A 38-year-old Filipino patient, G3P2+0 presented to the emergency department on the 18th of October 2019 complaining of acute onset of lower abdominal pain associated with a history of amenorrhea for three months. She was unsure of the date of her last menstrual period and had no previous antenatal follow-up. She was medically free, and her past obstetric history included a normal uncomplicated vaginal delivery, followed by a cesarean section which was performed four years back. She had no allergies and was not taking any medication or contraception. Upon presentation, she complained of generalized lower abdominal pain, which was of a sudden onset, continuous, not radiating, and not relieved by oral analgesia. The pain was associated with nausea and symptoms of anemia such as dizziness and shortness of breath, but there was no history of loss of consciousness, gastrointestinal or urinary tract symptoms. There was no history of fever or symptoms suggestive of pelvic inflammatory disease.
Upon clinical examination, the patient looked pale and distressed. Her blood pressure was 90/42 mmHg, with a pulse rate of 110 beats per minute. Her abdomen was generally distended and tender on both superficial and deep palpation, with signs suggestive of peritonitis. Her hemoglobin count measured 3.2 g/L, and her total white cell count was 7.5 g/L.
Based on the above scenario identify how a diagnosis would be established, what therapy is indicated, and what preoperative nursing interventions are appropriate.
Provide a complete nursing diagnosis for the patient in this case study
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