In this case study, the patient is a 47-year-old man who was admitted to the emergency room with abdominal pain. His known health history is that the patient has ulcerative colitis, but has not taken his medications for several months. The first step for the advanced practice nurse is to ask the patient about his symptoms and past medical history. Subjective data are necessary to determine whether the patient’s pain is due to inflammation of his existing inflammatory bowel disease or a sign of another condition. For instance, the nurse may collect information about the patient’s pain severity, location, onset, and factors that exacerbate or relieve it (Ball et al., 2023).
Apart from medical history, the patient’s social environment – family, employment, and living conditions – is also crucial as it may contribute to his health. Then, a physical examination of the patient’s abdominal system is required. Testing, such as stool culture and endoscopy, is common among patients seeking treatment (Segal et al., 2021). In an emergency, one may rely on a physical assessment for initial response and urgent treatment.
An ethical issue to consider in this scenario is the absence of insurance. It is likely that the patient has not been taking medications due to financial difficulties and has been unable to come into the office to obtain a prescription or undergo regular testing. Uninsured patients often resort to waiting until a crisis to receive treatment, which further exacerbates their financial difficulties (Venkatesh et al., 2019).
As an advanced practice nurse, I would discuss the importance of prescribed medications in the case of ulcerative colitis. I would also consult the patient about affordable ways of getting cheaper drugs and finding insurance that covers this condition. Finally, I would recommend getting more information about ulcerative colitis management and talking about the risks of colon cancer to increase the patient’s awareness about his health concerns.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). Elsevier Mosby.
Segal, J. P., LeBlanc, J. F., & Hart, A. L. (2021). Ulcerative colitis: An update. Clinical Medicine, 21(2), 135–139.
Venkatesh, A. K., Chou, S. C., Li, S. X., Choi, J., Ross, J. S., D’Onofrio, G., Krumholz, H. M., & Dharmarajan, K. (2019). Association between insurance status and access to hospital care in emergency department disposition. JAMA Internal Medicine, 179(5), 686–693.