Abdominal/Gastrointestinal Assessment Flashcards
Name the 4 layers of muscle that protect the abdominal content.
1: Inguinal ligament
2: Transverse
3: Internal oblique
4: External oblique
What is the linea alba?
A tendinous seam that joins the abdominal muscles of the ventral wall.
What are the 4 major quadrants of the stomach?
Right Upper (RUQ) Right Lower (RLQ) Left Lower (LLQ) Left Upper (LUQ)
What are the differences of an abdominal assessment for infants and children?
- Prominent umbilical cord in newborns
- Liver takes up more space in abdomen and may be palpated below the right costal margin
- Bladder lies between symphysis and umbilicus (higher then in an adult)
- Abdominal wall less muscular, organs are easier to palpate
What are the differences of an abdominal assessment for a pregnant women?
- Acid Reflux
- Decreased gastric motility-prolongs transit time in gut, therefore more water absorbed, leads to constipation
- Constipation and increased venous pressure in lower pelvis can lead to hemorrhoids
- Intestines displaced upward and posteriorly by enlarging uterus
- Bowel sounds diminished
- Appendix displaced upward and to the right
- Striae and linea nigra
What are the differences of an abdominal assessment for an aging adult?
- May have fat accumulation also know as the “spare tire”
- Decreased salivation, dry mouth
- Esophageal emptying delayed (be careful feeding in supine position)
- Gastric acid secretion decreases-interferes with vitamin B12 absorption leading to anemia, and lowered incidence of gallstones
- Decreased liver size (normal function but decreased drug metabolism
- Constipation
What is the RNAO BPG for treating constipation?
- Drink lots of fluids
- Reduce caffeine
- Eat dietary fibres
- Implement routine toiletting
- Exercise
What things should be noted when doing a GI history on an adult?
- Meal/snack patterns
- Types of food consumed
- Exercise patterns
- Weight less then body requirement (fatigue, hunger, body image, activity pattern, family/social feedback)
- Body more then body requirement (timelines, eating habits, exercise pattern, Hormonal irregularities)
What things should be noted when doing a GI history on an aging adult?
- What is their access to food
- Alone or shared meals
- 24 hour intake history
- Swallowing, digestive difficulties
- Activity pattern post meal
- Bowel history
What food chain and cultural issues need to be considered in gi health?
- 70% of the world population is lactose intolerant
- There is recent rise in celiac disease (gluten intolerance)
- 10-20% of Canadians suffer from heartburn
- High incident of gastric ulcers (alcohol, smoking, helicobacter pylori, 8-10 million Canadians have H. pylori and 75% are first nations)
- One of the highest rates of inflammatory bowel disease
How can the nurse support relaxed abdominal muscles during abdominal exam?
- Ask patient to empty their bladder
- Warm room, warm equipment, warm hands
- Supine, head on pillow, arms at side, knees raised on pillow
- Examine painful, tender areas last
- Distraction-emotive imagery, soft voice, story, breathing
What is an aortic aneurysm? How might a nurse observe possible aortic aneurysms during abdominal assessment?
•An aortic aneurysm is a bulge in the artery.
Why is it important to watch patient behavior when examining the abdomen?
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What are the four contour shapes of the abdomen?
- Flat
- Scaphoid
- Round
- Protuberant
What are striae?
Stretch marks
