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FNP Review 9

GI sign symptoms abdominal pain

abdominal pain: common etilogies in various ages all: gastroenteritis; <2 yr: trauma, intussessception, incarcerated hernia; 2-5 yr: sickle cell anemia, right lower lobe PNA, UTI; > 5yr: appendicitis; adolescent: dysmenorrhea, ectopic pregnancy; adults: pancreatitis, cholecystitis, PUD, renal stones
abdominal pain: assessment: history onset: sudden, rapid or gradual; progression; migration; character & intensity; localization
Kehr's sign
visceral vs. somatic pain visceral: due to distention of a hollow viscus; poorly localized; somatic: due to peritoneal inflammation; sharper & more localized
rebound tenderness palpate deeply in the abdomen where the client has pain and suddenly release pressure; positive Blumberg's sign: perceive pain when pressure released
Rovsing's sign palpate deeply in LLQ; pain in RLQ during pressure in LLQ positive Rovsing's sign
obturator sign support client right knee & ankle, flex hip & knee & rotate leg internally & externally; positive if pain in RLQ appendicitis or perforated appendix
Murphy's sign to assess RUQ pain or tenderness, press fingertips under the liver boarder at the right costal margin and ask client to inhale deeply; accentuated sharp pain that causes client to hold his or her breath cholecystisis
psoas sign raise client right leg from the hip & place your hand on the lower thigh; ask client to keep leg elevated as you apply pressure downward against lower thigh; pain in RLQ associated with irriation of iliopsoas muscle appendicitis
abdominal pain: differential diagnosis base on location RUQ: cholecystitis, cholelithiasis, hepatitis; RLQ: appendicitis, ectopic pregnancy, tubo-ovarian pathology; LUQ: splenic enlargement, pancreatitis; LLQ: diverticulitis, PID, ectopic pregnancy; epigastric/midline: gastritis, PUD, AAA
Created by: deleted user
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