A 17-year-old high school football player was struck in the abdomen by another player during a tackle. Your assessment reveals signs of shock and pain to the patient's left shoulder, which is unremarkable for trauma. Examination of the patient's abdomen is also unremarkable for obvious injury.

Based on your assessment findings and the patient's clinical presentation, you should suspect:

Based on the assessment findings of shock, pain in the left shoulder, and unremarkable abdominal examination after being struck in the abdomen during a football tackle, the nurse should suspect a possible splenic injury or rupture.

The left shoulder pain can be indicative of referred pain from the diaphragm, as the spleen is located in the upper left quadrant of the abdomen and irritation of the diaphragm can cause pain to be referred to the left shoulder. Signs of shock, such as hypotension, tachycardia, and pallor, can suggest internal bleeding, which can occur due to a splenic injury. The spleen is highly vascular, and if it sustains trauma, it can lead to significant bleeding and subsequent shock.

Further diagnostic tests, such as ultrasound, CT scan, or laboratory tests may be necessary to confirm or rule out a splenic injury and guide appropriate management. Immediate medical evaluation and intervention are crucial in such cases to prevent further complications.

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