Gastointestinal tract chapt 30 (639-644)

Question 1

What are the two methods of subdividing the abd?

Answer 1

4 quadrants (RUQ, LUQ, RLQ, LLQ) or 9 regions (R hypochondriac/epigastric/L hypochondriac; R lumbar/umbilical/L lumbar; R inguinal/hypogastric/L Inguinal

Question 2

In what order would the method of assessment be for the abd?

Answer 2

Inspection, auscultation, palpation, percussion

Question 3

Why is auscultation done before palpation of the abd?

Answer 3

Auscultation is done before palpation because palpation can cause movement or stimulation of the bowel which increases bowel motility and heightens BS.

Question 4

In what quadrant can I find the liver, GB, R adrenal gland?

Answer 4

RUQ

Question 5

In what quadrant can I find the L ovary sigmoid colon, L ureter?

Answer 5

LLQ

Question 6

In what quadrant can I find the appendix?

Answer 6

RLQ

Question 7

In what quadrant can I find the pancreas, spleen, stomach, and L adrenal gland?

Answer 7

LUQ

Question 8

Difficulty in swallowing is defined as:

Answer 8

dysphagia

Question 9

To make the assessment of the abd more comfortable, what should you have your pt do prior?

Answer 9

empty their bladder and bowels

Question 10

Vomiting blood is defined as:

Answer 10

hematemesis

Question 11

You’re assessing the abd of your pt and you notice purple striae on the abd. This finding is:

Answer 11

abnormal and indicative of Cushing’s disease or rapid weight gain/loss

Question 12

To assess the liver and spleen contour of the abd, what will you have your pt do?

Answer 12

Have the pt take a deep breath and hold it to make an enlarge liver or spleen more obvious.

Question 13

You’re assessing the abd of your pt and you notice no vascular pattern on the abd. This finding is:

Answer 13

normal.

Question 14

You’re assessing the abd of your pt and you notice a venous pattern (dilated veins) on the abd. This finding is:

Answer 14

abnormal and indicative of liver disease, ascities, or obstruction

Question 15

What do I auscultate for when assessing the abd?

Answer 15

I am auscultating for BS (diaphragm); vascular sounds over the aorta artery (below ziphoid process) renal artery, iliac artery, and femoral artery (use bell); peritoneal friction rubs

Question 16

You’re auscultating the abd of your pt and you hear rough grating sounds like two pieces of leather rubbing together. This finding is:

Answer 16

peritoneal friction rub: abnormal and indicative of inflammation, infection, or abnormal growth

Question 17

You’re auscultating the abd of your pt and you notice a loud bruit over the aortic area. This finding is:

Answer 17

abnormal and indicative of an aneurysm

Question 18

You’re assessing the abd of your pt and you notice a distended palpable as smooth and round tense mass over the bladder. This is finding is:

Answer 18

abnormal and indicative of urinary retention

Question 19

Upon auscultating the abd, you hear extremely soft and infrequent sounds (one per minute). This finding is:

Answer 19

hypoactive and abnormal and indicative of decreased motility usually associated during surgery, inflammation, paralytic ileus, or late bowel obstruction

Question 20

You’re auscultating the abd and you hear high pitched, loud rushing sounds that occur frequently (every 3 sec). This finding is:

Answer 20

hyperactive and abnormal associated w/diarrhea, early bowel obstruction or the use of laxatives. Hyperactive is also known as borborygmi

Question 21

When listening to bowel sounds, what are the name of the ausculatory sites according to Berman:

Answer 21

Starting from R upper –> under Ziphoid –>L upper –> L lower –>R Lower –> to femoral sites: renal arteries, aorta, iliac arteries, and then the femoral arteries

Question 22

You’re assessing the abd of an 3 year and you notice that the pt’s belly has a “pot belly” appearance. This finding is:

Answer 22

normal for toddlers till they are 4 yo

Question 23

Why may older adults have a more rounded abd?

Answer 23

Increase of adipose tissue and decrease in muscle tone

Question 24

Which pt would have an easier abd to palpate: younger or older?

Answer 24

older because the abd wall is thinner and slacker in older pts and also because of muscle wasting

Question 25

You’re assessing your pt and he tells you that he’s feeling pain in his chest that’s not relieved by antiacids but he feels better when he lies down. He says he began feeling his symptoms when working in the back yard. This finding is:

Answer 25

abnormal and indicative of cardiac pain

Question 26

You’re assessing your pt and she tells you that she’s feeling pain in her chest. She says the pain occurs when she is eating something and only feels better if she sits upright and takes antiacids. This finding is:

Answer 26

abnormal and indicative of gastrointestinal pain

Question 27

Where can gastrointestinal pain occur and what can relieve or aggravate it:

Answer 27

Pain ca occur in the chest or abd and is aggravated by ingestion or lack of food intake. Relieved by sitting upright, eating, antacids

Question 28

Where can cardiac pain occur and what can relieve or aggravate it:

Answer 28

Pain occurs in the chest and is aggravate by activity or anxiety. Relieved by resting or taking nitroglycerin

Question 29

You’re inspecting the abd of your pt and you notice marked aortic pulsations. This finding is:

Answer 29

abnormal (only aortic pulsations can be normal in thin pts)