2410wk3&4 (exam1) Flashcards
describe CAGE ?s (alcohol)
C= Concerned about PT's drinking/ Cutting down A= Annoyance of criticism about drinking G= Guilty about drinking or some action while drinking E= Eye-opener drink needed in morning
describe HITS (domestic violence)
Hurt you?
Insult you?
Threaten
Scream
FICA (spirituality)
Faith
Importance
Community
Address axn in care: how does faith affect PT care
History of present illness 8 characteristics
location character/quality quantity severity timing setting: what brings it on aggravating or relieving factors associated factors patient perception
what is PQRSTU
provocative/palliative quantity quality region radiation severity timing understanding (PT's understanding of problem)
what part of health history does cc (chief complaint) go under
reason for seeking care
I.D. what part of health history these fall under
accidents/injuries
childhood illness
hospitalizations
past medical history
I.D. what part of health history these fall under
operations
pregnancy and progeny
serious illness
past medical history
I.D. what part of health history these fall under immunization hx last exam allergies current Rx
past medical history
purpose of review of systems (3)
- evaluate past and present health state of each body system
- double check for signficant data omitted
- evaluate health promotion practices
I.D. what part of health history these fall under
self esteem
ADL
Exercise
functional assessment
I.D. what part of health history these fall under
sleep/rest
nutrition/elimination
relationships
func. assessment
I.D. what part of health history these fall under
spirituality
coping/stress
habits
func. assessment
I.D. what part of health history these fall under
environmental hazards
intimate partner violence
occupational health
functional assessment
landmarks of abdomen
anterior: costal margin
posterior: symphsis pubis anterior iliac crest
central: umbilicus
organs of RUQ (7)
liver gallbladder duodenum tail of pancreas kidney/adrenal hepatic flexure ascending & transverse colon
organs of LUQ (7)
stomach spleen left liver lube body of pancreas kidney adrenal splenic flexure transverse & descending colon
RLQ
cecum
appendix
ovary & tube/spermatic cord
ureter
LLQ
part of descending colon
sigmoid
ovary & tube/ spermatic cord
ureter
developmental considerations for infants ab
liver takes up more space
.5-2.5 cm below costal border
bladder lies higher
less musculature
developmental considerations pregnancy
BS hypoactive, GI motility less constipation appendicitis difficult to diagnose skin changes of ab hemorroids
developmental consideration elderly
increased fat deposits musculature relaxed liver size decreases esophageal emptying delay (increase risk of aspiration) higher incidence of gallstones
cultural considerations
lactose intolerance
dysphagia vs dysphasia
dysphagia difficulty swallowing
dysphasia: difficulty with speech
3 types of ab pain and quality
visceral: dull poorly localized (from organ stretch)
parietal(somatic): inflamm over peritoneum, sharp well localized
referred: disorder in another site
3 possible sources of hematemesis & associated symptoms
stomach duodenal esophogeal cancers
colicky pain, N/V/D fever chills
of days w/o BM that indicate constipation
blood in GI tract
site of bleeding if stool is black vs red
- 3 or more
- melena
- black upper GI, red lower GI
umbilicus variations everted inverted enlarged cullen's sign
- ascites, mass, or pregnancy
- obese
- umbilical hernia
- bluish discoloration indic. of intraperitoneal bleeding
what would cause abnorm pulsations in abdom.
HTN, aortic aneurysm hyperthyroidism
normal range for Bowel sounds BS
where are BS always present
term for lots of BS
what causes hypoactive BS
5-30 a minute
RLQ b/c of ileoceccal valve
borborybmus
surgery or inflammation of peritoneum
4 sites of vascular asculation
aorta, renal, iliac, and femoral
percussing for liver span
begin RMCL in lung resonance until dullness percussed (5th or 6th ICS) and then percuss from site of abdom tympany until dullness (6-12cm)
percussing spleen
9th to 11th ICS MAL (castell’s point) should hear tympany unless splenomegaly (dullness)
site of costovertebral angle tenderness
12th rib
what does positive wave test indicate
ascites ->cirrhosis, hepatitis, <3 failure
differentiation between inflammation & organ distention
inflamm: pain is unchanged or increased with pressure
organ distention: decrease with pressure
whats rebound tenderness & indicative of…
inspiratory arrest
ilopsoas muscle test
obturator test
- blumberg’s sign for peritoneal inflamm
- murphy’s sign for inflamm of gallbladder
- pushing down on (R) leg causing pain in RLQ indicates apendicitis
- pt supine while holding ankle rotating bent knee inward (apendicitis)
what is mcburney’s point and what does pain @ this sight indicate
midpoint between iliac crest and umbilicus, apendicitis
4 types of abdom hernias
- ventral: soft mass that protrudes into ab wall in weak spots
- umbilical hernia: congenital seen best when crying or straining
- epiplocele defect in the ab wall in the midline above umbilicus
- diastasis recti separation of rectus sheath occurs in obesity & mulitparous
define ileus, when does it occur why
stopped bowel funx, after surgery b/c of anesthesia
