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HA Week 11
Health Assessment Exam 3 - Abdomen and GI System
| Question | Answer |
|---|---|
| what is the main concept of the GI system? | elimination |
| right upper quadrant | ascending colon, duodenum, gallbladder, right kidney, liver, pancreas (head), transverse colon, ureter |
| right lower quadrant | appendix, ascending colon, bladder, cecum, rectum, ovary, uterus, Fallopian tube, prostate, spermatic cord, small intestine, ureter |
| left upper quadrant | depending colon, left kidney, pancreas, spleen, stomach, transverse colon, ureter |
| left lower quadrant | bladder, descending colon, ovary, uterus, Fallopian tube, prostate, sporadic cord, small intestine, sigmoid colon, ureter |
| dysphagia | difficulty swallowing |
| odynophagia | painful swallowing |
| gastrointestinal health history | abdominal pain, indigestion, nausea, vomiting (blood), loss of appetite, early satiety, dysphagia, odynophagia, change in bowel function, diarrhea, constipation, jaundice |
| visceral pain | hollow organs, may be difficult to localize, typically palpable near midline, gnawing, burning, cramping, aching |
| parietal pain | from inflammation of parietal peritoneum, steady aching pain, usually more severe than visceral, more precisely localized, aggravated by movement or coughing |
| referred pain | felt in more distant sites, seems to radiate or travel from original site, develops as initial pain becomes more intense |
| how do you assess abdominal pain? | OLDCARTS |
| what are the alarm symptoms of the GI tract? | dysphagia, odynopahgia, recurrent vomiting, GI bleeding, palpable mass |
| Health history questions for right lower quadrant | sharp and continuous? intermittent and cramping? rebound? doubled over? |
| health history questions for left lower quadrant | fever? loss of appetite? absent bowel sounds? firmness? guarding? rebound tenderness? |
| green stool | food moving through large intestine too quickly or patient could have eaten lots of leafy green vegetables or green food coloring |
| yellow stool | greasy, foul smelling indicates excess fat which could be due to a malabsorption disorder like celiac disease |
| black stool | internal bleeding; iron or bismuth intake could also cause this color stool |
| light-colored, white, or clay colored stool | bile duct obstruction, could be normal for some people, medications can cause this color |
| blood stained or red stool | symptom of cancer; need to see a doctor |
| where would you expose the patient when assessing the GI tract? | exposed abdomen from diploid process to symphysis pubis |
| what should a patient do before deep palpation of the bladder? | empty the bladder |
| what is the order of examination of the abdomen | Inspect, Auscultate, Percuss, Palpate |
| peristalsis | wavelike movements; seen in thin adults and adults with intestinal obstructions |
| flat contour | horizontal line from the diploid process to the symphysis pubis |
| convex contour | rounded |
| concave or scaphoid contour | sunken appearance |
| distended contour | protrusion of the abdomen due to fat, fluid, hernias, or flatus |
| pulsations | regular beats of movement midline above the umbilicus; normally seen in thin adults or in a mass |
| fat | areas of fat tissue; skin does not look taunt |
| fluid | the flanks protrude and when client turns the fluid moves to the dependent side |
| flatus | protrusion is midline and the flanks are normal |
| hernia | protrusions are visible through the abdominal wall; seen better when the patient raises the arm |
| striae | stretch marks |
| when is dullness heard over the abdomen? | tumor, pregnancy, ascites |
| what sound should be heard over the abdomen? | tympany |
| what part of the stethoscope do you use to auscultate the abdomen? | diaphragm |
| what are expected findings for auscultation of the bowels? | high pitched clicks and gurgles; 5-35 times a minute |
| what should you do is the bowel sounds are absent? | listen for a full 5 minutes |
| borborygmi | loud growing sounds |
| hyperactive sounds | increased motility |
| friction rubs | inflammation in the peritoneum |
| venous hum | humming sound that indicated cirrhosis or portal vein HTN |
| where is dullness normally heard? | over the liver, spleen, or full bladder |
| what should the normal liver span be? | 6 to 12 cm |
| when should you percuss the liver? | when enlargement is suspected |
| normal spleen percussion | the normal spleen cannot be percussed or may hear a small area of splenic dullness at the 6th to 10th intercostal space |
| how to assess possible ascites? | test for shifting dullness and observe for a fluid wave |
| when should you palpate tender areas? | palpate tender areas last |
| when should you palpate the bladder? | palpate only when full |
| deep palpation of the abdomen? | press 4-6 cm; one hand approach or 2 hand approach |
| blumberg's sign | rebound tenderness |
| rebound tenderness | apply firm pressure for 4 second with the hand; after releasing the pressure, observe the clien |
| positive rebound tenderness | if releasing the pressure caused pain |
| Screening for alcohol abuse | CAGE - Cut down, Annoyed by criticism, Guilty, Eye opener |
| Hepatitis A | fecal-oral transmission; vaccine available; stress good handwashing techniques prophylaxis: serum globulin |
| Hepatitis B | more serious health threat; vaccine available; most asymptomatic until develop symptoms of advanced liver disease |
| risk categories for hepatitis B | sexual contacts, people with percutaneous or mucosal exposure to blood, travelers, patients which chronic liver disease, HIV infection |
| CDC immunization recommendations for Hepatitis B | all adults in a high-risk setting, adults in occupations involving exposure to blood or infectious body fluids, US Preventive Services Task Force, all pregnant women at first prenatal visit |
| Hepatitis C | no vaccine available, repeated percutaneous exposure to blood, treatment and cure available |
| colorectal cancer | screening; assessing risk factors |
| risk factors for colorectal cancer | past cancer? history of inflammatory bowel disease? family history? high fat diet? physical inactivity? obesity? smoking? alcohol use? |
| protective factors for colorectal cancer | diet high in fruits and veggies, diet high in fiber, regular physical activity, use of aspirin or NSAIDS |
| what is the main concept of the genitourinary tract? | elimination |
| health history for genitourinary tract | suprapubic pain; dysuria, urgency, or frequency; hesitancy, decreased urine stream in males; polyuria or not curia; urinary incontinence; hematuria; kidney or flank pain; ureteral colic |
| when is genitourinary tract assessed? | at the same time as the abdominal exam |
| what should you use when examining the prostate? | lubrication and gloves |
| what should the patient do before examination of the genitourinary tract? | empty the bladder |
| kidney percussion | fist percussion; costovertebral angles at the scapular lines on the back; should not be tender |
| what can CVA pain indicate? | pyelonephritis, glomerulonephritis, or nephrolithiasis (kidney stones) |
| kidney palpation | should not be palpable |
| bladder percussion and palpation | normally cannot be examined unless distended above symphysis pubis; palpate for tenderness, percuss for dullness |
| prevention of urinary incontinence | pelvic muscle training (Kegel exercises); biofeedback (bladder training) |
| stress incontinence | small amounts of urine are leaked due to a weak urethras sphincter |
| urge incontinence | moderate amounts of urine are leaked due to small bladder capacity |
| overflow incontinence | continuous dribbling of urine; bladder may be enlarged; impaired bladder sensation |
| functional incontinence | inability to ge to the bathroom in time because of health or environmental concerns |
| medication incontinence | drugs impact incontinence |
| what is the 2nd leading cause of death in males? | prostate cancer |
| risk factors for prostate cancer | age, family history, African American |
| screening for prostate issues | prostate specific antigen (PSA), digital rectal exam (DRE), screen annually at age 40 |
| concerning symptoms with the prostate | incomplete emptying of the bladder, urinary frequency/urgency, weak or intermittent urine stream, hesitancy with initiating flow, hematuria, nocturne, pelvic pain |
Created by:
ballen9519
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