Complete Shadow Health Abdominal Pain Assessment for Danny Rivera. Acute appendicitis presentation — McBurney point tenderness, rebound tenderness positive, WBC 14.8, low-grade fever 38.1°C. Complete abdominal examination, OLDCARTS pain evaluation and surgical referral documented. Used in GCU, Chamberlain and Aspen programs.
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Danny Rivera presents with right lower quadrant abdominal pain that began 12 hours ago as periumbilical pain and has migrated to the RLQ. He rates pain at 8/10, sharp and constant. He has had one episode of vomiting and his appetite is decreased. Low-grade fever of 38.1°C on arrival.
The Abdominal Pain Assessment covers the complete abdominal history using OLDCARTS, nausea and vomiting documentation, bowel habits and the full abdominal physical examination. Key findings include maximal tenderness at McBurney point (two-thirds of the way from umbilicus to ASIS), positive rebound tenderness (Blumberg sign), positive Rovsing sign and voluntary guarding in the RLQ.
WBC 14.8 (elevated). McBurney point tenderness. Rebound tenderness positive. Diagnosis: Acute appendicitis. Surgical consultation placed, NPO ordered, IV access and fluids initiated.