Abdominal and Male Genitourinary assessment Flashcards
What does the GI system contain
stomach, small intestines, large intestines, liver, gallbladder, pancreas, spleen
What does the urinary system contain
kidneys, ureters, bladder, urethra
What is the purpose of stomach
mixes and churns food with gastric juice contains acid and a protein-digesting enzyme called pepsin, creating chyme
What is the purpose the liver
makes bile which aids in the digestion and absorption of fat
What is the purpose of the gallbladder
stores bile and releases it into the small intestine when needed
What is the purpose of the pancreas
insulin production, releases bicarbonate to neutralize intestinal contents; produces enzymes that digest carbohydrates, protein, and fat
What is the purpose of the spleen
controls the levels of white blood cells, red blood cells, and platelets
What do you follow for an assessment
the flow of the contents of the stomach (the large intestines)
What is the direction of the abdominal assessment
RLQ –> RUQ –> LUQ –> LLQ
What do you need to properly assess the abdomen
proper exposure
What main organs are in the RLQ
appendix, ascending colon
Why do you hear bowel sounds best in the RLQ
because of the ileocecal valve
What main organs are in the RUQ
liver, gallbladder, ascending colon
What main organs are in the LUQ
stomach, spleen, pancreas
What main organs are in the LLQ
descending colon
What should the patient do before you start the assessment
void, position supine with knees slightly flexed
How do you palpate a painful area
last and extra softly
What order do you do an abdominal assessment
inspection –> auscultation –> percussion –> palpation
Why does percussion occur before palpation
you don’t want to stimulate the bowel and change the bowel sounds
What do you assess during inspection (3)
size, symmetry, contour, and condition of the abdomen
position, contour, and color of the umbilicus
look for lesions, scars, striae, superficial veins, and hair distribution
How do you check for bulges
have the patient raise their hands
How do you check the shape of a patient’s abdomen
stand at the client’s side and view across the abdomen
When is the best time to auscultate the abdomen
shortly after eating or when eating is overdue
How long are bowel sounds usually heard over the ileocecal valve after eating
4-8 minutes after a meal
What do you percuss the abdomen for
gas, fluid, tenderness, masses
What are the types of abdomen contour (4)
flat, scaphoid, rounded, protuberant
When is a protuberant abdomen expected
in infants and children
Are scars, striae, and superficial veins common variations
yes
What causes a more rounded abdomen in older adults
decreased muscle tone
When are peristaltic waves common to see
in thin patients, infants, and children
What do men tend to use when they breathe
abdominal muscles
What do peristaltic waves mean
an intestinal obstruction
What do pulsations indicate
aortic aneurysms
What is expected findings for an umbilicus
inverted, midline, no discharge or discoloration
What does protrusion of the umbilicus mean
hernia or underlying mass
What is an expected finding for auscultation
irregular gurgling/tinkling sounds every 5-15 seconds or 30 times per minute
Borborygmi
the characteristic sounds of growling or rumbling that the stomach and intestines make as food, fluids, and gas pass through them
Hypoactive bowel sounds
extremely soft, infrequent, <5 sounds/min, indicates decreased motility
When are hypoactive bowel sounds often heard
post-op, peritonitis, bowel obstruction
Hyperactive bowel sounds
increased high-pitched, loud rushing every 2-3 seconds or >30 minutes indicates increased motility
When are hyperactive bowel sounds often heard
diarrhea, early bowel obstruction, or with use of laxatives
How long do you have to listen for bowel sounds for in order to indicate absence of bowel sounds
5 minutes
What does an absence of bowel sounds mean
cessation of intestinal motility
Ileus
lack of intestinal activity
When is Ileus common
after surgery
Are bruits expected or unexpected findings
unexpected
How do you listen for bruits
use stethoscope bell over aorta, renal, femoral, and ileac arteries to listen
What does a bruits indicate
an aneurysm or altered blood flow
Tympanny
a normal sound heard over gas
Dullness
heard over organs or over an area of fluid/mass
What do high-pitched sounds or extensive dullness indicate
enlargement or underlying mass
What age-related changes are found in the stomach
decreased gastric motility and reduction in gastric mucus
What do age-related changes in the stomach cause
increased susceptibility to peptic ulcer disease and gastritis. increased with medications, especially NSAIDs
What age-related changes are found in the intestines
decrease in nutrient absorption, lipids, amino acids, glucose, calcium, and iron, peristalsis is slowed
Is constipation normal with aging
No, but it is common
What age-related changes are found in the gallbladder and liver
decrease in blood flow, decreasing use of fat-soluble medications
Penis
external reproductive organ of the male made of the shaft and the glans
Male urethra
found in the shaft, drains the bladder
Scrotum
bag of skin that holds and helps protect the testicles
Testes (testicles)
two small organs found inside the scrotum responsible for making sperm and producing testosterone
Epididymis
a long tube located near each testicle important for moving sperm from the testicles
Seminal vesicles
sac-like glands behind the bladder that releases semen
Vas deferens
a tube that carries the sperm out of the scrotal sac
Rectum
the lower end of the large intestine that leads to the anus
Anus
the opening at the end of the digestive tract where bowel contents leave the body
Prostate gland
a sex gland in men that secretes a slightly alkaline fluid that forms the seminal fluid, which carries sperm
What do you inspect in the male genitourinary assessment (7)
hair distribution/color/condition, skin of the penis, foreskin?, urethral meatus, lesions, discharge, inguinal area
What do you observe for the scrotal sac (4)
condition, size, symmetry, and position
What do you palpate in the male genitourinary assessment
shaft of the penis, foreskin if present, lymph nodes in inner thigh
How to perform testicular self-examination
check for scrotal swelling, palpate testes, roll testes gently in horizontal plane (using thumb and index finger), feel for any abnormalities, locate epididymis
Hypospadias
urethral opening at the bottom of the penis
When is hypospadias common
in infants
Epispadias
urethral opening at the top of the penis
Pilonidal cyst
blocked sebaceous gland at the base of the spine
Why is incontinence a problem in 1/3 of adults
the bladder-supporting muscles weaken
What happens to the scrotum with age
enlarges
