Nokea
Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her left lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her leftover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isnt hungry. She had a little diarrhea yesterday but no bowel movements today. She has a temperature of 100.9F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 9460 mm Hg. She has some discomfort to deep palpation in the left lower quadrant. The AGACNP suspects
Correct Answer: A
Rationale: The correct answer is A: Irritable bowel syndrome. Mrs. Maroldo's history of recurrent left lower quadrant pain that usually resolves with antibiotics suggests a chronic condition rather than an acute one like diverticulitis, appendicitis, or inflammatory bowel disease. Her lack of nausea, vomiting, and severe symptoms, along with the presence of diarrhea and no bowel movements, align more with irritable bowel syndrome. Additionally, her vital signs are not significantly elevated, ruling out acute conditions like appendicitis. Discomfort to deep palpation in the left lower quadrant is common in irritable bowel syndrome due to visceral hypersensitivity. Therefore, based on her chronic symptoms, lack of severe signs, and typical presentation, the most likely diagnosis is irritable bowel syndrome.