Assessment of the Abdomen and Gastrointestinal System Assessment of the Abdomen and Gastrointestinal System Additional subjective history should be assessed by asking specific, focused assessment questions that point out the possible changes in the client’s digestion, appetite, and bowel movements, including the color, consistency, frequency, and regularity. Further questions include cases of bloody stools, exacerbation of abdominal pain, and rectal bleeding. Additional questions should also determine if the patient experienced any fever and chills, malaise or fatigue that can be associated with nausea and diarrhea. The assessment should focus on identifying if the patient has experienced any changes, either positive or negative, within one year. Such questions are critical during the review of the patient’s system. The patient’s objective health history is essential and should focus on collecting vital signs, physical assessment findings, the overall assessment of the patient, and the lab diagnostics findings. The objective should also focus on determining the characteristics of the abdomen and establish its status, i.e., whether it is flat or obese, distended, or non-distended. Additional assessment should also be performed on the patient’s mucous membranes to identify if they exhibit any dryness which is an indication of dehydration given that the patient has diarrhea and nausea but without vomiting. Based on the assessment note, as well as the additional information provided in the objective, the client exhibits apparent symptoms of gastroenteritis. These symptoms may include abdominal pain, nausea, vomiting, diarrhea, fever, and hearing hyperactive bowel sounds on auscultation (Dains, Baumann, and Scheibel, 2019). Based on the assessment of diarrhea accompanied by a fever of 99.8 temperature, the information confirms that the client has an infection. Further diagnostic tests are recommended to get a better diagnosis. These tests include the fecal occult blood test/Hemoccult test, stool culture, endoscopy, computed tomography scanning, leukocytes, and biopsy (Dains, Baumann, and Scheibel, 2019; Colyar, 2015). The Hemoccult test can be used to rule out bloody stool, while leukocytes will screen for inflammatory diarrhea. Positive results on both the Hemoccult test and leukocytes would confirm the diagnosis of inflammatory diarrhea. A stool culture would help in identifying and isolating pathogens that will be useful in determining the exact diagnosis and the appropriate drugs for specific macro-organisms. Performing an endoscopy is essential in the diagnosis of acute diarrhea, and the findings will confirm if it is non-infection acute diarrhea, including cancer, inflammatory bowel disease or ischemic colitis. The computed tomography scan will be used to rule out other causes that may imitate diverticulitis, given the patient’s left lower quadrant pain (Dains, Baumann, and Scheibel, 2019). Therefore, the current diagnosis cannot be acc.

1. Assessment of the Abdomen and Gastrointestinal System
Assessment of the Abdomen and Gastrointestinal System
Additional subjective history should be assessed by asking
specific, focused assessment questions that point out the
possible changes in the client’s digestion, appetite, and bowel
movements, including the color, consistency, frequency, and
regularity. Further questions include cases of bloody stools,
exacerbation of abdominal pain, and rectal bleeding. Additional
questions should also determine if the patient experienced any
fever and chills, malaise or fatigue that can be associated with
nausea and diarrhea. The assessment should focus on
identifying if the patient has experienced any changes, either
positive or negative, within one year. Such questions are critical
during the review of the patient’s system.
The patient’s objective health history is essential and should
focus on collecting vital signs, physical assessment findings,
the overall assessment of the patient, and the lab diagnostics
findings. The objective should also focus on determining the
characteristics of the abdomen and establish its status, i.e.,
whether it is flat or obese, distended, or non-distended.
Additional assessment should also be performed on the patient’s
mucous membranes to identify if they exhibit any dryness which
is an indication of dehydration given that the patient has
diarrhea and nausea but without vomiting.
Based on the assessment note, as well as the additional
information provided in the objective, the client exhibits
apparent symptoms of gastroenteritis. These symptoms may
include abdominal pain, nausea, vomiting, diarrhea, fever, and
hearing hyperactive bowel sounds on auscultation (Dains,

2. Baumann, and Scheibel, 2019). Based on the assessment of
diarrhea accompanied by a fever of 99.8 temperature, the
information confirms that the client has an infection.
Further diagnostic tests are recommended to get a better
diagnosis. These tests include the fecal occult blood
test/Hemoccult test, stool culture, endoscopy, computed
tomography scanning, leukocytes, and biopsy (Dains, Baumann,
and Scheibel, 2019; Colyar, 2015). The Hemoccult test can be
used to rule out bloody stool, while leukocytes will screen for
inflammatory diarrhea. Positive results on both the Hemoccult
test and leukocytes would confirm the diagnosis of
inflammatory diarrhea. A stool culture would help in identifying
and isolating pathogens that will be useful in determining the
exact diagnosis and the appropriate drugs for specific macro-
organisms. Performing an endoscopy is essential in the
diagnosis of acute diarrhea, and the findings will confirm if it is
non-infection acute diarrhea, including cancer, inflammatory
bowel disease or ischemic colitis. The computed tomography
scan will be used to rule out other causes that may imitate
diverticulitis, given the patient’s left lower quadrant pain
(Dains, Baumann, and Scheibel, 2019). Therefore, the current
diagnosis cannot be accepted as the final diagnosis.
The current diagnosis is acceptable as a likely differential
diagnosis, with more diagnostic tests recommended to achieve a
more definitive concluding diagnosis. Additional tests and
evaluations recommended include diverticulitis, bowelCancer,
Ulcerative colitis, and Crohn's disease.
• Diverticulitis: It is the most common cause of left lower
quadrant pain. Its clinical symptoms include left lower-quadrant
pain, nausea and vomiting, and fever (Hammond, Nikolaidis, &
Miller, 2010). • Bowel cancer: Colon/Bowel cancer is selected
because of the patient’s abdominal pain and the likely changes
in the client’s stool due to diarrhea and as well as the presence

3. of blood in the feces. Some of the common symptoms of bowel
cancer include rectal bleeding, abdominal pain, loss of weight,
loss of appetite, changes in bowel movement, and fatigue
(Walter et al., 2016).• Ulcerative colitis: Ulcerative colitis is a
disease associated with the inflammation of the colon, the
rectum or both, and causes rectal bleeding tenesmus, and the
passage of mucus. Other symptoms include abdominal
crampingand diarrhea caused by increased colon involvement
(Dains, Baumann, and Scheibel, 2019).• Crohn's disease: Crohn
disease is a disease associated with the inflammation of the
digestive tract. Some of the clinical signs include abdominal
cramping, tenderness, rectal bleeding, and diarrhea (Dains,
Baumann, and Scheibel, 2019). It is also associated with
chronic bloody diarrhea, fever, and weight loss.
References
Colyar, M. R. (2015). Advanced practice nursing procedures.
Philadelphia, PA: F. A. Davis.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced
health assessment and clinical diagnosis in primary care (6th
ed.). St. Louis, MO: Elsevier Mosby.
Hammond, N. A., Nikolaidis, P., & Miller, F. H. (2010). Left
lower quadrant pain: guidelines from the American College of
Radiology appropriateness criteria.
American family physician
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82
(7), 766-770.
Walter, F. M., Emery, J. D., Mendonca, S., Hall, N., Morris, H.
C., Mills, K., ... & Rutter, M. D. (2016). Symptoms and patient
factors associated with longer time to diagnosis for colorectal
cancer: results from a prospective cohort study.

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