abdominal assessment Flashcards
dysphagia
difficulty swallowing
hematemesis
blood in vomit
anorexia
loss or lack of appetite
odynophagia
pain with swallowing
review of systems questions
last menstrual period and last bowel movement, organ specific questions
liver and gall bladder specific ROS questions
jaundice, grey or mustard colored stools, heavy alcohol intake
spleen specific ROS questions
any recent impact to abdomen
kidneys specific ROS questions
flank pain
uterus and ovaries specific ROS questions
last menstrual period, change in cycle
stomach, pancreas, and intestines specific ROS questions
GI symptoms
bowel function questions
diarrhea, constipation, character, pattern, diet, routine medications
jaundice
liver and gall bladder, color of stools and urine, sclerae assessment
hepatitis
A (fecal), B (blood/body fluids), C (blood)
objective assessment/preparation
offer privacy, bend patient’s knees, order of assessment changes, examine painful areas LAST
what should you inspect for in the abdomen?
contour, symmetry, skin characteristics, umbilicus, abnormal movements
expected findings of INSPECTION of abdomen
- flat, round, obese
- symmetrical contour
- even pigmentation, faintly visible vessels
- umbilicus midline and inverted
- faint epigastric pulsations in thin people
unexpected findings of INSPECTION of abdomen
asymmetrical contour, skin discoloration, everted umbilicus, visible movements
turner’s sign
bruising along the flank
cullen’s sign
core bruising
what to auscultate for on the abdomen
bruits and bowel sounds
frequency of bowel sounds
normoactive, hypoactive, hyperactive, absence
normoactive frequency
5-30 seconds apart
hypoactive frequency
60 seconds apart
hyperactive frequency
3 seconds apart
absent frequency
no sounds after 5 minutes
expected findings of bowel sounds
active and no bruits
unexpected findings of bowel sounds
hypoactive sounds, hyperactive sounds, absent bowel sounds, bruits
palpation of abdomen
always performed last, painful areas last
CVA tenderness
tapping kidneys to see if they are inflamed
appendicitis signs
rebound tenderness, inspiratory arrest, McBurney’s point tenderness, Iliopsoas muscle test, obturator test
common sites of referred abdominal pain
(liver, esophagus, ulcer, gallbladder, appendix, pancreas, kidney, small intestine, colon)
RUQ, behind sternum, shoulder, RUQ, RLQ, midscapular line. flank, radiating, colicky/bloating
how to assess for distended bladder
inspect, palpate, percuss
common diagnostic studies for abdomen
AST, ALT, amylase and lipase, CT scan, MRI, ultrasound, occult fecal blood test
red flag findings
severe abdominal pain with instant relief, bloody stools or emesis, abdominal rigidity, inability to retain fluids to replace losses, mass in abdominal wall
RLQ organs
appendix and ascending colon
RUP organs
liver and gallbladder
LUQ organs
stomach, spleen, and pancreas
LLQ organs
sigmoid colon
