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Health Assessment Exam 4 > Ch. 21 Abdominal Assessment > Flashcards

Ch. 21 Abdominal Assessment Flashcards

1
Q

What is defined in the abdominal area?

A
  • from the diaphragm to the pelvis
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2
Q

What is located in the RUQ?

A 
Liver
Gallbladder
Duodenum 
Right Kidney & Adrenal Gland
Head of the Pancreas 
Part of Ascending & Transverse Colon
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3
Q

What is located in the LUQ?

A 
Stomach
Spleen
Left lobe of Liver
Pancreas
Splenic Flexure of Colon
Part of Transverse & Descending Colon
Left Kidney & Adrenal Gland
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4
Q

What is located in the RLQ?

A 
Right Ureter
Right Ovary & Tube(female)
Right Spermatic cord (male)
Ascending colon
Appendix 
Cecum
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5
Q

What is located in the LLQ?

A 
Part of Descending colon
Sigmoid colon
Left Ureter
Left Ovary & tube (female)
Left spermatic cord (male)
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6
Q

What is located in the midline of the abdomen?

A

Aorta
Uterus (if enlarged)
Bladder (If distended)

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7
Q

Besides the 4 quadrants, how else is the abdomen sectioned?

A

Epigastric
Umbilical
Hypogastric or Suprapubic

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8
Q

What should we take into consideration when dealing with abdomens of babies?

A
  • they don’t have abdominal musculature
  • large livers
  • urinary bladder is located higher
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9
Q

What should we take into consideration when assessing a pregnant woman’s abdomen?

A
  • Morning sickness
  • heartburn, esophageal reflux
  • decreased gastric motility
  • constipation due to decreased motility (increases water absorption)
  • hemorrhoids from increased venous pressure in lower pelvis
  • enlarging uterus displaces intestines
  • striae (stretch marks)
  • Linea Nigra (dark line)
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10
Q

What should we take into consideration when assessing an aging adult’s abdomen?

A
  • fat redistribution to the abdomen
  • abdominal musculature relaxes
  • salivation decreases
  • decreased sense of taste
  • esophageal emptying is delayed which would lead to aspiration if eating in supine position
  • increased gastric acid may cause pernicious anemia
  • increased incidence of gallstones (more common in females)
  • liver size decreases
  • constipation
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11
Q

In which race is lactose intolerance commonly seen?

A

book says African americans and Mexican Americans although she says differently… see other question about lactose intolerance occurrence

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12
Q

What topic areas should we focus on when collecting subjective data for the abdominal assessment?

A 
Appetite
Dysphagia
Food Intolerance
Abdominal Pain
Nausea/Vomiting
Bowel Habits
Past Abdominal History
Medications
Nutritional Assessment
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13
Q

what are some risk factors for liver problems?

A

alcohol consumption

medications (affect clotting factors like prothrombin)

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14
Q

Why is it important to note if a patient is taking aspirin or Advil?

A

can erode stomach lining and cause ulcers

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15
Q

Why is it important to note if a patient is taking Nexium over the counter for reflux?

A

alters pH

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16
Q

Why is it important to note if a patient is taking any herbal substances like ginseng ?

A

decreases clotting

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17
Q

What are some Addition History topics for infants and children?

A
  • breastfeeding v. bottle feeding
  • what formula do you use?
  • how do you introduce new foods (how often, what kinds)?
  • how often does the child eat?
  • does the child eat non foods like grass, dirt or paint chips?
  • constipation? how long?
18
Q

What additional history should you take for adolescents?

A 
Do you eat regularly?
What is your exercise pattern?
look for signs of eating disorders
do they eat out a lot?
Caloric intake
19
Q

What additional history should you take for the aging adult?

A

do you eat alone?
diet recall
do they get enough fluids
encourage some activity to prevent constipation

20
Q

Which race is sickle cell disease seen in most?

A

African Americans

21
Q

Which race has a high prevalence of G6PD

A

African Americans

22
Q

Which cultures are known for being lactose intolerant?

A

African Americans, Jewish Descent, Mediterranean Descent

23
Q

Which race has a high occurrence of gastric and liver cancers?

A

Asian Americans

24
Q

Which race has a high occurrence of alcoholism?

A

Native Americans

25
Q

Which culture has a high occurrence of Crohn’s Disease?

A

Jewish Descent

26
Q

What are some common abdominal symptoms?

A 
indigestion
anorexia
nausea/vomiting
hematemesis
abdominal pain
dysphagia
change In bowel function (constipation/diarrhea)
jaundice
urinary/renal symptoms
urinary incontinence
kidney or flank pain
ureteral colic
27
Q

What do we inspect when assessing the abdomen?

A

abdomen: bloating, distention, look at contour

urine

Emesis (vomit)

Stool

28
Q

What do we auscultate for when assessing the abdomen?

A 
Bowel sounds
Vascular sounds(i.e. "swish" sound seen with pulsating mass)
29
Q

how long must we listen to the bowel without hearing any sounds at all before determining there really is no bowel activity?

A

5 mins

30
Q

What do we palpate for when assessing the abdomen?

A 
muscle guarding (light palpation)
masses or enlarged organs (deep palpation)
31
Q

Why do we auscultate before palpating the abdomen?

A

b/c palpation can stimulate gastrointestinal movement

32
Q

What four words are used to describe the contour of an abdomen when the patient is supine?

A

Flat (normal)
Scaphoid ( caves in)
Rounded (normal)
Protuberant (extreme poking out)

33
Q

How do we describe bowel sounds?

A

Hyperactive
Active
Hypoactive
Absent

34
Q

What is Blumberg’s Sign?

A

“rebound tenderness”

pain on release of pressure confirms rebound tenderness, which is a reliable sign of peritoneal inflammation (appendicitis)

35
Q

What is the Iliopsoas Muscle Test?

A
  • performed when acute abdominal pain of appendicitis is suspected
    1. Person supine, lift the right leg straight up flexing at the hip
    2. push down over the lower part of the right thigh as the person tries to hold the leg up
36
Q

What is the Obturator test?

A

another test for appendicitis that stretches the Obturator muscle. evidence shows however that this test does not work to diagnose appendicitis.

37
Q

What are some abnormalities that are associated with the abdomen?

A 
GERD (reflux)
Hiatal Hernia (through diaphragm)
Peptic Ulcer Disease (NSAIDs, medications)
Crohn's Disease
Ulcerative Colitis (bloody BM)
Diverticulitis
Viral Hepatitis (Hep. A & Hep. C)
Cirrhosis
Cholecystitis (inflammation of gallbladder) 
Cholelithiasis (gall stones )
38
Q

What are some abnormal bowel sounds we listen for?

A

Hypoactive Bowel Sounds
Hyperactive Bowel Sounds
Arterial Bruit
Venous Hum

39
Q

What is a venous hum and where would we be able to find it while auscultating the abdomen?

A
  • Umbilicus Area
  • comes from the inferior vena cava
  • medium pitch, continuous sound, pressure on bell may obliterate it
  • may be seen with palpable thrill
  • occurs with Portal HTN and Cirrhotic Liver
40
Q

When the patient reports that a certain spot in the abdomen in tender, it is best to….

A

palpate that spot last to prevent pain from interfering with the rest of the examination

41
Q

Where is pain from appendicitis usually seen?

A

RLQ

Health Assessment Exam 4 (4 decks)

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