2410wk3&4 (exam1) Flashcards by Danbi Martin

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

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describe HITS (domestic violence)

Hurt you?
Insult you?
Threaten
Scream

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FICA (spirituality)

Faith
Importance
Community
Address axn in care: how does faith affect PT care

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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

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what is PQRSTU

provocative/palliative
quantity quality
region radiation
severity
timing
understanding (PT's understanding of problem)

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what part of health history does cc (chief complaint) go under

reason for seeking care

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I.D. what part of health history these fall under
accidents/injuries
childhood illness
hospitalizations

past medical history

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I.D. what part of health history these fall under
operations
pregnancy and progeny
serious illness

past medical history

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I.D. what part of health history these fall under
immunization hx
last exam
allergies
current Rx

past medical history

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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

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I.D. what part of health history these fall under
self esteem
ADL
Exercise

functional assessment

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I.D. what part of health history these fall under
sleep/rest
nutrition/elimination
relationships

func. assessment

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I.D. what part of health history these fall under
spirituality
coping/stress
habits

func. assessment

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I.D. what part of health history these fall under
environmental hazards
intimate partner violence
occupational health

functional assessment

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landmarks of abdomen

anterior: costal margin
posterior: symphsis pubis anterior iliac crest
central: umbilicus

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organs of RUQ (7)

liver
gallbladder
duodenum
tail of pancreas
kidney/adrenal
hepatic flexure
ascending & transverse colon

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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

1. 3 or more 2. melena 3. black upper GI, red lower GI

``` umbilicus variations everted inverted enlarged cullen's sign ```

1. ascites, mass, or pregnancy 2. obese 3. umbilical hernia 4. 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

1. blumberg's sign for peritoneal inflamm 2. murphy's sign for inflamm of gallbladder 3. pushing down on (R) leg causing pain in RLQ indicates apendicitis 4. 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

1. ventral: soft mass that protrudes into ab wall in weak spots 2. umbilical hernia: congenital seen best when crying or straining 3. epiplocele defect in the ab wall in the midline above umbilicus 4. 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