Abdomen Flashcards
DC: Infants
Abdominal wall thinner—easier to palpate organs.
Liver takes up more abdominal space.
Bladder higher in abdomen.
DC: pregnancy
Decreased motility of GI tract.
Intestines displaced upward and posterior by enlarging uterus
DC: Aging adult
-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
Criteria for constipation
-Decrease in stool frequency (less than 3 times per week)
Straining
-Hard stool
-Feel of incomplete evacuation and anorectal blockage
Common causes of constipation
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
Visceral pain
dull, general, poorly localized
Parietal pain
pain inflammatory, sharp, localized, aggravated by movement
subjective data: bowel habits
frequency; color; consistency; diarrhea/constipation; laxative use
Inspection position
have client supine/arms by side/pillow under head and under knees
Normal contour of abdomen
flat, rounded
Abnormal contour of abdomen
Scaphoid
Protuberant
Inspection components
a) Contour: flat; scaphoid; rounded; protuberant
b) Symmetry
c) Umbilicus
d) Skin
e) Pulsation or movement
f) Hair distribution
g) Demeanor
Bowel sounds: documentation and normal
Character, frequency
High pitched, gurgling, cascading
Hyperactive bowel sounds
loud, high-pitched, rushing, tinkling
Hypoactive bowel sounds
infrequent normal sounds
Auscultative vascular sounds
listen for bruits over aorta, renal arteries, iliac arteries, femoral arteries (esp. in clients with hypertension)
Note: location, pitch, timing
Percussion
Used to assess relative density of abdominal contents; locate organs; screen for abdominal fluid or masses
Percussion process
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
Palpation process
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.
Characteristics to note if lump is identified
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
Special procedures
Fluid wave- tests for ascites
Shifting dullness- tests for ascites fluid buildup
Ascites occurs with?
Heart failure Portal hypertension cirrhosis Pancreatis Cancer
Scratch test
Uses auscultation to detect the lower border of the liver
What occurs to the liver in people with chronic emphysema
Liver is displaced downward by hyperinflated lungs
positive spleen percussion sign
Indicates splenomegaly
Detects mild to moderate splenomegaly before it becomes palpable: mono, malaria, cirrhosis
