GIT - Assessment & Diagnostic Tests Flashcards
1
Q
Assessment
A
- health history - previous problems
- chief complaint - if pain - onset, duration, characteristics, location, severity
- physical assessment
- inspection
- auscultation
- percussion
- palpation
2
Q
Assessment - Abdomen Divisions
A
- 4 quadrants +
- right upper quadrant
- left upper quadrant
- right lower quadrant
- left lower quadrant
- 9 regions #
- right hypochondriac region (below the ribs)
- epigastric region
- left hypochondriac region
- right lumbar region
- umbilical region
- left lumbar region
- right iliac region
- hypogastric region (below the stomach)
- left iliac region
3
Q
General Assessment
A
- pain history - PQRST
- indigestion
- intestinal gas
- nausea & vomiting
- change of bowel habits - constipation / diarrhoea
- nutritional patterns - food habits
- weight gain / loss
- medications - prescribed and OTC
- vital signs
4
Q
Physical Assessment - Inspection
A
- observe position patient assumes - flexing knees, guarding
- start at mouth - status of tongue, wastage, damage, swelling, colour, pallor, teeth
- abdomen - should be flat, if full / distended - gas, fluid, obstruction, constipation, if concave - malnutrition
- 5 F’s - flatus, faeces, fat, feotus, fibroids
- measure girth of abdomen at level umbilicus
5
Q
Physical Assessment - Inspection - Output
A
- vomiting
- type (projectile)
- colour (coffee grounds, bright blood)
- smell (faecal smelling)
- frequency
- amount
- faeces
- urine
- NG asperate if inserted for decompression
6
Q
Physical Assessment - Auscultation
A
- listen for 1-2 minutes
- only after listening for 5 minutes can it be determined that there are NO bowel sounds
- bowel sounds - usually gurgling / clicking
7
Q
Physical Assessment - Percussion / Palpation
A
- looking for excessive gas, fluid, solid or masses
- 2 middle fingers, striking happens from wrist
- on gas - timpanic or resonate, on fluid - dull, on solid - feel the lump
- palpation - for lumps, pain, guarding, distention
8
Q
Assessment Abnormalities
A
- mouth
- ulcer, leukoplakia (white or grey patches inside the mouth), herpes simplex, monilia (yeast infection), glossitis (swelling in the tongue), gingivitis (gum disease)
- abdomen
- distention, ascites (buildup of fluid due to liver being unable to filter / get rid of excess), bruit (sound of turbulent blood flow), hyperresonance (exaggeration of resonance), hepatomegaly (enlarged liver), splenomegaly (enlarged spleen)
- oesphagus / stomach
- dysphagia (difficulty swallowing), haematemesis (vomiting blood)
- rectum
- fissue, tenesmus (involuntary frequent spasms of the rectum), steatorrhoea (presence of fat in feces), melaena stool
9
Q
Diagnostic Studies
A
- most will require empty stomach and / or bowel
- bowel preperations - gylcoprep, low residue diets, laxatives
- common tests:
- barium swallow / enema
- ultrasound
- cholangiogram - biliary tract, liver, gallblader, pancreas
- gastric analysis - gasteroenteritis, bowel obstruction
- breath tests - intolerances, peptic ulcer diease (urea breath tests)
- stools tested for fat, blood, pus, paracites
- endoscopy
- colonoscopy
- plain abdo x-ray, CT, MRI
- FBE