Abdominal (and Nutrition) Assessment Flashcards
What are some health history you want to obtain from the patient?
- GI problems
- Operations in abdomen
- Abdominal x ray studies
- medications
- alcohol/tobacco/drug use
- activity level
- nutritional assessment
Dysphagia
difficulty swallowing
Older adult questions
- how do you get groceries/prep meals?
- do you eat alone or share your meal with others?
- do you have trouble chewing or swallowing?
- how often do you bowels move?
- how much liquid do you drink per day?
- amount of fiber in diet?
- do you take any medications for constipation?
Assessing dietary intake
24 hr recall Food frequency questionnaire Food diary Direct Observation During hospitalization, document intake
Nutritional Assessment
- changes in appetite, senses
- recent surgery, trauma, burns. infection
- chronic illness
- eating patterns
- usual weight
- nausea, vomiting, diarrhea, constipation
- food allergies/intolerances
- medications/supplements
- self-care behaviors
- alcohol and drug use
- exercise and activity patterns
Which quadrant is the liver in?
RUQ
Which quadrant is the gallbladder in?
RUQ
Where is the stomach
LUQ
Abdomen inspection terms
- Flat
- Rounded
- Obese
Abdomen auscultation terms
-Normoactive
-Hypoactive
-Hyperactive
(in all 4 quadrants)
Abdomen palpation terms
- soft
- firm
- distended
- tender
- non-tender
What is the order for an abdomen exam?
Inspection, auscultation, percussion, palpation
How long should you auscultate the stomach before you state “absent”?
2 minutes
What do bruits in the abdomen indicate?
Aortic aneurysm
Renal artery stenosis
Femoral artery occlusions
What does a normal stomach sound like?
Tympany
What should normal liver, spleen, adipose tissue sound like?
Dullness
What does costovertebral angle tenderness indicate?
Kidney inflammation
Palpation technique of abdomen
- use 4 fingers
- gentle, circular motion 1 cm deep
- lift and move clockwise
- do not drag
Obesity - inspection
Uniformly rounded with sunken umbilicus
Air/Gas - inspection
Single rounded curve
Air/Gas - percussion
Tympany over large area
Ascites - inspection
Single curve and everted umbilicus
-bulging flanks, taunt skin, increased abdominal girth
Ascites - auscultation
Normal but diminished over fluid
Ascites - percussion
Tympany over bowels but dull over fluid
Ascites - palpation
Taut skin and increased pressure
Feces - inspection
Localized distension
Feces - percussion
Tympany with dullness over fecal mass
Feces - palpation
Rope-like mass