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
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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
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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
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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
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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
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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
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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
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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
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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
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