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health assessment 3b


obesity I: uniformly rounded, umblicus sunken A:normal bowel sounds P:tympany, scattered dullness P:normal, hard to feel
air or gas I: single round curce A: depends on cause, hyperactive w/early intestinal obstructions P:tympany over large area P:may have muscle spasm of ab wall
ascites I:single curve, everted umbilicus, bulging flanks wen supine;taut glistening skin, recent weight gain A:normal bowel sound, diminisde over ascitic fluid P:tympany @ top where intest float, dull over fluid, wave + shifting dullness P: taut skin, i intra
ovarian cysts (large) I: curve in lower half of ab, midline; everted umbilicus A:normal bowerl over up ab P:top dull over fluid, intest pushed super; large cyst produce wave + shift dullness P:aortic pulsation
pregancy I:single curve, umbilicus protudes, breast engorged A: fetal heart tones, bowel diminished P:tympany over intest, dull over uterus P:fetal parts + movements
tumor I: localized distention A:normal bowel sound P:dull over mass P: define borders, distinguis from enlarged organ or normal palpable skin structure
feces I: localized distention A: normal bowel sound P: tympany, scatterd dullness over fecal mass P: plastic or ropelike mass w/feces in intest
Liver pain shoulder - hepatitis may have mild to moderate, dull pain RUQ or epigastrium,
esophagus pain GERD is complex symptom of inflammation, include bruning pain in midepigastrium or bhind low sternum that radiates upward, "heartburn" -occur 30-60 min after eating, aggravated by lying down or bending over
gallbladder pain sudden pain in RUQ radiate to R/L scapula, which builds over time (2-4hrs) after ingestion of fatty foods, alcohol, or cafeeine -assocaited w/nausea, vomiting, + murphy, or sudden stop in inspriration w/RUQ palpate
pancreas pain boring midepigastric pain radiating to bac + sometimes to L scapula or flank, sever nusea, + vomiting
doudenum pain dull, aching, gnawing pain, does not radiate, mayb be relieved by food, + may awaken person in sleep
stomach pain dull, aching, gnawing epigastic pain; radiates to bac or substeranl are
appendix pain starts as dull, diffuse pain in periumbilical region that shifts to sever, sharp, persistent pain + tenderness localized in RLQ
kidney pain sudden onset of sever, colicky flank or lower ab pain
small intestine pain generalized ab pain, with nausea, diarrhea
colon pain large bowel obstruction moderate, colicky pain of gradual onset in low ab, bloating -IBS has sharp or burning, cramping pain over wiede are, does not radiat, brough t on by meals, releived by bowel movement
umbilical hernia soft, skin-covered mass, which is protursion of the omentum or intestine through a weakness or incomplete closure in umbilical ring
epigastric hernia small, fatty nodule at epigastrium midline; can feel it, palable wen standing
incisional hernia bulge nera olde operative scar show wen supine but apparent wen person increases intraab pressure by a sit up, stand
diastasis recti midline longitudal ridge, seperation ab recuts muscles -ridge revealed wn intraab pressure increased by raising head while supine
succussion splash very loud splach aus over U Ab wen infant is rocked side to side -indicates I air + fluid in stomach
hypoactive bowel sounds diminished or absent bowel sounds signal decresase motility as result of itis -occur with pneumonia
hyperactive bowel sounds loud, gurgling sounds, borborygmi, signal increased motility -ovvur with early mechanical bowel obstruction, gastroeneteritis, brisk diarrhea, lazative use
peritoneal fricition rub rough, grating sound, indicates peritoneal itis; occur rarely -liver:friciton rub over LR rib cage from abscess/tumor -spleen:friciton rub over LL rib cage form abscess, infection, or tumor
vascular sounds arterial-bruit: indicates turbulent blood flow, w/bell; occur with aortic aneurysm, renarl arter stenosis, partial occlussion of femoral artery -venous hum: rare, preumbilical region, from inferior vena cava, medium ptich; occur w/portal HTN + cirrhotic
enlarged iver enlarged, smooth, nontender with fatty infiltration, portal obstruction or cirrhosis -feels enlarged + smooth but is tender to palpation with early HF, acute hepatitis, or hepatic abscess
enlarged nodular liver enlarged + nodular occur w/late portal cirrhois, metastic cancer, tertiary syphilis
enlarged gallbladder tender suggest acute felt behind liver border as smooth + firm mass like sausage -nontender feels smooth susagelike mass; occur wne filled with stones
enlarged spleen retains in splenic notch on medial edge acute infection it is moderately enlarge + soft with rounded eges chronic cause:firm or hard with sharp edgges -not tender to palpation, only if peritoneum inflammed
enlarged kidney enlarged w/hydronephrosis, cyst, or neoplasm; similar shape to enlarged spleen -percussion tympany bc overriding bowel
aortic aneurysm below renal artery + extend in umbilivus -palable+ feel like pulsating mass in U ab; bruit, femoral pulse present but decreased
Created by: xnyzlatinangelx