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NURS 307 > Chapter 21: Abdomen > Flashcards

Chapter 21: Abdomen Flashcards

1
Q

abdomen

A

large oval cavity extending from diaphragm down to the brim of the pelvis

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2
Q

Viscera

A

includes all internal organs.

Two types: hollow viscera and solid viscera.

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3
Q

solid viscera

A

includes liver, pancreas, spleen, adrenal glands, kidneys, ovaries and uterus

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4
Q

hollow viscera

A

stomach, gallbladder, small intestine, colon and bladder

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5
Q

Abdomen is divided into four quadrants

A

RUQ, LUQ, RLQ, LLQ

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6
Q

Right Upper Quadrant includes

A
  • liver
  • gallbladder
  • duodenum
  • head of pancreas
  • R kidney and adrenal
  • hepatic flexure of colon
  • part of ascending and transverse colon
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7
Q

Left Upper Quadrant includes

A
  • stomach
  • spleen
  • L lobe of liver
  • L kidney and adrenal
  • splenic flexure of colon
  • part of ascending and transverse colon
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8
Q

Right Lower Quadrant includes

A
  • cecum
  • appendix
  • R ovary and tube
  • R ureter
  • R spermatic cord
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9
Q

Left Lower Quadrant includes

A
  • part of descending colon
  • sigmoid, colon
  • L ovary and tube
  • L ureter
  • L spermatic cord
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10
Q

Midline, Epigastric, Umbilicus and Suprapubic includes

A

aorta, uterus if enlarged, bladder if distended

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11
Q

Cultural Considerations

A

A. lactose intolerant

B. Obesity

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12
Q

Cultural Considerations: Lactose Intolerant

A

African Americans, Hispanic and Caucasians groups at birth have an increased incidence of lactose intolerance.

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13
Q

Cultural Considerations: Obesity

A
  • combinations of intake, physical activity and genetic predisposition.
  • about 30-50% of US adults are obese, and stats vary among ethnic groups
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14
Q

What information would you need to obtain under the History (Subjective Data) category?

A

A. Any change in appetite, weight gain or weight loss
B. Dysphagia
C. Food intolerance
D. Abdominal Pain: location, character of pain
E. Nausea/Vomiting
F. Bowel Habits: frequency, consistency, details
G. Past Abdominal History: ulcer, hepatitis, appendicitis, colitis, hernia, surgery
H. Medications, alcohol use, smoking hx
I. Nutritional Assessment: 24 hour diet recall

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15
Q

What would you need to do under the Physical Exam/Assessment (Objective Data) category?

A

A. Inspection
B. Auscultate
C. Palpation
D. Percussion

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16
Q

Inspection of the Abdomen

A

note contour, symmetry, umbilicus and skin

17
Q

Auscultation of the Abdomen

A

auscultate bowel sounds in all 4 quadrants (with diaphragm) and auscultate for vascular sounds (bruits) (with bell)

18
Q

Palpation of the Abdomen

A
  1. light palpation
  2. deep palpation
  3. palpate liver and spleen (usually not palpable)
  4. palpate aortic pulsations (normal 2-4 cm wide)
19
Q

Percussion of the Abdomen

A
  1. percuss all 4 quadrants, note general tympany and dullness
  2. percuss liver span (nl 6-12 cm) - enlarged liver span indicates hepatomegaly
  3. percuss costovertebral angle tenderness (CVA)
20
Q

Special Procedures when assessing the abdomen

A
  1. Rebound Tenderness
  2. Inspiratory Arrest
  3. Iliopsoas Muscle Test
  4. Obturator Test
  5. Alvarado Score
21
Q

Rebound Tenderness (Blumberg’s Sign)

A

associated with appendicitis

22
Q

Inspiratory Arrest (Murphy’s Test)

A

hold fingers under liver border, have pt take a deep breath - normal response is no pain with procedure (not routinely done)

23
Q

Iliopsoas Muscle Test

A
  • lift R leg straight up, then push down over the lower part, while pt resists
  • normal/negative if no pain in RLQ (not routinely done)
  • can be used to check for appendicitis
24
Q

Obturator Test

A
  • lift R leg, flex at hip and 90’ at knee.

- hold the ankle and rotate leg internally and externally (not routinely done)

25
Q

Alvarado Score

A
  • one point for each criterion except where 2 points noted: pain migrating to right iliac fossa, anorexia, nausea/vomiting, RLQ pain (2 points), rebound tenderness, fever, WBC >10,000, neutrophils (>76% shift to left) (2pts)
  • 4 points suspects appendicitis
26
Q

Common Abdominal Abnormalities

A 
A. Ascites
B. Constipation
C. Umbilical Hernia
D. Hepatitis
E. Gastroesophageal Reflux (GER/GERD)
F. Aortic Aneurysm
G. Appendicitis
H. Gastroenteritis/Gastritis (AGE)
I. Cholecystitis
27
Q

Why must the abdomen be auscultated before percussion and palpation?

A

percussion and palpation can increase peristalsis, which would give a false interpretation of bowel sounds

28
Q

Bowel sounds

A
  • high-pitched, gurgling, and cascading sounds that irregularly occur from 5 to 30 times per minute.
  • originate from the movement of air and fluid through the small intestine.
29
Q

Borborygmi

A

term used for hyperperistalsis when the person actually feels his or her stomach growling. (hyperactive bowel sound)

30
Q

What happens to gastric acid secretion with aging?

A

decreased gastric acid secretion

31
Q

Black stools may be tarry as a result of

A

occult blood (melena) from gastrointestinal bleeding

32
Q

Before reporting a finding as silent bowel sounds, the nurse should listen for at least

A

5 minutes

33
Q

Gaseous distension produces what kind of sound during percussion

A

hyperresonance

34
Q

Air produces what kind of sound during percussion

A

tympany

35
Q

Gray stools occur with

A

hepatitis

36
Q

peptic ulcer disease occurs with

A

NSAIDS, alcohol, smoking and helicobacter pylori infection.

37
Q

hernia

A

protrusion of abdominal viscera through abnormal opening in muscle wall

38
Q

dullness occurs over

A

a distended bladder, adipose tissue, fluid or a mass

39
Q

During palpation, what indicates that the liver is enlarged?

A

a liver palpated more than 1 - 2cm below the right costal margins is enlarged.

NURS 307 (29 decks)

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