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N143 > Module 3- Abdominal Assessment > Flashcards

Module 3- Abdominal Assessment Flashcards

1
Q

what is the correct order for the abdominal assessment?

A

inspect, auscultate, palpate, percuss

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2
Q

why is it important to auscultate before palpating?

A

to lessen the chance of altering the frequency and character of bowel sounds

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3
Q

how to men and women breathe?

A

men breathe abdominally and women breathe more costally

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4
Q

define peristalsis

A

movement of contents through the intestines

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5
Q

when auscultating, what are you listening for?

A

listening for bowel sounds

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6
Q

what is increased motility caused by?

A

inflammation of bowel, anxiety, diarrhea, bleeding, excessive ingestion of laxatives, reaction of intestines to certain foods

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7
Q

what is palpation used for?

A

detect areas of abdominal tenderness, distension, or masses

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8
Q

define guarding

A

tensing muscles upon palpation (tells you the pain is pretty significant)

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9
Q

while doing the abdominal assessment, what is something you MUST complete when pain is suspected?

A

Pain assessment!!!

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10
Q

describe the process of defecation (bowel elimination)

A

begins with contractions in the left colon, moving the stool toward anus
-relaxation of the internal anal sphincter occurs when stool reaches the rectum and there’s a need to defecate

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11
Q

define the valsalva maneuver

A

when pressure is exerted to expel feces through voluntary contraction of the abdominal muscles and the diaphragm while maintaining forced expiration against a closed airway

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12
Q

if bed ridden, what is the best position for one who needs to defecate?

A

have head of bed up as much as possible to allow as normal of a squatting position as possible

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13
Q

list factors affecting normal bowel elimination

A
  • fibre is a good thing to eat to reduce constipation (brown bread, vegetables)
  • physical activity (promotes peristalsis)
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14
Q

what are the characteristics of normal feces?

A

brown, soft, formed, occurs daily-2/3 times weekly

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15
Q

what are characteristics of abnormal feces?

A

white, black (tarry), mucous/pus, liquid or hard, narrow, bloody, more than 3 times a day or less than once a week

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16
Q

briefly describe the process of digital removal of stool

A
  • explain procedure
  • hand hygiene and gloves**
  • index finger with jelly
  • advance finger along rectal wall
  • gently loosen fecal mass by massaging around it
  • work feces down toward end of rectum
  • assess vitals
  • take off gloves and hand hygiene
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17
Q

what is enema?

A

liquid or gas injected into rectum (ordered by physician)

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18
Q

list some organs that are solid viscera (maintain characteristic shape)

A

liver, spleen, pancreas, kidneys etc

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19
Q

whats hollow viscera? gives examples

A

hollow-type organs. gall bladder, small intestine, colon, bladder

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20
Q

would hollow or solid viscera be resonant while percussing?

A

hollow viscera would be resonant

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21
Q

where is the liver, stomach, spleen, kidneys, colon located? (anatomical location)

A 
liver= RUQ
stomach= LUQ
spleen= LUQ
left kidney= LUQ
right kidney= RUQ
colon= LLQ
22
Q

what are developmental considerations for infants and children?

A
  • abdominal wall is less muscular and therefore organs may be easier to palpate
  • increased risk for dehydration because high turnover of water and electrolytes (which can cause gastrointestinal illness)
23
Q

what are developmental considerations for pregnant women?

A
  • morning sickness
  • elevated levels of progesterone and relaxes all smooth muscle, which leads to decrease in gastrointestinal motility and prolongation of gastric emptying time
  • due to reduced motility- more water is reabsorbed from colon and causes constipation
  • skin changes such as striae (stretch marks) and linea nigra (pregnancy line on tummy)
24
Q

what are developmental considerations for older adults?

A
  • decreased estrogen levels which causes fat accumulation in suprapubic area in women
  • fat deposits in men known as the “big belly”
  • with further aging, adipose tissue is distributed away from face/extremities and goes into hips and abdomen
  • abdominal musculature relaxes
  • salvation decreases (causing dryness of mouth)
  • decrease in sense of taste
  • esophageal emptying is delayed
  • gastric acid secretion decreases (orally administered drugs may be impaired or delayed)
  • more susceptible to dehydration because ability to conserve water is reduced
25
Q

list subjective data for abdominal assessment

A
  1. Appetite
  2. Dysphagia
  3. Food intolerance
  4. Abdominal pain
  5. Nausea/vomiting
  6. Bowel habits
  7. Past abdominal history
  8. Medications
  9. Nutritional assessment
26
Q

what are some health history questions you’d ask if someone came in with some abdominal issues/pain?

A
  1. Any change in appetite? Any change in weight (anorexia)?
  2. Any difficulty swallowing (dysphagia)? When did you first notice this?
  3. Food intolerance-anything you can’t eat? (pyrosis=heartburn)
  4. Abdominal pain. Point to where pain is, and do pain assessment
    Nausea/vomiting. Is it bloody? How much do you throw up?
    *ask about all subjective data
27
Q

when palpating, does it matter where you start?

A

no, just start in one quadrant and move your way to all four. make sure to check tender areas last

28
Q

for an infant, what organ should NOT be percussed?

A

the spleen

29
Q

when could a bowel diversion be needed in a patient?

A

-certain diseases cause conditions that prevent a normal pssage of feces through rectum

30
Q

a stoma may be required with bowel diversions. what is a stoma?

A

a temporary or permanent artificial opening in abdominal wall

31
Q

what are the two types of ostomies?

A
  • an ileostomy bypasses the entire large intestine which results in frequent and liquid stools
  • a colostomy of transverse colon results in more solid, formed stools
32
Q

what are the recommended foods for patients with ostomies?

A

-recommend low-fibre diets (bread, noodles, rice, cream cheese, eggs etc)

33
Q

when should an ostomy pouch be emptied?

A

empty pouch if its more than 1/3 to 1/2 full!

34
Q

for best type of pouching system, what needs to be assessed on patients abdomen?

A

A. Contour and peristomal plane
B. Presence of scars, incisions
C. Location and type of stoma

35
Q

how often should each ostomy pouch be changed?

A

every 3-7 days unless leakage occurs

36
Q

can ostomies be used in showers/baths?

A

yes, just need to be patted dry afterwards

37
Q

where is the location of ostomy based on?

A

the location influences the consistency of stool

38
Q

what factors do nurses have to consider when selecting a diet to promote normal bowel elimination?

A

• Frequency of defecation
• Fecal characteristics
-The effect of foods on the gastrointestinal function

39
Q

why is selecting the proper size of ostomy pouching system so important?

A

necessary to prevent damage to the skin around the stoma

40
Q

where are most nutrients and electrolytes absorbed?

A

in the small intestine

41
Q

define protuberant?

A

bulging

42
Q

whats scaphoid?

A

tummy dips in

43
Q

whats the term borobrygmi?

A

hyperactive bowel sounds (can hear without putting stethoscope on abdomen)

44
Q

is there a higher or lower pitch when percussing over a solid?

A

a higher pitch

45
Q

abdomen might be more protuberant when less than ___ years old

A

4 years old

46
Q

what should the stoma look like upon inspection?

A

moist, round, protrudes slightly (2-3cm), should have no pain around stoma site

47
Q

stool closer to the small bowel will be?

A

more watery closer to the stool

48
Q

stool closer to the rectum will be?

A

more formed the stool will be

49
Q

what are psychological considerations for those with ostomies?

A
  • the underlying reason for an ostomy
  • presence and severity of ostomy complications
  • presence and severity of comorbid conditions
  • sexual function and other body changes
  • ability to pay for ostomy supplies
  • health related quality of life
  • access to post-op supportive care and counselling
50
Q

why do you start in the lower right quadrant?

A

cause thats where the bowel sounds start and where the ileocecal valve is

51
Q

what sounds do you hear with hollow and dense organs with percussing?

A

-low pitch over hollow organ and high pitch over dull/dense organ

N143 (10 decks)

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