Discussion

Major meltdown in progress re:pathophys

Oct 18, 200619 yr

UGGGGHHHHH,

I received a ptient today with an admitting diagnosis of Abdominal mass. I need to do a pathophysiology on that diagnosis, with all the related stuff: diagnostic tests, etiology, signs/symptoms, medical management, nursing imlications, and health care deviation requisites. My problem is; is that I know what the end result was, but I need to do the patho on the admitting Dx, and that (abdominal mass) is too braod that I am having a hard time narrowing the focus inot something that is clear and concise.

Any kind words or suggestions. Or even a slap on the face to tell me to get over it?

Thanks,

T:uhoh21:

Oct 18, 200619 yr

:trout: Get over it.

Now, seriously.... take a deep breath, and take it one step at a time.

Okay so "abdominal mass" is a HUGE subject area.

See if you can narrow it down by

Patient complaint

Patient history

Labs

Dont be afraid to do a GENERAL pathology work up. By gum... sometimes thats just plain what you have to do.

But do a damn good job of it :wink2:

If you go with the GENERAL work up also make sure you have a good strong list of If this:Then that

Your instructor will want to see that you've done your research.

You could also do a mini work up on the final dx - just to cover your bases.

Oct 18, 200619 yr

Author

Thanks for the slap, I stopped hyperventilating long enough to think again. :bugeyes:

I ended up writing most everything as an abdominal mass, but I did pull out the information that doctor used to come to her conclusion of colorectal cancer and focused the patho portion on that. I hope my instructor apppreciates the effort!

Oct 18, 200619 yr

Sounds like you did the right thing. The adbominal mass was the admitting diagnosis, but that's too broad.

Gotta love patho. :)

Oct 18, 200619 yr

Experts

an abdominal mass is nothing more than a symptom. if you must do the pathophysiology on the admitting diagnosis then i would approach it from the view of doing first the normal anatomy and structures in the abdomen and then doing a focus on the potential reasons for a mass to be present and the causes of each of those masses. this, i believe, would be differential diagnosis. my book on physical examination, textbook of physical diagnosis, history and examination, 3rd edition, by mark h. swartz has this to say about abdominal masses on page 362: "an abdominal mass may be a neoplasm or a hernia. an abdominal hernia refers to a protrusion from the peritoneal cavity into which peritoneal contents are extruded. the contents may be omentum, intestine, or bladder wall. an abdominal hernia may be inguinal, femoral, umbilical, or internal, depending on its location. the most common complaint is swelling, which may or may not be painful. an inguinal hernia may manifest as a mass in the groin or scrotum. the major complications of a hernia are intestinal obstruction and intestinal strangulation from interference of blood supply. a hernia is termed reducible when it can be emptied of its contents by pressure or a change in posture. a symptom of a pulsatile abdominal mass should alert the examiner to the possibility of an aortic aneurysm."

i would check out some of the medical school physical assessment sites that are listed on this thread:

https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum)

there are several of them that have some information in the abdominal assessment that might be helpful for you. a hernia is usually going to be determined through physical exam more so that an x-ray. a neoplasm is going to need x-rays and labwork.

these sites at family practice notebook include tests to be ordered to diagnose. you can also do a search for each of the various hernias and tumors to get signs and symptoms:

http://www.fpnotebook.com/sur54.htm - inguinal hernia

http://www.fpnotebook.com/hem74.htm - serum tumor markers (lab tests when ruling out cancer)

http://www.fpnotebook.com/hem75.htm - serum acid phosphatase

http://www.fpnotebook.com/hem76.htm - serum cancer antigen-125