7.14 Abdominal Complaints Flashcards
Bladder distention is a sign of what?
Urethral obstruction
This condition causes frequent, urgent urination. Other symptoms include dysuria, nocturia, fever, chills, low back pain, and myalgia.
Prostatitis
Colicky Pain, NV, Constipation, abdominal distention.
Vomitus begins as gastric juice and bile; eventually contains ileal fecal contents.
Small Intestine Obstruction
- NVD, abdominal discomfort.
- Fever, malaise, hyperactive bowel sounds.
Gastroenteritis
Bloody vomitus
Peptic ulcer disease
- Large volume of bright red blood in the vomit may result from this
- Constitutes a life-threatening medical emergency.
Esophagel varicies (enlarged veins)
A physiological intestinal obstruction usually effects the small bowel and occurs most commonly after abdominal surgery or use of anticholinergic medications.
Signs: Severe abdominal distention, vomiting.
Paralytic ileus
May occur with narcotic use, poor dietary habits, sluggish bowel function. NV may begin after several days.
CONSTIPATION.
Sudden, diffuse abdominal pain usually most intense over the area of underlying problem.
Intestinal motility decreases, paralytic ileus develops.
Weakness, pallor, sweating, cold skin, from loss of fluid & electrolytes
Peritonitis
Colicky pain, nausea, vomiting, constipation, abdominal distention.
May also complain of drowsiness, intense thirst, malaise, aching.
Bowel sounds = hyperactive with a rushing sound.
Intestinal obstruction
Steady epigastric pain centers close to the umbilicus and radiates between the tenth thoracic and 6th lumbar vertebrae.
Pain is unrelieved by vomiting.
Severe attacks produce extreme pain, persistant vomiting and abdominal rigidity.
Pancreatitis
Recurrent LLQ pain accompanied by alternating constipation and diarrhea. Pain usually abates after defecation or passage of flatus. May have mild nausea, low-grade fever.
Diverticulitis
Localized midepigastric pain with heartburn.
Develops 2 hours or more after meals. Eating may relieve the pain.
Peptic ulcer
Condition produces colicky pain in the RLQ with cramping, tenderness, flatulence, nausea, fever and diarrhea. May have bloody stools, complain of weight loss, weakness, fatigue.
Chrohn’s Disease.
Beginning as RUQ or periumbilical pain, localizes in the RLQ. Palpation reveals a rigid, board-like abdominal wall and rebound tenderness.
Diarrhea, fever and tachycardia develop later.
Appendicitis
Acute abdominal pain in the RUQ, occasionally radiating to the back- pain usually develops after a meal rich in fats- may occur at night, awakening the pt from sleep- may complain of belching. gassiness, sweating, vomiting, and clay-colored stools- Jaundice will occur if the bile duct is blocked.
Cholecystitis
Bleeding by irritating the urethral wall- occurs at the beginning of urination.
Also nausea, vomiting.
Renal Calculi
Infection that affects the renal pelvis and parenchyma- complaints of severe flank pain, shaking chills, fever, and tachycardia.
Pyelonephritis
Infection by anaerobic or aerobic organisms-Fever and a purulent vaginal discharge are usually present.
Pelvic Inflammatory Disease
Rapid onset of sharp, lower abdominal pain, occasionally radiating to the shoulders and neck. Commonly, the pain begins after an activity that increases abdominal pressure, such as a bowel movement.
Ruptured Ectopic Pregnancy
Characterized by constant pain in the lower abdomen, vagina, posterior pelvis, and back, endometriosis usually begins 5 to 7 days before menses peaks, and lasts for 2 - 3 days.
Endometriosis
Ascites from portal congestion may be severe enough to impair breathing.-abdominal distention accompanies jaundice, lethargy, mental status changes, asterixis, coagulopathies, pruritus, dependent edema, and enlarged superficial abdominal veins.
Cirrhosis
Ascites occurs in advanced disease- complain of dyspepsia, urinary frequency, constipation, pelvic discomfort, and weight loss.
Ovarian Cancer
Accompanied by tinkling bowel sounds. Diarrhea may develop from liquid stool being forced around the fecal blockage.
Fecal impaction
A protrusion of intestine through the abdominal wall, a hernia may disappear momentarily when pressed back into the abdominal wall. If the section of intestine becomes strangulated, pt will complain of pain and possibly anorexia and vomiting.
Hernia
Uniformly rounded abdomen, the umbilicus is buried deeply in the abdominal wall, and excessive fat occurs in other body areas.
Obesity
Signs include loss of sphincter control or an urgent need to defecate upon arising in the morning, blood or mucus in the stool, and a sense of incomplete evacuation.
Colorectalcancer
Injury can cause loss of sphincter control and lead to incontinence.
Sphincter Trauma
Known by a protrusion of the rectal mucosa through the anus- may also complain of a persistent sensation of rectal fullness, bloody diarrhea, and pain in the lower abdomen from ulceration.
Rectal prolapse
Compression affecting the lumbar or sacral area may cause loss of bowel control.
Spinal Cord Prolapse
Urine leakage results from physical strain, such as sneezing, coughing, or quick movements (stress incontinence).
Muscle weakness
Retention causes dribbling because the distended bladder can’t contract strongly enough to force a urine stream (overflow incontinence). The bladder will be distended on palpation.
Urinary retention
These meds can cause bladder distention, which may result in incontinence from overflow or from weak muscles unaccustomed to a full bladder.
Diuretic medication
Urinary incontinence accompanies purulent vaginal or penile discharge and dysuria.
Gonorrhea
Constipation may be only early sign. After several days, the pt may complain of colicky abdominal pain with spasm- abdomen will be distended, and loops of large bowel may become visible on the abdominal wall.
Large Intestine Obstruction
What drug may slow bowel motility?
Narcotic use
Chronic constipation. Causes include low dietary fiber, chronic laxative or enema use, poor hydration, and a sedentary lifestyle. The pt complains of mild abdominal discomfort and of having to strain to produce hard, dry stool.
Inactive colon
Recurrent bloody diarrhea with mucous- intermittent asymptomatic remissions-spastic rectum and anus, abdominal pain, irritability, weight loss, weakness, anorexia, nausea, and vomiting.
Ulcerative colitis
Increases urinary frequency and decreases the amount voided each time. Other symptoms include dysuria, cramps or spasm of the bladder, nocturia, and a feeling of warmth or burning during urination. Urine typically will be cloudy or may have a foul odor. In older people, confusion may be the first sign of a UTI.
UTI
Increases urinary frequency and decreases the amount voided each time.
Urethral obstruction
Pain occurs after urination- due to dehydration, infection, and urinary stasis.
Bladder Calculus
complain of colicky abdominal pain, palpable mass – smoking increases risk
Renal cell carcinoma (85% of all renal tumors)
hematuria continuous during urination.
Trauma or injury to the kidney
Low platelet count -continuous during urination.
Thrombocytopenia
Irritation and bleeding of the bladder wall- bleeding at the end of urination.
Bladder infection
Continuous during urination.-history of streptococcal infection of sore throat.
Glomerulonephritis
Spontaneous bleeding in the urinary tract.
Anticoagulation medications
Can cause hematuria without underlying urinary pathology
Smoking
Intermittent bleeding with defecation. Bleeding from first-degree hemorrhoids appears on stool or toilet paper. Prolapsed, second-degree hemorrhoids usually return to the anal canal spontaneously after defecation. Third-degree hemorrhoids cause constant and prolapse in response to any increase in intraabdominal pressure.
Hemmorrhoids
Abscesses and fissures result from abrasions or tears in the lining of the anal canal and subsequent E. coli infection.-may result from treatment of internal hemorrhoids, enemas, anal sex, or insertion of foreign objects.
Anorectal abscess or fisure
Blood in the stool. Frank blood indicates a lower GI source of bleeding. Black, tarry guaiac-positive stools indicate a source of bleeding higher in the intestinal tract.
Lower GI bleeding
Characterized by excessive straining and the inability to completely evacuate the bowel. Pain, bleeding, and pruritus ani are other signs. Scarring after surgery, inflammation, or laxative abuse may cause anorectal strictures.
Anorectal stricture
Polyps high in the rectum leave a streak of blood on the stool. Low rectal polyps bleed freely.
Rectyl polyps
Urgent need to defecate upon arising, and blood or mucus in the stool.
Colorectal cancer
What would you assess if you found Hematuria? (3)
May be the first sign of _____.
- Assess the skin for signs of bruising or petechiae.
- Assess the abdominal wall for signs of recent trauma.
- Palpate the abdomen for an abdominal mass.
*Hematuria may be the first sign of renal cell carcinoma.
