Chapter21Abdomen

Question 1

Infants and children: DC

Answer 1

abdominal wall thinner—easier to palpate organs.
Liver takes up more abdominal space.
Bladder higher in abdomen.

Question 2

Pregnant women: DC

Answer 2

Decrease motility of the GI tract. Intestines displaced upward and posterior by enlarging uterus.
The appendix maybe displaced upward and to the right.

Question 3

Aging Dult: DC

Answer 3

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
*Constipation is not a consequence of aging

Question 4

visceral pain from

Answer 4

an internal organ (dull, general, poorly localize)

Question 5

parietal pain from

Answer 5

inflammation of overlying peritoneum. (sharp, precisely localized, aggravated by movement

Question 6

Common causes of constipation are

Answer 6

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

Question 7

Nutritional assessment

Answer 7

24 hour recall

Question 8

chronic pain of gastric ulcers occurs usually on a

Answer 8

empty stomach

Question 9

pain of duodenal ulcers occurs

Answer 9

2-3 hours after a meal and is relieved by more food

Question 10

gray stools occur with

Answer 10

hepatitis and bile duct block

Question 11

Peptic ulcer disease occurs with frequent use of

Answer 11

NSAIDS, alcohol, smoking and H. pylori infection

Question 12

Aging adult and diet recall

Answer 12

a 24-hour recall may not be sufficient because daily pattern may vary. Attempt week long diary of intake. Food patterns may differ during the month if money income runs out.

Question 13

Inspection of abdomen: have the client

Answer 13

supine/arms by side/pillow under head and under knees

Question 14

cutaneous angiomas (spider nevi) occur with

Answer 14

portal hypertension or liver disease.

Question 15

Recent striae are what color and then they turn?

Answer 15

pink and then turn silvery white.

Question 16

Order of objective data for abdomen

Answer 16

Inspection, auscultation, percussion, palpate

Question 17

What do bowel sounds sound like?

Answer 17

high pitched, gurgling cascading sounds, occurring irregularly anywhere from 5-30 times per minutes.

Question 18

Is it necessary to listen to abdomen in all four quadrants.

Answer 18

No because the sounds radiate widely over the abdomen., the gurgle you hear in the RLQ may originate in the stomach.

Question 19

One type of hyperactive sounds is fairly common: hyperperistalsis, when you feel your “stomach growling,” termed

Answer 19

borborygmus

Question 20

A perfectly “silent abdomen:

Answer 20

is uncommon; you must listen for 5 minutes by your watch before deciding if bowel sounds are completely absent.

Question 21

Vascular sounds in the abdoment

Answer 21

not the presence of bruits, using firmer pressure, check over aorta, renal arteries iliac and femoral arteries, especially in a person with hypertension No such sounds should be present.

Question 22

A systolic bruit is a

Answer 22

pulsatile blowing sound and occurs with stenosis or occlusion of an artery.

Question 23

What 3 things should you not in vascular sounds

Answer 23

location, pitch and timing.

Question 24

Hyperactive bowel sounds:

Answer 24

loud, high pitch, rushing tinkling.

Question 25

Costovertebral angle tenderness (CVAT)

Answer 25

Indirect fist percussion causes the tissues to vibrate instead of producing a sound too assess the kidney place one hand over the 12th rib at the CVA on the back. * sharp pain occurs with inflammation of the kidney or paranephric area.

Question 26

Ascites occurs with

Answer 26

HF, portal hypertension, cirrhosis, hepatitis, pancreatitis and cancer

Question 27

Where to percuss for splenic dullness

Answer 27

percussing for dull note from 9th to 11th ICS just behind the left midaxillary line.

Question 28

palpation is used to determine

Answer 28

size, location, and consistency of certain organs; to screen for abnormal mass or tenderness.

Question 29

light palapation

Answer 29

use first four fingers; gentle rotary motion; sliding fingers and skin together; depress 11 cm

Question 30

Deep palpation

Answer 30

using same technique as light palpation, depress 5-8 cm.

Question 31

when do you palpate identified tend areas

Answer 31

last during examination

Question 32

involuntary rigidity

Answer 32

is a constant boardlike hardness of the muscles. It is a protective mechanism accompanying acute inflammation of the peritoneum. It may be unilateral and the same area usually becomes painful when the person increases intra abdominal pressure by attempting to sit up

Question 33

What is the only mild tenderness that is normally present when palapting

Answer 33

the sigmoid colon. any other tenderness should be investigated.

Question 34

Aging adult on inspection

Answer 34

you may not an increased deposits of subq fat on the abdomen and hips because it is redistributed away from the extremities. The abdominal musculature is thinner and has less ton than that of the younger adult, thus in the absence of obesity, you may note peristalsis.