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abdomen
foundations exam 4
| Question | Answer |
|---|---|
| organs in right upper quadrant | pylorous, duodenum, liver, right kidney and adrenal gland, hepatic flexure of colon, head of pancreas |
| organs in left upper quadrant | stomach, spleen, left kidney and adrenal gland, splenic flexure of colon, body of pancreas |
| organs in right lower quadrant | cecum, appendix, right ovary and fallopian tube (female), right ureter and lower kidney pole, right spermatic cord (male) |
| organs in left lower quadrant | sigmoid colon, left ovary and fallopian tube (female), left ureter and lower kidney pole, left spermatic cord (male) |
| organs located in the midline | urinary bladder, urethra (female) |
| abdominal assessment risk factors to identify | abdominal pain, indigestion, nausea, changes in bowel habits, appetite, alcohol ingestion, menstrual history, hx abdominal surgery |
| abdominal assessment sequence | inspection, auscultation, percussion, palpation |
| abdominal assessment: inspect | inspect color and surface characteristics: umbilicus, contour, symmetry, visible masses or scars, pulsations |
| severe protrusion of umbilicus | umbilical hernia |
| if you see pulsating mass on abdomen... | do not palpate! |
| hernia | protrusion of an organ through weakened abdominal muscles |
| incisional hernia | hernia over incision |
| asymmetry in abdomen needs... | advances imaging and referral to provider |
| when you see abdominal scarring on pt... | ask them what it is from |
| stria | "stretch marks", result of skin stretching from weight gain or pregnancy |
| distention, bloating | indicates trapped gas, overeating, too much carbonation |
| swelling of the abdomen | symmetrically distended, fluid buildup in perineal cavity |
| ascites | abdominal swelling secondary to liver problem |
| auscultating the abdomen is used to assess... | bowel sounds and vascular sounds |
| how to auscultate abdomen | auscultate all 4 quadrants, light pressure with diaphragm of stethescope |
| normal bowel sounds on auscultation | gurgles or clicks, usually occur every 5-15 seconds |
| how long should you listen in each quadrant before documenting bowel sounds are absent? | 1 minute |
| hypoactive/ decreased bowel sounds | after abdominal surgery, late bowel obstruction |
| hyperactive/ increased bowel sounds | diarrhea, early bowel obstruction |
| absent bowel sounds | indicating peritonitis or paralytic ileus |
| what to do if bowel sounds are absent? | look at pt conditions (ex post op), frequent abdominal assessments, encourage ambulation to wake bowel up |
| what indicated partial bowel obstruction? | bowel sounds that are high pitched tinkling or rushes of high-pitched sounds indicate a partial bowel obstruction |
| auscultating vascular sounds of abdomen | use bell of stethoscope- auscultate over abdominal aorta, renal arteries, femoral arteries, iliac arteries for bruit |
| normal vascular sounds of abdomen heard on auscultation | shouldn't hear anything |
| bruits | swooshing or blowing sounds over a blood vessel |
| what are bruits caused by? | turbulent blood flow, possible stenosis (narrowing) or occlusion of an artery; abnormal dilation of a vessel |
| when would you expect to hear a bruit "normally"? | if a patient has AV fistula for dialysis |
| is percussion normally done by bedside nurses? | no, only under certain circumstances |
| what can percussion be used for? | to determine if distension is from fluid or air |
| percussion: flatness | bones such as the clavicle, ribs, sternum |
| percussion: dullness | dense organs such as the liver, spleen, heart |
| percussion: resonance | adult lung |
| percussion: hyperresonance | child lung |
| percussion: tympany | abdominal area such as intestines and stomach |
| palpation | LIGHT palpation only to assess the abdomen- used to assess a visible mass or determine if distention is soft or firm and any areas of tenderness |
| what to watch for when palpating | the patients face for nonverbal signs of pain |
| how to palpate | palpate each quadrant in a systematic manner- note tenderness or masses, palpate tender/ painful areas last, don't palpate a pulsating mass |
| what could a pulsating mass indicate? | an aneurysm |
| what could happen if you palpate a pulsating mass? | could cause rupture or disrupt clot forming embolus |
| normal findings of palpation | soft and non-tender |
| abnormal findings of palpation | spasms, rigidity, masses, pain |
| what could abnormal findings of palpation indicate? | trauma, peritonitis, infection, tumors, enlarged/ diseases abdominal organs |
| normal abdominal assessment | abdomen soft, non-tender, non-distended without visible masses, rashes, or lesions, bowel sounds active x4 |
| age related variants in abdominal assessment: newborns and children | "potbelly" under age 5, may see peristaltic waves, newborn umbilicus dries and falls off within first few weeks |
| age related variants in abdominal assessment: older adults | decreased bowel sounds, decreased abdominal tone, fat accumulation on the abdomen and hips |
Created by:
camrynfoster