Passage / Scenario

Nurse's Notes (0700 hrs): The client reports a sudden onset of severe abdominal pain that started 4 hours ago. He describes the pain as sharp and constant, located in the upper right quadrant of the abdomen. The client has vomited twice in the past hour, with the vomitus being greenish in color. He denies any recent trauma or injury. The client appears anxious and is clutching his abdomen. He has a history of hypertension and is currently on medication for it. The client denies any known allergies; Physical Examination Results (0700 hrs): The client is alert and oriented but appears to be in significant distress. His skin is pale and diaphoretic. The abdomen is distended and tender to palpation, especially in the upper right quadrant. There is guarding and rebound tenderness noted. Bowel sounds are hypoactive. The client exhibits mild jaundice, with yellowing of the sclera. There are no visible signs of trauma or bruising on the abdomen; Vital Signs (0700 hrs): Temperature: 38.3°C (100.9°F), Pulse: 110 beats per minute, Respiratory Rate: 24 breaths per minute, Blood Pressure: 150/90 mm Hg, Oxygen Saturation: 95% on room air; A nurse is caring for a 45-year-old male client in the emergency department who presented with severe abdominal pain and vomiting.