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CNUR 107 > Gastrointestinal and Genitourinary > Flashcards

Gastrointestinal and Genitourinary Flashcards

1
Q

Inside the abdominal cavity, all the internal organs are called

A

viscera

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2
Q

where is the spleen

A

in the upper left side of your abdomen, next to your stomach and behind your left ribs

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2
Q

Where is the stomach

A

upper abdomen on the left side of your body.

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3
Q

Where is the small intestine

A

connects the stomach and the large intestine. It is about 20 feet long and folds many times to fit inside the abdomen.

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4
Q

Descending colon

A

on the right side of the abdomen

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5
Q

Where is the gallbladder

A

on the right side of your abdomen, just beneath your liver.

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6
Q

what organs are in the upper right quadrant

A

liver, right kidney, colon, pancreas, gallbladder

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7
Q

What organs are in the lower right quadrant

A

right kidney, colon, small intestine, major artery and vein to right leg, appendix

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8
Q

What is in the left upper quadrant

A

liver, spleen, left kidney, stomach, colon, pancreas

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9
Q

Where is the hypochondriac region

A

upper left and right

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10
Q

where ss the epigastric region

A

upper middle

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11
Q

Where is the lumbar region

A

the middle

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12
Q

Where is the iliac region

A

Left and right lower

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13
Q

Where is the hypogastric region

A

lower middle

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14
Q

Order of assessment

A

assess, inspect, auscultate, percuss, palpate

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15
Q

What position does the patient lie in during assessment

A

Spine with head and knees bent on pillow arms at side

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16
Q

Inspection includes

A

contour
symmetry
umbilicus
skin
pulsation
hair distribution & demeanor

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17
Q

Subjective data

A

Appetite
Dysphagia
Food intolerance
Abdominal pain
Nausea/vomiting
Bowel habits
Past abdominal history
Medications
Alcohol and tobacco
Nutritional assessment
Family history (IBD, celiac, ca)

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18
Q

contour includes

A

rounded
protuberant (very large)
scaphoid (Skinn)
flat

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18
Q

Striae

A

stretch marks

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19
Q

Pulsations and movement in the abdomen

A

aorta
respiratory movement
Peristalsis

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20
Q

What do bowel sounds sound like e

A

High pitched gurgling – irregular – should hear 5-30 times

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21
Q

Hyperactive bowel sounds mean??

A

tingling, loud, high pitched - heard in diarrhea, constipation

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21
Q

Hypoactive bowel sounds mean??

A

bowel obstruction, following surgery, peritonitis, torsion of bowel (decrease in peristalsis)

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22
Q

If the patient has hypertension what might you hear

A

a bruit—a vascular sound similar to a heart murmur—caused by turbulent blood flow through a narrowed artery

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23
Q

how long do you listen before deciding there is no bowel sounds

A

5 minutes

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24
Q

What may cause a bruit

A

plaque build up

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25
Q

Tympany

A

normal sound – d/t air in the intestines which rise to the surface when pt is supine

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26
Q

Dullness could indicate

A

distended bladder, fluid, mass, adipose tissue

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27
Q

Light palpation

A

depress skin about 1 cm
- use rotary motion
- move clockwise around the abdomen

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27
Q

If you do feel a mass, document

A

Location
Size
Shape
Consistency (soft, firm, hard)
Surface (smooth or nodular)
Mobility
Pulse felt
Tenderness

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28
Q

Why are seniors GI tracts lower

A

Decreased salivation[leads to decreased sense of taste], gastric acid secretion, delayed esophageal emptying

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29
Q

Social Determinant of Health & Health Promotion

A

Risk for obesity
Lactose intolerance due to lower level of lactase
Celiac disease
Gastrointestinal ulcers (peptic ulcer and duodenal ulcer)
Inflammatory bowel disease
Infectious disease such as hepatitis A
Health promotion –preventing damage to the liver

30
Q

What are common causes of constipation in older adults?

A

Decreased mobility, adverse reaction of medications, poor dietary habits (decreased fluid intake)

31
Q

When the patient reports that a certain abdominal spot is tender, it is best to:

A

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

32
Q

causes for abdominal destension

A

fluid, flatus, follicles

33
Q

when doing a male genitalia exam

A

use hard strokes - if erection – reassure that it not unusual & continue with exam or leave room and com back in a few minutes

34
Q

When preparing for GU assessment consider

A

Modesty
Fear of pain
Negative judgments
Invasion of privacy

35
Q

Structure of penis

A

Glans
Corona
Urethra
Foreskin

36
Q

Corona

A

refers to the circumference of the base of the glans penis which forms a rounded projecting border

37
Q

male infants/child development

A

Descent of testes
Foreskin easily retracted around age 6

38
Q

Male Adolescents Development

A

Signs of puberty
Tanner’s sexual maturity rating

39
Q

male Adults and older adults development

A

Sperm production begins to decrease at 40 years
Testosterone declines gradually after age 55 years
Scrotal sac pendulous
Slower and less intense sexual response
Sexual expression in later life
Physical changes do not interfere with libido

40
Q

stage one of tanners male development

A

10 and younger
-no pubic hair testes and penis are small they are prepubertal

41
Q

Stage 2 of tanners male development

A

10-13
sparse thin hair id at base of penis, tests enlarge scrotal skin becomes courser and redder

42
Q

Stage 3 tanners male development

A

12-14 scrotum and testies continue to grow. penis lengthens with diameter increasing slowly. Pubic hair will become darker, coarse, curly, extending laterally

43
Q

Stage 4 tanners male development

A

13-15
-penis and testes continue to grow pubic hair extends across public squares the medial thigh

44
Q

stage 5 tanners male development

A

15-17 penis is at full size pubiv hair is diamonds appearance with adult colour tenure extends surface of medial thighs

45
Q

Subjective Data

A

Groin - hernias
Frequency, urgency, nocturia
Dysuria – burning with voiding
Hesitancy and straining
Hx of UTI’s
Colour
Past history – any kidney disease, flank pain, kidney stones
Penis
Scrotum – lumps, swelling, self-care behaviours
Sexual activity - # of partners in past 6 months, any issues with erections
STI contact - condoms

45
Q

Comprehensive physical assessment:

A

penis
Scrotum
Inguinal region and femoral areas

46
Q

Warning signs of STI

A

urethral discharge, bloody or purulent
Scrotal or testicular pain
Burning or pain during urination
Penile erosion

47
Q

Paraphimosis

A

a common urologic emergency that occurs in uncircumcised males when the foreskin becomes trapped behind the corona of the glans penis

48
Q

Smegma

A

whitish cheesy material) – sebaceous secretions that collect under the prepuce*

49
Q

Penis should appear

A

hairless, wrinkled, without lesions.

50
Q

Phimosis

A

unable to retract the foreskin

51
Q

indirect inguinal hernia

A

-most common Indirect inguinal hernias occurs when abdominal contents protrude through the internal inguinal ring and into the inguinal canal

51
Q

Direct inguinal hernia

A

protrusion of abdominal contents through the transversalis fascia within Hesselbach’s triangle.

52
Q

Testicular self-examination tips

A

TSE is best performed after a warm shower or bath.
Examine each testicle one at a time with both hands.
Cancerous lumps usually are on the sides of the testicle but can show up on the front.
Make an appointment with a physician, preferably a urologist

53
Q

most common age for testitcular cancer

A

15-49

54
Q

Warning signs to watch out for with self testicular exams

A

Enlargement of the testes
Pain or discomfort
Heaviness in the scrotum
A dull ache in the groin
Significant loss of size of one testicle
Sudden collection of fluid in the scrotum

55
Q

Sexual maturity in girls stage 1

A

preadolescent no pibic hair. Mons and labia covered with sine villus hair as on the abdomen

56
Q

sexual maturity in girls stage 2

A

growth of sparse hair mostly on labs, long downy hair slightly pigmented only slightly curly

57
Q

sexual maturity in girls stage 3

A

growth sparse and spreading over the pubis hair is getting dark and curly

58
Q

stage 4 of sexual maturity in girls

A

hair is adult in type but a smaller area non medial thigh

59
Q

stage 5 of sexual maturity in girls

A

adult in type and growing down to thighs

60
Q

Questions to ask about pregnancy

A

of pregnancy, lives births, living children, complications, misscarages, abortions

61
Q

Personal history questions

A

menstruation (consistency), Menopause, urinary issue, disscharge, immunizations

62
Q

External genitalia
for a female

A

Mons pubis
Labia majora and Labia minora
urethra
Clitoris
Vestibule
Vaginal introitus
Perineum
Anus

63
Q

Skene’s glands

A

surround urethral meatus
Bartholin’s glands – on either side of the vaginal orifice

64
Q

External inspection: wear gloves

A

skin color
- hair distribution
- labia majora – symmetrical & plump (before having children)
- slightly shrunken & less defined (after having children)
- lesions
Separate the majora to inspect:
- labia minora
- urethra
- vaginal opening
- perineum
- anus

65
Q

Common genital or rectal symptoms

A

Pelvic pain
Vaginal discharge, burning, or itching
Menstrual disorders
Structural problems
Hemorrhoids

66
Q

Different in older women genitalia

A

Labia and clitoris smaller and paler
Epithelial layers thinner & flatter – cervix pale.
Thinning & drying of vaginal mucosa
Uterus & ovaries decrease in size
Ovarian follicles disappear
Ligaments & connective tissue lose muscle tone & elasticity

67
Q

Cervix

A

The lower, narrow end of the uterus (womb) that connects the uterus to the vagina (birth canal).

68
Q

Primary health promotion for cervical cancer

A

modify risk factors (safer sex, limiting partners, & HPV vaccine)

69
Q

Secondary health promotion for cervical cancer

A

earlier diagnosis and treatment ( Accessible Pap smears, HPV viral screening, )

70
Q

Teritary health promotion for cervical cancer

A

: Seeking to limit disability caused by the condition (early and effective treatment of precancerous legions)

71
Q

When should cervical cancer screening begin

A

Should begin at age 21 or approx. 3 years after first intimate sexual activity *which ever occurs LATER.

72
Q

How often should cervical screening occur

A

If results are normal, the person should be screened every 2 years until 3 consecutive normal results. AFTER receiving 3 consecutive normal results screening can be spaced every 3 years

73
Q

Increased risk or past cervical disease-

A

these individuals need to be screened annually
Included confirmed biopsy of high-grade squamous intraepithelial lesion or Adenocarcinoma in situ
On immunosuppression who have ever been sexually active (ie: AIDS/HIV, organ transplant, long term corticosteroids).
Women with invasive cervical cancer- after hysterectomy continue with vault smears.

74
Q

when can you stop getting screening

A

Can discontinue screening when older then 69 years old and 3 consecutive satisfactory and negative pap test in the last 10 years and are not immunocompromised.

75
Q

Transgender Men and Cervical Cancer Screening- What Do We Know?

A

No consensus on screening rates for transgender, genderqueer, or gender non binary people related to cervical cancer
No consensus on HPV vaccination rates for transgender people
Some research suggest that transgender men may have increase rates of unsatisfactory results (not necessarily abnormal but the cytologist is unable to read the results).

CNUR 107 (5 decks)

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