Question

The nurse is assessing a client in the emergency department (ED) who complains of right lower quadrant pain. The nurse determines that the client is exhibiting a positive psoas sign. Based on the client's assessment data, which conditions does the nurse suspect?

1) Constipation
2) Appendicitis
3) Cholecystitis
4) Small bowel obstruction
5) Peritonitis

Answer 1

A positive psoas sign in a patient with right lower quadrant pain is most suggestive of appendicitis, although other conditions like peritonitis should also be considered in the differential diagnosis.

Step-by-step explanation:

The nurse is assessing a client in the emergency department (ED) who complains of right lower quadrant pain and is exhibiting a positive psoas sign. A positive psoas sign is indicative of irritation to the iliopsoas group of hip flexors in the abdomen and often suggests appendicitis. This assessment finding is most commonly associated with appendicitis, due to the location of the appendix in the right lower quadrant where the psoas muscles are located. However, similar symptoms can be seen in other conditions such as peritonitis, which is an inflammation of the peritoneum. While less likely in this context, it is important to rule out other conditions that can also cause right lower quadrant pain such as kidney stones, urinary tract infections, or gastroenteritis. It is also important to consider the patient's medical history and any recent treatments or surgeries that could be related to the symptoms.