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Abdomen Flashcards

1
Q

how many quadrants do you divide the abdomen into?

A

four

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2
Q

Begin with ____ and follow with auscultation

A

inspection

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3
Q

Skin, umbilicus, contour and symmetry, enlarged organs or masses, movements or pulsations

A

inspect these areas

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4
Q

what are you auscultating for?

A

bruits
peristalsis
bororygmi

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5
Q

what are you going to obtain in their health history?

A

appetite
weight gain or loss
dysphagia
intolerance to certain foods
any abdominal pain
n/v
bowel movements
past abdominal problems

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6
Q

antiemetics need to be given ____ minutes before eating or drinking for a patient who is nauseous ?

A

30 - 40 minutes

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7
Q

-How do you get your groceries?
-Prepare your meals?
-Do you have any trouble swallowing?
-How often do you have bowel movements?
-How often do you take anything forconstipation? Rx / OTC/ herbs
-What meds do you take?

A

age considerations for older adults, these are questions you need to ask

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8
Q

t/f: Aging should not affect general GI function unless associated with a disease process

A

true

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9
Q

what decreases with age in the mouth?

A

salivation
sense of taste
gastric acid secretion
esophageal emptying
liver size
bacterial flora

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10
Q

what increases with age as far as GI in older adults?

A

constipation

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11
Q

Nutrition
Allergies
Medications
Cigarette/tobacco
ETOH intake
Recreational drug use
Stool characteristics
Urine characteristics
Exposure to infectious disease
Recent stressful life events
Possibility of Pregnancy

A

focused health history

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12
Q

What are the steps for assessment in proper order?

A

inspection
auscultation
percussion
palpation
other tests

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13
Q

Labs with abdominal pain?

A

UA
CBC -possible infection if elevated
LFT -liver function test
Guiac card -checks stool for blood

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14
Q

what do you want to do before palpating the bladder?

A

have them urinate

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15
Q

what position do you palpate abdomen in?

A

supine

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16
Q

what is the first thing youre going to do before palpating?

A

provide privacy

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17
Q

when should you palpate painful areas?

A

last

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18
Q

Skin color
Striae, scars, veins
Symmetry, contour
Distention or masses

A

inspection

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19
Q

Accumulation of fluid in the peritoneal cavity
Portal Hypertension
Decreased Liver Function
Spider nevi (cutaneous angiomas)
Caput medusae
Visible or distended veins

A

liver failure from alcoholism
ascites

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20
Q

what is this?

A

ascites

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21
Q

can indicate liver disease (abd/chest, sometimes back)

A

spider angioma

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22
Q
A

spider angioma

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23
Q
A
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24
Q
A
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25
ostomy and stoma
26
which quadrants do you listen for bowel sounds in ?
all four
27
which direction do you go in when auscultating?
clockwise
28
how much do you need to listen to minimum for each quadrant?
at LEAST 5 SECONDS
29
: a rumbling or gurgling noise made by the movement of fluid and gas in the intestines. Sometimes audible to the naked ear.
BORBORYGMUS
30
how long should you listen to bowel sounds in each quadrant before you document no bowel sounds heard?
5 minutes in each quadrant
31
how many sounds are normal per minute?
5-30 sounds per minute
32
is no bowel sounds a medical emergency/
yes
33
Listen for at least _______ in all quadrants before documenting absent bowel sounds
5 minutes
34
______ sounds could mean an obstruction = this can be an urgent situation
Hyperactive
35
Determines size and shape of the liver, spleen, and kidneys Detects fluid, gaseous distention, and masses Gently tapping on the skin to create a vibration
percussion
36
tympany ?
gas
37
dullness indicates?
solid masses, fluid
38
Performed last Detects tenderness, distention, or masses May be light or deep, as appropriate Aortic pulsation
palpation
39
detects aortic pulsation
palpation
40
Use light pressure from the finger pads detects painful areas and masses watch the clients face for painful reaction note areas of tenderness and masses note if ripple life effects are pesent patient guarding
palpation
41
location of pain is not necessarily where the involved organ is, this is called?
referred pain
42
what factors affect bowel elimination?
Lifestyle; Psychological Variables Food & Fluids (milk products and cheese can cause constipation) Activity/Muscle Tone Pathologic conditions Medications Diagnostic Tests; Surgery/Anesthesia
43
constipation meds?
laxatives/stool softeners enemas or suppositories
44
what is the biggest concern with diarrhea?
dehydration
45
how do you help promote skin integrity with elimination?
don't leave patient on bedpan for long periods of time clean well
46
what do you use the HAT for?
Use a toilet hat to collect urine and/or bowel movement
47
Abdomen soft, rounded, and symmetric without distention; no lesions or scars, or visible peristalsis. Bowel sounds present in all 4 quadrants. No tenderness on palpation. Reports good appetite; no constipation, last BM this morning, medium/soft, no nausea or diarrhea. Voiding well and denies laxative use.
documentation for a normal exam
48
hemoptysis
coughing up blood
49
hematemesis
vomiting of blood
50
tympany indicates?
gas
51
dullness indicates?
solid masses, fluid
52
uses light pressure from finger pads detects painful areas and masses watch the clients face for painful reaction note areas of tenderness and masses note if ripple life effects are present patient guarding
palpation
53
Depress about 1 cm -Assess skin pulsations -Always ______ palpation before deep palpation -Clockwise fashion
light
54
______palpation- depress skin about 5-8 cm
Deep
55
Always assess tender areas ______ Watch pt’s expression during palpation
last
56
location of pain is not necessarily where the involved organ is, is what?
referred pain
57
may be felt where the organ was located in fetal development
referred pain
58
spleen referred pain can present?
in the left shoulder
59
kidney referred pain may present where?
groin pain
60
separate hard lumps in feces incidates?
very constipated
61
lumpy and sausage like
slightly constipated
62
a sausage shape with cracks in the surface
normal
63
soft blobs with clear cut edges
lacking fiber
64
mushy consistency with ragged edges liquid consistency with no solid pieces
inflammation
65
Lifestyle; Psychological Variables Food & Fluids Activity/Muscle Tone Pathologic conditions Medications Diagnostic Tests; Surgery/Anesthesia
factors affecting bowel eimination
66
milk products and cheese can cause?
constipation
67
constipation nursing interventions?
laxatives or stool softeners enemas or suppositories digital removal
68
positioning, privacy, exercise, fiber supplement/nutrition program
prevention strategies for constipation
69
Imodium find and resolve cause replace fluids and electrolytes help decrease flatulence
nursing interventions for diarrhea
70
Do not leave patient on bedpan for long periods of time Clean well promotes?
skin integrity
71
Use a toilet ______ to collect urine and/or bowel movement
hat
72
Abdomen soft, rounded, and symmetric without distention; no lesions or scars, or visible peristalsis. Bowel sounds present in all 4 quadrants. No tenderness on palpation. Reports good appetite; no constipation, last BM this morning, medium/soft, no nausea or diarrhea. Voiding well and denies laxative use.
documentation for a normal exam

Nursing Funds (17 decks)

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