T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (Ed). On arrival,

Question

you note that he is trembling and nearly doubled over with severe abdominal pain. T.B.

indicates that he
has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid back
as a deep, sharp, boring pain. He is more comfortable walking or sitting bent forward rather than lying
flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but "none
as bad as this." He feels nauseated but has not vomited, although he did vomit a week ago with a similar
episode. T.B. experienced an acute onset of pain after eating fried fish and chips at a fast-food restaurant
earlier today. He is not happy to be in the hospital and is grumpy that his daughter insisted on taking him
to the Ed for evaluation.
After orienting him to the room, you perform your physical assessment. The findings are as follows:
He is awake, alert, and oriented× 3, and he moves all extremities well. He is restless, constantly shifting
his position, and complains of fatigue. Breath sounds are clear to auscultation. Heart sounds are clear and
crisp, with no murmur or rub noted and with a regular rate and rhythm. Abdomen is flat, slightly rigid, and
very tender to palpation throughout, especially in the RUQ; bowel sounds are present. He reports having
light-colored stools for 1 week. The patient voids dark amber urine but denies dysuria. skin and sclera
are jaundiced. Admission vital signs are blood pressure 164/100, pulse of 132 beats/min, respiration 26
breaths/min, temperature of 100° F (37.8° C), spo2 96% on 2 L of oxygen by nasal cannula.
What structures are located in the RUQ of the abdomen?
What will be an ideal response?

Answer 1

Liver, gallbladder, head of the pancreas, duodenum, antral portion of stomach, right kidney, and
colon