With the ER patient, I’ll call Pam, presenting in the ER with left lower quadrant (LLQ) pain I can quickly think of potential diagnosis she is suffering with. The three that come to mind are ectopic pregnancy, diverticulitis, and ureteral calculi. Ectopic pregnancy …show more content…
Having pain in the left lower quadrant is most common. Pain is often described as cramping, and may be associated with changes to bowel habits. Patients may exhibit nausea and vomiting, constipation, diarrhea, and bloating (Shahedi, …show more content…
If the patient is stable then place them on a cardiac monitor, place oxygen, place IV and fluid if indicated, and draw labs. Starting with the subjective assessment I would ask when the pain started, the severity, and the location. Does she have any abdominal problems, has she ate any food that was cooked in an unsanitary manner, has she drank any contaminated water, has she same in a pond or lake recently, and has she started taking any new medications, like NSAID’s. I would then inspect her abdomen evaluating the contour looking for distention, symmetry, and protuberance. I would then auscultate to evaluate her bowel sounds. Percussion to assess and screen for masses. Listen to sounds to determine if it is tympany or dullness. Palpation would be done light then deep to assess for any masses, and tenderness. I would expect to find LLQ tenderness, since most diverticula occur in the sigmoid colon. CT of the abdomen is the best test to run to determine if she has free air, ruptured diverticulum, or fecal matter outside the bowel. These finding would warrant a consult to the general surgeon and the patient would be prepared for the operating