Describe six (6) ROS questions you would explore further with him to determine the location, severity, and timing of his pain.

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CC: “I have stomach pain.”
HPI: Max is an 80-year-old male with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and a pacemaker placed 10 years ago for third-degree heart block. He presents today with a complaint of abdominal pain.
You suspect a bowel obstruction in Max, an 80-year-old patient with complaints of cramping abdominal pain, nausea, and vomiting for 4 days.
Describe six (6) ROS questions you would explore further with him to determine the location, severity, and timing of his pain.
PE: On exam, the abdomen appears distended, Max has generalized tenderness over the epigastric region on palpation. He is guarding so the exam is limited. Bowel sounds are decreased.
His vital signs are normal. He describes his abdominal pain as 7/10.
As the APRN, you order an abdominal x-ray.
Test results:
The abdominal x-ray is indeterminate.
What are your next diagnostic choices to determine a bowel obstruction in this patient?
List at least three differential diagnoses for abdominal pain.
The CT scan shows that Max has a small bowel obstruction. What is your next step?

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