i-Human Case Study | Christine Smith | Flank Pain Walden University | Advanced Health Assessment
I-Human Case Study
Christine Smith — Flank Pain
Graduate Premium Sick Visit Case: H&P + Dx
Advanced Health Assessment & Diagnostic
Reasoning
Walden University
Nrnp 6531 / Nr 509 / Nr 667 / Class 6512
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 1
,i-Human Case Study | Christine Smith | Flank Pain Walden University | Advanced Health Assessment
PATIENT SNAPSHOT
Patient Name Christine Smith (C.S.)
Age 33 years old
Sex Female
Height 5'6" (168 cm)
Weight 130.0 lb (59.1 kg)
BMI 21.0 (Normal/Healthy weight)
Reason for Encounter Flank pain — right-sided, worsening over 2 days
Location Outpatient clinic
Case Week Week #7
Case Author Swaramsi Katragadda, MD — i-Human Content Team
Course Advanced Health Assessment & Diagnostic Reasoning
Body Systems Involved Genitourinary/Renal, Gastrointestinal, Sexual/Reproductive
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 2
, i-Human Case Study | Christine Smith | Flank Pain Walden University | Advanced Health Assessment
SECTION I: SUBJECTIVE DATA
Chief Complaint (CC)
"I've been having a whole lot of pain on the upper side near my back — that's called the
flank, right? It started out mild when I first woke up two days ago. After breakfast that
morning I started feeling sick to my stomach, and then the pain got severe by the
afternoon."
History of Present Illness (HPI)
C.S. is a 33-year-old female who presents to the outpatient clinic with a 2-day history of right-sided
flank pain. The pain began as mild discomfort upon waking approximately 2 days ago and
progressively worsened to severe intensity by the afternoon of the first day. The pain is located a
few inches below the 12th rib on the right side posteriorly and is constant since onset, with ongoing
worsening. It is described as achy and uncomfortable, rated 8/10 in severity.
Associated symptoms include nausea, vomiting (3–4 episodes), decreased appetite, and fever.
The fever began one day after the onset of flank pain and nausea, with a peak temperature of
101°F documented by the patient. Acetaminophen was taken and provided some relief from the
fever. Pain does not change with position — lying still, changing position, or moving does not
alleviate or worsen the discomfort.
Pertinent history includes three prior urinary tract infections (UTIs): the first approximately two
years ago, the second approximately eight months ago, and the most recent approximately two
months ago for which antibiotics were prescribed. The patient notes that current flank pain is
different from prior UTI-related pain — it is higher up and more severe than the lower abdominal
discomfort she experienced during previous UTIs.
Flank Pain — OLDCARTS
Onset Approximately 2 days ago; began mild upon waking, worsened
significantly by afternoon
Location Right flank — a few inches below the 12th rib on the right side
posteriorly; localized
Duration Constant since onset; present for 2 days; progressive
worsening
Character Achy, deep, uncomfortable; does not radiate to groin or
elsewhere
Aggravating Factors No positional change relieves or worsens the pain; consistent,
unremitting
Relieving Factors Nothing noted to relieve flank pain; acetaminophen helps fever
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 3
I-Human Case Study
Christine Smith — Flank Pain
Graduate Premium Sick Visit Case: H&P + Dx
Advanced Health Assessment & Diagnostic
Reasoning
Walden University
Nrnp 6531 / Nr 509 / Nr 667 / Class 6512
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 1
,i-Human Case Study | Christine Smith | Flank Pain Walden University | Advanced Health Assessment
PATIENT SNAPSHOT
Patient Name Christine Smith (C.S.)
Age 33 years old
Sex Female
Height 5'6" (168 cm)
Weight 130.0 lb (59.1 kg)
BMI 21.0 (Normal/Healthy weight)
Reason for Encounter Flank pain — right-sided, worsening over 2 days
Location Outpatient clinic
Case Week Week #7
Case Author Swaramsi Katragadda, MD — i-Human Content Team
Course Advanced Health Assessment & Diagnostic Reasoning
Body Systems Involved Genitourinary/Renal, Gastrointestinal, Sexual/Reproductive
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 2
, i-Human Case Study | Christine Smith | Flank Pain Walden University | Advanced Health Assessment
SECTION I: SUBJECTIVE DATA
Chief Complaint (CC)
"I've been having a whole lot of pain on the upper side near my back — that's called the
flank, right? It started out mild when I first woke up two days ago. After breakfast that
morning I started feeling sick to my stomach, and then the pain got severe by the
afternoon."
History of Present Illness (HPI)
C.S. is a 33-year-old female who presents to the outpatient clinic with a 2-day history of right-sided
flank pain. The pain began as mild discomfort upon waking approximately 2 days ago and
progressively worsened to severe intensity by the afternoon of the first day. The pain is located a
few inches below the 12th rib on the right side posteriorly and is constant since onset, with ongoing
worsening. It is described as achy and uncomfortable, rated 8/10 in severity.
Associated symptoms include nausea, vomiting (3–4 episodes), decreased appetite, and fever.
The fever began one day after the onset of flank pain and nausea, with a peak temperature of
101°F documented by the patient. Acetaminophen was taken and provided some relief from the
fever. Pain does not change with position — lying still, changing position, or moving does not
alleviate or worsen the discomfort.
Pertinent history includes three prior urinary tract infections (UTIs): the first approximately two
years ago, the second approximately eight months ago, and the most recent approximately two
months ago for which antibiotics were prescribed. The patient notes that current flank pain is
different from prior UTI-related pain — it is higher up and more severe than the lower abdominal
discomfort she experienced during previous UTIs.
Flank Pain — OLDCARTS
Onset Approximately 2 days ago; began mild upon waking, worsened
significantly by afternoon
Location Right flank — a few inches below the 12th rib on the right side
posteriorly; localized
Duration Constant since onset; present for 2 days; progressive
worsening
Character Achy, deep, uncomfortable; does not radiate to groin or
elsewhere
Aggravating Factors No positional change relieves or worsens the pain; consistent,
unremitting
Relieving Factors Nothing noted to relieve flank pain; acetaminophen helps fever
Walden University — NRNP/NR Advanced Health Assessment & Diagnostic Reasoning Page 3
