared using the required
sanitation protocols. The patient’s history of travel must be documented since the risk of
gastroenteritis increases when travelling when exposed to infectious agents. Associated
symptoms such as vomiting, bloating and burning should also be established.Advanced
Health Assessment.Additional Objective DataIt will be necessary to include details about the
patient’s possible exposure to infectious conditions and the characteristics of the stool that
was obtained for examination. Details on the condition of the abdomen in terms of the skin
color, symmetry and contours on inspection should be included. Information on any masses
felt on palpation, pulsations, veins and scars should also be included. The frequency and
character of the bowel sounds, bruits in the femoral, iliac and aortic places on auscultation
should also be highlighted. According to Kendall & Moreira (2017), bruits are indicative of a
possible obstruction, gastroenteritis or peritonitis. Documentation of abnormal findings

2. such as ascites, distention or organ enlargement on percussion should also be done. In case
any mass is felt, documentation should include its shape, mobility, location and
size.Advanced Health Assessment.A comparison with the normal findings should be made
whereby: the abdomen is round, soft and symmetric without any visible peristalsis,
distention, lesions and scars. The aorta should be medially located without any visible
peristalsis or bruits, the umbilicus should be inverted, medial and without herniation
(Kendall & Moreira, 2017). While bowel sounds should be present in all four quadrants, the
spleen, liver and kidney should be non-tender and non-palpable.Advanced Health
Assessment.How the Subjective and Objective Data Support the AssessmentBased on the
client’s assessment, she had gastroenteritis and pain on the left lower quadrant. The
subjective data provided by the client revealed that she experienced severe abdominal pain
for three days and diarrhea. Objective data revealed that the client had a low grade fever of
99.8 and hyperactive bowel sounds, symptoms that are often accompanied with lack of
energy and dehydration due to frequent diarrhea and vomiting in patients with
gastroenteritis.Advanced Health Assessment.Appropriate Diagnostic TestsThe most
appropriate test for this patient to make a diagnosis is a stool test alongside a
comprehensive medical history. To make a more definite diagnosis, the signs and symptoms
reported by the client should be compared against gastroenteritis actual signs and
symptoms. According to Lacy et al. (2016), a stool test will help to determine if the client
has a parasitic, bacterial or viral infection. Watery stool will suggest a viral infection while
bloody stool will suggest bacterial gastroenteritis.Whether I Would Accept/Reject the
Current DiagnosisThe patient’s current diagnosis is gastroenteritis whose signs and
symptoms are: dehydration, abdominal pain, vomiting, fever and diarrhea which begin 12-
72 hours immediately one gets into contact with an infectious agent, symptoms that last for
less than two weeks (Scallan et al., 2018). The frequent diarrhea due to hyperactive bowel
sounds cause abdominal pain, findings which are consistent with the patient’s presentation,
the objective and subjective data provided. Thus, I would accept the present
diagnosis.Advanced Health Assessment.Possible Differential DiagnosesAppendicitisUTI
(Urinary Tract Infection)IBD (Inflammatory Bowel Disease)Week 6: Assessment of the
Abdomen and Gastrointestinal SystemABDOMINAL ASSESSMENTSubjective:• CC: “My
stomach hurts, I have diarrhea and nothing seems to help.”• HPI: JR, 47 yo WM, complains
of having generalized abdominal pain that started 3 days ago. He has not taken any
medications because he did not know what to take. He states the pain is a 5/10 today but
has been as much as 9/10 when it first started. He has been able to eat, with some nausea
afterwards.• PMH: HTN, Diabetes, hx of GI bleed 4 years ago • Medications: Lisinopril 10mg,
Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs• Allergies: NKDA• FH: No hx of
colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD• Social: Denies
tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)Objective:• VS: Temp 99.8;
BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs• Heart: RRR, no murmurs • Lungs: CTA, chest
wall symmetrical• Skin: Intact without lesions, no urticaria• Abd: soft, hyperactive bowel
sounds, pos pain in the LLQ• Diagnostics: None Assessment: • Left lower quadrant pain•
Gastroenteritis PLAN: This section is not required for the assignments in this course (NURS
6512) but will be required for future coursesAdvanced Health Assessment.