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168.362 > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What are some common signs and symptoms of acute abdominal pain?

A 
Nausea
Vomiting
Diarrhoea
Constipation
Flatulence
Fever
Bloating
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2
Q

What is in the right upper quadrant?

A 
Liver
Gallbladder
Duodenum
Head of pancreas
Right kidney and adrenal
Hepatic flexure of colon
Part of ascending and transverse
colon
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3
Q

What is in the Left Upper Quadrant?

A 
Stomach
Spleen
Left lobe of liver
Body of pancreas
Left kidney and adrenal
Splenic flexure of colon
Part of transverse and descending
colon
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4
Q

What is in the right lower quadrant?

A 
Cecum
Appendix
Right ovary and tube
Right ureter
Right spermatic cord
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5
Q

What is in the left lower quadrant?

A 
Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord
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6
Q

What organs are in the midline of the abdomen?

A

Aorta
Uterus (if enlarged)
Bladder (if distended

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7
Q

What does OLD CARTS stand for?

A 
For abdominal assessment?
O- ONSET
L – LOCATION
D – DURATION
C – CHARACTERISTIC
A – AGGRAVATING FACTORS
R – RELIEVING FACTORS
T –TIMING
S – SEVERITY
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8
Q

What is the aetiology of Inflammation?

A 
Gastroenteritis
Appendicitis
Pancreatitis
Diverticulitis
Cholecystitis
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9
Q

What is the life-threatening effect for Inflammation?

A

Risk of perforation (peritonitis)
Fluid shifts to area of inflammation
Unable to ingest fluid

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10
Q

What can Inflammation lead to?

A

Septic shock

Hypovolaemic shock

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11
Q

What is the aetiology for peritonitis?

A 
Perforated peptic ulcers
Ruptured peptic ulcers
Ruptured diverticula
Ruptured appendix
Intestinal perforation
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12
Q

What is the life-threatening effect for Peritonitis?

A

Overwhelming infection
Fluid shifts to area of inflammation
Unable to ingest fluid

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13
Q

What can peritonitis lead to?

A

Septic shock

Hypovolaemic shock

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14
Q

What is the aetiology for Obstruction?

A

Bowel obstruction
Biliary obstruction
Mesenteric vascular occlusion

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15
Q

What is the life-threatening effects for obstruction?

A

Strangulation risk
Fluid trapped in bowel
Fluid shifts to interstitial space
Unable to ingest fluid

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16
Q

What can obstruction lead to?

A

Septic shock

Hypovolaemic shock

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17
Q

What is the aetiology for Internal Bleeding?

A

Trauma
Ruptured abdominal aneurysm
GI bleed

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18
Q

What is the life-threatening effects for Internal Bleeding?

A

Blood lost from vascular space

Unable to ingest fluid

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19
Q

What can Internal Bleeding lead to?

A

Hypovolaemic shock

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20
Q

What is appendicitis?

A

Inflammation of the appendix, a narrow blind tube that extends from the inferior part of the cecum.

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21
Q

What is the most common cause of appendicitis?

A

Obstruction of the lumen by faeces, foreign body or tumor

22
Q

What can obstruction of the lumen result in?

A

Distention
Venous engorgement
Accumulation of mucus and bacteria, which can lead to gangrene and perforation

23
Q

What are the signs and symptoms of Appendicitis?

A

Periumbilical pain
Anorexia
Nausea and vomiting
Persistent pain, eventually shifting right lower quadrant and localizing at McBurney’s point
Localized tenderness, rebound tenderness and muscle guarding
Patient may lie still often with the right leg flexed

24
Q

What is peritonitis?

A

Localized or generalized inflammatory process of peritoneum which results in massive fluid shifts and adhesions as body attempts to wall off infection

25
Q

What is the nursing assessment you would undertake of a patient complaining of acute abdominal pain?

A 
Pain Assessment
Patient History
Vital Signs
Family History
Diet 
Medications
Constipation
Last Bowel Motion
Presenting Complaint
LOC
I/O
Skin Color/Temperature
Abdominal Assessment (inspection, palpation, percussion, auscultation)
ABCD
26
Q

What are some diagnostic studies and MDT care?

A 
FBC & Lytes,    
?X-match
urinalysis
?stool spec 
ECG
AXR
USS
CT scan (+/- contrast)
27
Q

What are the symptoms of peritonitis?

A 
Abdominal pain
Rebound tenderness
Muscular rigidity
Spasm
Patient has shallow
respirations
Abdominal distension
Fever
Tachycardia, tachypnoea
Nausea and vomiting
28
Q

What causes Intestinal Obstruction?

A

Partial/Complete obstruction occurs when intestinal contents cannot pass through the GI tract and it requires URGENT treatment

29
Q

What are the two types of Intestinal Obstruction?

A

Mechanical - something obstructing the lumen

Non-mechanical - when muscles/nerves within the intestines do not function properly

30
Q

What are the symptoms of Small Intestinal Obstruction?

A 
Rapid onset
Frequent and copious vomiting
Colicky, cramp-like, intermittent pain
Feces for a short time
Greatly increased abdominal distension
31
Q

What are the symptoms of Large Intestinal Obstruction

A 
Gradual onset
Vomiting is rare
Low-grade, cramping abdominal pain
Absolute constipation
Increased abdominal distention
32
Q

What is the nursing assessment for Intestinal Obstruction?

A 
Early recognition of deterioration (hypovolemic shock, bowel
strangulation)
Patient history & physical examination
Assessment of vomitus
Hydration status
Pain
Nutritional status
Need for surgery
Anxiety
33
Q

What is cholelithiasis?

A

Stones in gallbladder

34
Q

What is cholecystitis?

A

Inflammation of the gallbladder

35
Q

What is choledocholithiasis?

A

One or more gallstones in the CBD (common bile duct)

36
Q

What are the signs and symptoms of Cholelithiasis / acute

Cholecystitis?

A 
Pain
Indigestion
Fever
Jaundice
Nausea and Vomiting
Restlessness
Diaphoresis
Inflammation
Leukocylosis
37
Q

What is the nursing plan of care for Cholelithiasis / acute

Cholecystitis?

A 
Pain control
Antiemetic
Antibiotics
Maintain fluid and electrolytes
Potentially NBM
38
Q

What are signs and symptoms of Total Obstruction?

A 
Jaundice
Dark amber urine
Clay-colored stools
Pruritus
Intolerance of fatty foods
Bleeding tendencies
Steatorrhoea
39
Q

What are the aetiological factors for Acute Pancreatitis?

A 
Alcohol
Biliary tract disease
Trauma
Infection
Drugs
Postoperative GI surgery
40
Q

What can Acute Pancreatitis lead to?

A

Activation of pancreatic enzymes

Injury to pancreatic cells

41
Q

What are some pancreatic enzymes?

A 
Trypsin
Elastase
Phospholipase A
Lipase
Kallikrein
42
Q

What are the autodigestive effects of trypsin?

A

Oedema
Necrosis
Haemorrhage

43
Q

What are the autodigestive effects of elastase?

A

Haemmorhage

44
Q

What are the autodigestive effects of Phospholipase A?

A

Fat necrosis

45
Q

What are the autodigestive effects of Lipase?

A

Fat necrosis

46
Q

What are the autodigestive effects of Kallikrein?

A

Oedema
Vascular permeability
Smooth muscle contraction
Shock

47
Q

What are the Signs and Symptoms of Acute Pancreatitis?

A 
Abdominal pain – LUQ
radiating to the back
Aggravated by eating,
relieved by vomiting
Abdominal tenderness
with muscle guarding
Paralytic ileus
Greys Turners spots
Cullen’s sign
Signs of shock
Watch for respiratory
distress –ARF to ARDS
48
Q

What is the treatments for Pancreatitis?

A 
Relief and control of pain
Prevention of or treating shock
Fluid and electrolyte imbalances corrected
Nasogastric tube to decompress the
stomach
NBM (suppresses pancreatic enzymes) w/
NG
Antacids, PPI’s to neutralize gastric
secretions and decrease hydrochloric acid
stimulation
Antibiotics to treat infection,
antispasmodics
Removal of precipitating cause if possible
Nutritional therapy – enteral nutrition to
parenteral
When food allowed small frequent high
carbohydrates
49
Q

How do we manage pancreatitis?

A 
Pain management
Manage fluid imbalance
Manage nutritional
imbalances: maintain caloric
needs while NBM
Watch electrolytes and blood
glucose
Assessment: TPR, weight
Surgery: pre & post operative
care
50
Q

What are the surgeries for gallstones?

A

ERCP (Endoscopic Retrograde Cholangio-Pancreatography +/- Sphincterotomy or stenting
ESWL (Extracorporeal Shock Wave Lithotripsy)

168.362 (8 decks)

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