gastrointestinal assessment Flashcards
what are the quadrants in the abdomen?
4 quadrants
- right upper (RUQ)
- left upper (LUQ)
- right lower (RUQ)
- left lower (LLQ)
what organs are in the RUQ
- ascending and transverse colon
- duodenum
- gallbladder
- liver
- pancreas (head)
- pylorus
- rt adrenal gland
- rt ureter
- rt kidney
what organs are in the LUQ
spleen
stomach
transverse descending colon
pancreas(body and tail)
lt adrenal gland
lt kidney (upper pole)
lt ureter
what organs are in the RLQ
appendix
ascending colon
cecum
rt kidney (lower pole)
rt ovary and tube
rt ureter
rt spermatic cord
what organs are in the LLQ
sigmoid colon
lt kidney (lower pole)
lt ovary and tube
lt ureter
lt spermatic cord
what organs are in the midline of abdomen
bladder
uterus
prostate gland
what are factors for GI health
microbiome
caffeine
NSAIDs (nonsteroidal anti-inflammatory drugs)
food tolerances
fatty foods
family history
fiber/fluids/physical activity
narcotics
symptoms in order to do a GI assessment
abdomen pain
indigestion
anorexia
nausea or vomiting
dysphagia/odynophagia (difficulty/pain with swallowing)
change in bowel function
urinary/renal symptoms
menstrual symptoms
signs in order to do a GI assessment
dental issues
dehydration
fever
jaundice
quadrant tenderness
altered bowel sounds
abdominal guarding
impaction
types of abdominal pain
visceral
parietal
referred pain
what is visceral pain
organ distention (enlarged abdominal organs (bloating)) - pain is categorized as gnawing, burning, cramping, aching
what is parietal pain
inflammation of peritoneum (membrane that lines the inside of the abdomen and pelvis) - constant pain, localized over involved structure, steady, aching or sharp especially with movement
what is referred pain
when you feel the pain in one part of your body but the real source of pain is coming from somewhere else
what does orange coloured stool mean
happens due to
- certain medications with beta-carotene (a form of vitamin A)
- antacids which contain aluminum hydroxide
what does green coloured stool mean
happen due to
- green, blue foods or foods with a lot of dark purple of green (blueberries)
- food colouring
- vitamins that contain chlorophyll
- fast transit time can also cause stool to turn green
what does yellow coloured stool mean
happens commonly due to C-diff bacteria – yellow stool is a “tell tale” sign of infection
what does clay coloured stool mean
mal-absorption, hepatitis or gallbladder disorders (like a bile duct blockage)
what does red or maroon coloured stool mean
means presence of blood, hematochezia
- can indicate a fresher blood and therefore lower GI bleeding
what does black coloured stool mean
- can indicate blood from an upper GI bleed
- due to iron supplements
- black licorice
- beets
how to inspect abdomen during GI assessment
observe
- client’s general behavior and position (nervous? in pain?)
- skin (stretch marks? jaundice?)
- umbilicus (inverted? protruding?)
- peristaltic waves and pulsations
- contour, size, shape, symmetry, distention
make sure to observe from both the end and side of bed with the patient lying flat
why to auscultate before palpating the abdomen?
palpation may disturb the bowel , stimulating sounds artificially
what are you listening for when auscultating the abdomen
- bowel sounds (peristalsis) –> sounds like gurgling, clicking, combo of high/low pitch
- irregular by definition
how to auscultate abdomen
begin in the RLQ and move clockwise
(RLQ → RUQ → LUQ → LLQ)
factors that affect elimination and prevention of constipation
age
diet
fluid intake
physical activity
psychological factors
personal habits
position
pain
pregnancy
surgery/anesthetic
medications
