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PATHO > abdomen and nutritinal assessment > Flashcards

abdomen and nutritinal assessment Flashcards

1
Q

what are all the organs inside the abdominal cavity called?

A

the viscera

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2
Q

what are solid viscera?

A

organs in the abdomen that maintain a characteristic shape

ex, liver, pancreas, spleen, adrenal glands, kidneys, ovaries, and uterus

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3
Q

what is hollow viscera?

A
  • shape depends on content inside the organs.
  • usually not palpable
  • ex, stomach, gallbladder, small intestine, colon, bladder
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4
Q

what takes up most of the space in the right upper quadrant?

A

the liver

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5
Q

how is it possible to palpate the liver?

A

-lower edge of it is normally palpable in deep palpation

2-4cm below rib

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6
Q

what is located in all 4 quadrants?

A

the small intestine

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7
Q

what is the spleen?

A

a soft mass of lymphatic tissue on the posterolateral wall of the abdominal cavity

  • about 7cm long
  • normally palpable
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8
Q

where is the gallbladder?

A

it rests under the posterior surface of the liver

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9
Q

what do the right and left iliac arteries become?

A

the femoral arteries in the groin

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10
Q

what is located behind the stomach in the left upper quadrant?

A

the pancreas- a soft, lobulated gland

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11
Q

functions of the pancreas?

A
  • endocrine function is to regulate blood sugar

- exocrine function is to help with digestion by making enzymes

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12
Q

what are the kidneys protected by?

A

the posterior ribs and musculature

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13
Q

function of the kidneys?

A

-excrete wastes and regulates water and electrolytes

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14
Q

what is lactose?

A

its a digestive enzyme necessary for the absorption of lactose

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15
Q

what happens if an individual has a low level of lactose?

A

they are deemed lactose intolerant and have abdominal pain, bloating, and flatulence when they consume milk products

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16
Q

what is celiac disease?

A

an autoimmune condition in which intestinal tissue is damaged in response to eating gluten which results in conditions such as iron-deficiency anemia and osteoporosis

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17
Q

what is GERD?

A

symtoms of heartburn and regurgitation

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18
Q

what is some subjective data to ask a pt?

A
  • appetite (changes? weight changes? intolerance?)
  • dysphagia?
  • food intolerance? (food u cant eat? heartburn? bloating? indigestion? use of antacids?)
  • Abdominal pain? (worse before or after eating)
  • constipation? (is this normal for you)
  • nausea/vomiting
  • bowel habits
  • past abdominal history
  • medications
  • alcohol / tobacco
  • nutritional assessment
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19
Q

what types of pts tend to have dysphagia?

A
  • stroke patients
  • spinal injuries
  • cancers
  • ALS
  • pts with advanced dementia
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20
Q

what does acute abdominal pain necessitate?

A
  • urgent diagnosis

- could be appendicitis, cholecystitis, bowel obstruction, perforation

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21
Q

what is the number 1 complaint that ppl present with in the emergency room?

A

abdominal pain

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22
Q

what are some subjective questions to ask about nausea and vomiting?

A
  • how often?
  • is is associated with clickly pain, diarrhea, fever, chills
  • is it bloody?
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23
Q

what can cause hematemesis?

A
  • occurs with stomach or duodenal ulcers
  • esophageal varices (chronic alcohol use, swollen veins in lower esophagus that can rupture bleed)
  • Mallory Weiss tear: tears that occur from retching and acid. self limiting
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24
Q

what are some subjective questions to ask about bowel habits?

A
  • how often?
  • what color?
  • consistency?
  • any diarrhea or constipation?
  • stools may be black and tarry because of occult blood (melena) from GI bleeding
  • bright red blood in stools occurs with GI bleeding or localized bleeding around anus
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25
Q

what are some significant abdominal history occurrences?

A
  • ulcers
  • hepatisis
  • appendicitis
  • hernia
26
Q

questions to ask about medications related to abdominal history?

A
  • what meds are u currently taking?
  • use of any laxatives?
  • opioids increase constipation
  • use of laxatives?
  • NSAIDS can cause bleeding and damage to the stomach
27
Q

what included with inspecting the abdomen?

A
  • assess the contour: is it flat? rounded, scaphoid (anorexia), or protuberant (distended)
  • abdomen should be symmetrical
  • bruises
  • note any budging, visible masses or asymmetrical shapes (eg, hernia)
  • if you see a scar, ask about it
  • you may see pulsations from the aorta beneath the skin in the gastric area
28
Q

what do bowel sounds originate from?

A

they are from movement of air and fluid through the small intestine (peristalsis)

29
Q

what are hyperactive sounds (auscultation)

A

loud, high pitched rushing, tinkling sounds that signal increased motility (eg, bowel obstruction)

30
Q

what are hypoactive sounds (auscultation)

A

can be heard after surgery or with inflammation of the peritoneum. more common

31
Q

what are absent bowel sounds?

A

do not ever chart

-you would have to listen in each quadrant for 5 minutes (20 min total)

32
Q

what is important to remember about the usual examination sequence when it comes to the abdomen?

A

normal sequence: inspection, palpation, percussion and auscultation
-auscultate right after inspection- this is because percussion and palpation can increase peristalsis which would give a false interpretation of bowel sounds

33
Q

on percussion, what is a tympany notes?

A

it is heard predominant because air in the intestine rises when patient is supine

34
Q

where is dullness heard on percussion?

A

is heard over distended bladder, adipose tissue, fluid or mass

35
Q

what is the sequence of examination for the abdomen?

A

inspection, auscultation, percussion, palpation

36
Q

what should a nurse begin with when palpating the abdomen?

A

begin with light palpation and DO NOT use deep palpation on someone with abdominal pain
-save examination of tender areas last

37
Q

what is voluntary guarding?

A

Occurs when the patient is cold, tense, or ticklish

38
Q

what is involuntary rigidity?

A

is a constant board like hardness of the muscles. it accompanies peritonitis- an acute inflammation of the peritoneum

39
Q

what could right lower quadrant (RLQ) tenderness on palpation with acute abdominal pain migrating from the umbilicus possibly mean?

A

is can be indicative of appendicitis

  • refer to a surgeon immediately required
  • additional signs include nausea, vomiting, fever, and loss of appetite
40
Q

what is ascites?

A

fluid in the peritoneal cavity

-the abdomen is distended, the flanks are budging and the umbilicus is protruding and displaced downward

41
Q

what does ascites occur with?

A

heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, and cancer

42
Q

what sound on percussion would ascites present with?

A

dullness to percussion

43
Q

in what situations will the liver feel enlarged and smooth but is TENDER to palpation with?

A

occurs with heart failure, acute hepatitis, and hepatic abscess.
-more acute

44
Q

in what situations will the liver feel enlarged, smooth, and nontender to palpation?

A
  • fatty infiltration, portal obstruction or cirrhosis
45
Q

what is a fatty liver?

A

Fatty liver disease is a condition in which fat builds up in your liver

1) Nonalcoholic fatty liver disease (NAFLD)
2) Alcoholic fatty liver disease,

46
Q

where can the spleen extend to when extremely enlarged?

A

it can extend down to the left aspect of the pelvis

47
Q

what does splenomegaly occur with?

A
  • occurs with acute infections (mono) and is moderately enlarged and soft
  • is usually nontender
  • pts should refrain from contact sports- if the spleen ruptures it is highly vascular and will bleed a lot
48
Q

what is nutritional status?

A
  • is the degree of balance between nutrient intake and nutrient requirements
  • this balance is affected by income, education, social environments, nutritional literacy and access to protective foods
49
Q

when is optimal nutrition achieved?

A
  • when nutrients are consumed in amounts that support daily requirements
50
Q

what is undernutrition?

A

When nutrition reserves become depleted or when nutrient intake is inadequate to meet daily requirements or metabolic demands.
ex, eating disorders, depression, mania

51
Q

what is overnutrition?

A

-results from the consumption of nutrients - most frequently calories, sodium, and fat in excess requirement. obesity, sedentary lifestyle, medication, metabolic syndromes, hypothyroidism

52
Q

what happens with an infants weight in the first few days of life

A

infants lose weight during the first few days of life, birth weight is usually regained by day 7-10 after birth

53
Q

what does the Canadian pediatric society recommend about breast feeding?

A

recommends all full term infants should be exclusively breast fed for the first 6 months of life

54
Q

why should cows milk be avoided in the first year of life?

A

because It is associated with occult blood loss in stool

55
Q

why is it essential that sufficient calories, protein, vitamins and minerals are consumed during pregnancy?

A
  • they support the synthesis of maternal and fetal tissues during pregnancy
56
Q

what can be done to reduce the risk of neural tube defects in infants?

A

400 mcg of folic acid should be taken daily

57
Q

what is food security?

A

means that all ppl, at all times, have access to nutritious, safe, personally acceptable, and culturally appropriate foods, produced in ways that are environmentally sound and socially just

58
Q

what percentage of indigenous ppl living in isolated communities experiance food insecurity?

A

40-83%

59
Q

what is the first step in assessing nutritional status?

A

nutritional screening

60
Q

what is an important question to ask patients regarding meals?

A

the 24-hour recall- asking patient or family members what was last consumed in the past 24 hours

  • be aware pf gaps with this method
  • pt may alter truth for various reasons
  • snack items are usually underreported
61
Q

what are some subjective questions to ask a pt about their food intake?

A
  • eating patterns
  • usual weight
  • changes in appetite, taste, smell, chewing and swallowing
  • recent surgery, trauma, burns, infections-need a lot of calories and protein
  • nausea, vomiting, diarrhea, constipation
  • food allergies or intolerances
  • medications, nutritional supplements
  • exercise and activity patterns
  • psychological symptoms
  • physical impairments
62
Q

objective data for nutritional assessment?

A
  • body mass index

- waist to hip ratio (reflects body fat distribution as an indicator of health risks)

PATHO (15 decks)

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