Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Dillon Ch 17
Assessing the Abdomen
| Question | Answer |
|---|---|
| Name two developmental considerations in infants | ***liver takes up more space *** abd normally protrudes due to weak abd muscles |
| Name three developmental considerations in children | ***abd proportionately larger still ***diaphragmatic breathing is normal ***organs easily palpated due to underdeveloped abd muscles |
| Name 4 considerations in pregnancy | ***GERD/constipation --- ***diminished bowel sounds***linea nigra***striae |
| Name 4 considerations in older adults | ***reduction in digestive secretions---increased abd fat---GI slowing/constipation---general decline in organ function |
| what are signs of GI bleed? | change in stool color/odor---low bp/high HR---orthostatic hypoTN---pale/diaphoretic |
| What is ileus | when (often) a decreased blood suply causes total/complete blockage of intestin. Leads to decreased peristalsis and/or necrosis |
| what is peritonitis | inflamm of peritoneum, usually caused by collection of pus in abd |
| causes of constipation (besides diet/water/dehydration) | medications---lack of exercise---cancer---intestinal obstruction |
| Solid viscrea is normally encapsulated - name 3 | liver---spleen---kidneys |
| what organ fills most of RUQ | liver, which extends to MCL, lower edge may be palpable |
| Is hollow viscera normally palpable? | since it's shape depends on contents, it is not usually palpable |
| Name 5 hollow organs | stomach---gallbladder---small int---colon---bladder |
| Your pt has audible bruits, what shouldn't you do? | never palpate bruits, could be evidence of abdominal aortic aneurysm |
| What is the most common complaint r/t (related to) the abd | abd pain most common complaint - can be visceral, parietal or referred pain |
| name major organs of RUQ | liver---gallbladder---duodenum---ascending/descending colon---kidney/adrenal (retroperitoneal)---also head of pancreas, hepatic flxure of colon |
| name major organs of LUQ | spleen---stomach---body of pancreas---kidney/adrenal---trans/descending colon---AORTA-------also splemic flexure of colon |
| name major organs of RLQ | appendix---asc colon---ovary/enlarged uterus---distended bladder---part of kidney/ureter |
| Name major organs of LLQ | sigmoid colon---ovary/uterus---kidney/ureter---bladder |
| where do we find tympany upon percussion | over air filled organs - loud, high pitched hollow sound |
| where do we find dullness upon percussion | over solid organs |
| how does muscle sound upon percussion | sounds flat |
| what do you do if bowel sounds are absent? | ausculate for 5 minutes, may have slow peristalsis |
| best position for abd assessment | supine with knees flexed if needed---kids sit on parents laps with knees flexed |
| relevant biographical/subjective data | medications---dysphagia/dyspepsia---weight/appetite/elimination changes---n/v---abd pain---past abd surgeries---nutrition |
| relevant familial hx | family hx of colon ca---GI issues |
| what are we looking for in physical assessment (normal findings) | size/shape/symmetry---usual skin stuff---pulsations---have pt elevate head off of bed and assess for herniations |
| After we inspect, what is the NEXT thing we assess | always ausculatate before palpating/percussing in this order RLQ---RUQ---LUQ---LLQ |
| abnormal finding for abd percussion | large dull areas may indicate mass/enlarged organs----we expect to find SCATTERED areas of dullness due to fluid/feces |
| what would we expect to percuss on Gastric Air bubble | would expect tympany unless spleen enlarged |
| light palpation depth is | palpate 1/2 inch or 1 cm---save painful areas til last---observe for gaurding/pain |
| deep palpation depth is | palpate 2-3 inches or 5-8 cm. |
| where is it normal to have a slightly tender sensation upon deep palpation | LLQ sigmoid colon tenderness is normal finding |
| CVA assessed by | percussion of costal/vertebral angle to asses for kidney issue/UTI/pyelonephritis |
| where do we try to palpate the liver? (not always palpable) | under 11th/12th ribs, parallel to midline. push down and under right costal margin. Client take deep breath, may palpate edge on inspiration. But then again, maybe not! |
| how is visceral pain generally described | burning---cramping---diffuse---poorly localized |
| how is parietal pain generally described | severe---localized---aggrevated by movement |
| With ACUTE abd pain, we change the symptom assessment order to what? | RTQSP |
| a pt presents stating indigestion and points to chest area. what do you assess for first? | assess to rule out cardiac disease first |
| upper GI bleed is evidenced by what type of stool? | black, tarry (blood has oxidized through digest process) |
| Lower GI bleed is evidenced by what type of stool | red, bloody stool (hasn't had much time to oxidize to darker color) |
| clay colored stool might indicate | might indicate increased bile in obstructive jaundice |
| if a pt presents with prolonged diarrhea, what should we assess for? | assess for dehydration by skin turgor test, othrostatic hypoTN----also look for hypoKalemia (cardiac arrythmias, muscle weakness) |
| If a pt complains of indigestion, what should we assess FIRST | always assess vital signs ASAP. Pts with MI commonly complain of indigestion |
| Your pt presents with projectile vomitting, what should we assess first? | assess for neurological or vascular changes that may indicate stroke |
| what would the presence of coffee-ground emesis indicate? | blood in the stomach (which takes on this texture with its interaction with stomach acid) |
| normal bowel sounds rate per min | 5-30 clicks/min in each quadrant |
| normal findings ausculate vasculature | no bruits---no venous hums---no friction rub (which could indicate inflammed organs) |
| what test helps determine where boder of liver is | scratch test |
| the spleen is normally not detectable. If we need to assess position the pt how? | position on R side, percuss midaxillary line from resonance to dullness over spleen |
| when assessing the spleen we should always percuss before we do --- | percuss before we palpate so as not to rupture spleen |
| do not palpate these patients | those with organ transplant---child with Wilms' tumor---suspected aortic aneurysm |
| there are many other tests not covered in lecture, but are in the book. What should you do? | Haha - look at pages 594-601 - they are probably more than we need to know right now |
| Nine year old has ruptured appendix - what would I expect to auscultate with respect to bowel sounds | absent bowel sounds due to ruptured contents now in peritoneum which will paralyze GI motility |
| what is the correct sequence for assessing the abdoment | inspect---ausculate---percuss---palpate |
| to assess pt for hernias, have pt do thisq | have them lift head off of bead |
| what is normal liver span at right MCL | 6-12 cm |
| if a pt has liver disease, where would you most likely hear a venous hum | RUQ |
| What is the best test for assessing ascites | shifting dullness on percussion |
Created by:
MEPN 2013
Popular Nursing sets