sounds over spleen or liver tympany p dullness over LLQ abdomen soft in all is

Sounds over spleen or liver tympany p dullness over

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sounds over spleen or liver; tympany p dullness over LLQ; abdomen soft in all is noted in the LLQ with mild guarding, organomegaly; no CVA tenderness; liv hernias. • Rectal: No hemorrhoids, no f sphincter tone, fecal mass in rectal vau or irritation of vulva, abnormal discharg growths, or tenderness upon palpation dark yellow, normal odor. No nitrites, W detected; pH 6.5, SG 1.017. Assessment abdominal mass (LLQ) Differential diagnosis Obstipation, Intestinal  obstruction, IBS (Irritable bowel syndrome), LLQ abdominal mass. Differential diag diverticulitis, and intestinal obstruction. Plan Abdominal X-ray CT of abdomen CBC Pending diagnostic result,  may need gastrointestinal referal or surgical referal. Prescribes stool softner Educate importance of water intake Educate importance of  fiber intake; since she is not eating much, prescribe fiber substitutes powder. Instruct to seek emergency if she develop a worsening  abdominal pain, fever, nausea, and vomiting.  Diagnostics • Abdominal x-rays or CT s • CBC to assess for elevated WBCs as and electrolyte profile to evaluate elect Medication • None at this time Educatio increase/maintain fluid intake • Diet is i health. Pending diagnostic test results, diet rich in fiber such as whole wheat, p vegetables and oats Referral/Consulta results, may need GI or surgical referra Instruct the patient that is she develops and worsening abdominal pain, she sh attention • Revisit clinic in 5-7 days for 
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  • Fall '15
  • Objective pronoun, Ms. Park, LLQ

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