Ch 21 Abdomen Flashcards
Solid viscera includes
liver, pancreas, spleen, adrenal glands, kidneys, ovaries, uterus
hollow viscera includes
stomach, gall blader, small intestine, colon, bladder
Kidneys are located
- retroperitoneal (posterior to abdominal contents)
12th rib forms angle with
with vertebral column—costovertebral angle (CVA).
DC: Infants
abdominal wall thinner—easier to palpate organs.
Liver takes up more abdominal space.
Bladder higher in abdomen.
DC: pregnant women
decreased motility of GI tract.
Intestines displaced upward and posterior by enlarging uterus.
DC: Aging adult
increased adipose tissue.
Esophageal emptying delayed.
Gastric acid secretions decreased.
Incidence gallstones increased.
Drug metabolism by liver decreased.
Constipation symptoms evaluating using the Rome III symptom criteria:
Decrease in stool frequency (less than 3 times per week)
Straining
Hard stool
Feel of incomplete evacuation and anorectal blockage
Common causes of constipation
a) Decreased physical activity
b) Inadequate water intake
c) Low fiber diet
d) Side effects of medications
e) Irritable bowel syndrome
f) Bowel obstruction
g) Hypothyroidism
h) Inadequate toilet facilities
Gastric acid secretion decreases with aging which may cause
pernicious anemia (interferes with absorption of B12), iron deficiency anemia, malabsorption of calcium
SD: Abdomen list
1) Appetite
2) Dysphagia
3) food intolerance
4) abdominal pain
5) N/V
6) bowel habits
7) past abd history
8) meds
9) nutritional assessment
Liver size and aging
decreases by 25% between the ages of 20-70
pyrosis
heart burn
visceral abdominal pain
may be from and internal organ (dull, general, poorly localized)
parietal
inflammation overlying the peritoneum (sharp, precisely localized, aggravated by movement.)
pain of the duodenal ulcers occurs
2-3 hours after a meal and is relieved by more food
Hematemesis
vommitting of blood occurs with stomach or duodenal ulcers, and esophageal carices
Nutritional assessment is done via
24 hour recall
OD: Aging Adult
assess risk for nutritional deficit: limited access to grocery store, income, cooking facilities, decrease mobility, living along.
OD: Inspection
have client supine/arms by side/pillow under head and under knees
a) Contour: flat; scaphoid; rounded; protuberant
b) Symmetry
c) Umbilicus
d) Skin
e) Pulsation or movement
f) Hair distribution
g) Demeanor
Scaphoid abdomen
caves in
Auscultation: Bowel sounds
character, frequency. Normal: high-pitched, gurgling, cascading
Hyperactive: loud, high-pitched, rushing, tinkling
Hypoactive: infrequent normal sounds
Auscultation: Vascular sounds
firmer pressure with stethoscope; listen for bruits over aorta, renal arteries, iliac arteries, femoral arteries (esp. in clients with hypertension)
Note: location, pitch, timing
Percussion: used
used to assess relative density of abdominal contents; locate organs; screen for abdominal fluid or masses.
Percussion: general tympany
move clockwise; tympany should predominate
