A client in the emergency department is complaining of abdominal pain after an episode of nausea and vomiting. Which statement by the client to the nurse necessitates prompt notification of the health care provider?

  1. “I started hurting when I got up this morning to go to work.”
  2. “My grandmother had to have her appendix out many years ago.”
  3. “I haven’t eaten anything because I’ve been so nauseated and throwing up.”
  4. “The pain is worse when I cough or move but feels better when I bend my right hip.”
Number 4 is correct.
Rationale: Abdominal pain that increases with cough or movement and is relieved by bending the right hip or knees indicates perforation and peritonitis. Untreated peritonitis can be life-threatening. Pain is a common finding in appendicitis and other inflammatory bowel problems. Family history can play a part in the risk of abdominal alterations. Nausea and vomiting are common findings.