Addressing Chest Pain, Abdominal Pain, Ovarian Teratomas, and Mental Illness

Short Essays
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Short Essays
Question 1
When a patient presents a chest pain complaint, a primary care provider must consider several possibilities. A mere muscle strain or indigestion may cause chest pain, or it could be due to other serious causes. Regardless of the cause, a care provider has to take some important steps in assessing the patient. The first step is obtaining and examining a 12-lead ECG and a rhythm strip as soon as possible to identify early and accurately if the patient has ST-Elevation Myocardial Infarction (STEMI) (Curtis et al., 2019). The second step includes measuring the heart rate, respiratory rate, blood pressure, and oxygen saturation. In this step, the care provider also evaluates the patient's neurological status. The care provide does auscultation of the chest and notes abnormal lung, heart, and valve sounds. The third step is ascertaining the patient's social and medical history, current symptoms, and the nature of their discomfort.
There are several differential diagnoses for a patient with chest pain. The cause of chest pain can be acute myocardial infarction, characterized by a sudden onset of pain lasting for over 30 minutes (Curtis et al., 2019). Key characteristics of the pain include aching, pressure, choking, and tightness. The pain is worsened by anxiety and movement and can only be relieved by medication. Another cause of chest pain could be a pulmonary embolism, which occurs when one of the pulmonary arteries has a blockage. It occurs suddenly, and the patient feels crushing pain. It is made worse by breathing and relieved when the patient is not breathing (Curtis et al., 2019). Acute myocardial infarction treatment may require morphine sulfate, oxygen, aspirin, and glyceryl trinitrate, while the intervention for pulmonary embolism includes anticoagulants and clot dissolvers. Acute myocardial infarction may also require beta-blocker therapy.
Question 2
The primary care provider needs to use a systematic approach when assessing a patient with abdominal pain complaints. The first step is inspection, where the care provider observes the patient's face for discomfort, skin color, or diaphoresis (Curtis et al., 2019). The care provider also examines the abdomen for color by determining whether it is molted, pale, or characterized by jaundice. The second step is auscultation, which is done on all four quadrants to determine the pitch, quality, and bowel sound frequency. The third step is percussion, which is also performed on all four quadrants. As noted by Curtis et al. (2019), tympanic sounds may indicate air masses below, while dull sounds can mean the presence of tumors or solid organs.
Abdominal pain could mean several possibilities, and two associated differential treatments are appendicitis and cholecystitis. Appendicitis occurs when the appendiceal opening is obstructed, leading to a reduced blood supply and eventually bacterial infection (Curtis et al., 2019). If it is not treated, the inflammation progresses, making the appendix non-viable. Diagnosis is made by evaluation of clinical signs together with the physical examination. Ultrasound may sometimes indicate an enlarged appendix. For cholecystitis, the cystic duct becomes obstructed du...