Abdomen

Question 1

DC: Infants

Answer 1

Abdominal wall thinner—easier to palpate organs.
Liver takes up more abdominal space.
Bladder higher in abdomen.

Question 2

DC: pregnancy

Answer 2

Decreased motility of GI tract.

Intestines displaced upward and posterior by enlarging uterus

Question 3

DC: Aging adult

Answer 3

-increased adipose tissue.
-Esophageal emptying delayed
-Gastric acid secretions decreased
-Incidence gallstones increased
-Drug metabolism by liver decreased.
-Constipation symptoms evaluating using the Rome III symptom criteria:
-Decrease in stool frequency (less than 3 times per week)
Straining
-Hard stool
-Feel of incomplete evacuation and anorectal blockage

Question 4

Criteria for constipation

Answer 4

-Decrease in stool frequency (less than 3 times per week)
Straining
-Hard stool
-Feel of incomplete evacuation and anorectal blockage

Question 5

Common causes of constipation

Answer 5

a) Decreased physical activity
b) Inadequate water intake
c) Low fiber diet
d) Side effects of medications
e) Irritable bowel syndrome
f) Bowel obstruction
g) Hypothyroidism
h) Inadequate toilet facilities

Question 6

Visceral pain

Answer 6

dull, general, poorly localized

Question 7

Parietal pain

Answer 7

pain inflammatory, sharp, localized, aggravated by movement

Question 8

subjective data: bowel habits

Answer 8

frequency; color; consistency; diarrhea/constipation; laxative use

Question 9

Inspection position

Answer 9

have client supine/arms by side/pillow under head and under knees

Question 10

Normal contour of abdomen

Answer 10

flat, rounded

Question 11

Abnormal contour of abdomen

Answer 11

Scaphoid

Protuberant

Question 12

Inspection components

Answer 12

a) Contour: flat; scaphoid; rounded; protuberant
b) Symmetry
c) Umbilicus
d) Skin
e) Pulsation or movement
f) Hair distribution
g) Demeanor

Question 13

Bowel sounds: documentation and normal

Answer 13

Character, frequency

High pitched, gurgling, cascading

Question 14

Hyperactive bowel sounds

Answer 14

loud, high-pitched, rushing, tinkling

Question 15

Hypoactive bowel sounds

Answer 15

infrequent normal sounds

Question 16

Auscultative vascular sounds

Answer 16

listen for bruits over aorta, renal arteries, iliac arteries, femoral arteries (esp. in clients with hypertension)

Note: location, pitch, timing

Question 17

Percussion

Answer 17

Used to assess relative density of abdominal contents; locate organs; screen for abdominal fluid or masses

Question 18

Percussion process

Answer 18

a) General tympany—move clockwise; tympany should predominate
b) Liver span—will note change from tympany to dull sound
c) Splenic dullness—percussing for dull note from 9th to 11th ICS just behind the left midaxillary line.
d) CVAT—indirect fist percussion over 12th rib at the DVA

Question 19

Palpation process

Answer 19

Used to judge size, location, and consistency of certain organs; to screen for abnormal mass or tenderness.

Deep palpation—using same technique as light palpation, depress 5-8 cm.

• *palpate identified tender areas last during examination.
• *large or obese abdomen—use bimanual technique.

Question 20

Characteristics to note if lump is identified

Answer 20

a) Location
b) Size
c) Shape
d) Consistency (soft, firm, hard)
e) Surface (smooth, nodular)
f) Mobility (including movement with respirations)
g) Pulsatility
h) Tenderness

Question 21

Special procedures

Answer 21

Fluid wave- tests for ascites

Shifting dullness- tests for ascites fluid buildup

Question 22

Ascites occurs with?

Answer 22

Heart failure 
Portal hypertension
cirrhosis 
Pancreatis
Cancer

Question 23

Scratch test

Answer 23

Uses auscultation to detect the lower border of the liver

Question 24

What occurs to the liver in people with chronic emphysema

Answer 24

Liver is displaced downward by hyperinflated lungs

Question 25

positive spleen percussion sign

Answer 25

Indicates splenomegaly

Detects mild to moderate splenomegaly before it becomes palpable: mono, malaria, cirrhosis