Quiz #5 Concepts Flashcards
Abdomen & Urinary Concepts
Describe the abdomen
The largest cavity in the body
1) Digestive System
2) Urinary System
3) Reproductive system
Describe the alimentary canal
Hollow tube from mouth to anus
How long is the esophagus
10 inches long
Describe the stomach size
Dependent on the amount of food ingested
How long is the small intestine?
18 to 21 feet long
How long is the large intestine?
5 to 5.5 ft long
Describe the liver
Largest internal gland of the body
Functions:
1) Aid in protein, fats, and carb metabolism
2) Produce antibody
3) Produce bile
4) Produce substance for coagulation of blood
5) Detoxify harmful substances
6) Stores vitamins
Describe the gallbladder
Release stored bile for fat emulsification
Describe the pancreas
Both endocrine and exocrine glands
1) Endocrine -produces insulin for emulsification of sugar
2) Exocrine- produces pancreatic juice to aid in emulsification of carbs, protein, and fats
Describe the spleen
Largest lymphoid organ
Functions:
1) Filters blood
2) Graveyard of RBC
3) Site for lymphocyte proliferation and immune surveillance
What is the urinary system composed of
Composed of:
1) Kidneys
2) Ureters
3) Bladder
4) Urethra
Describe glomeruli
Clusters of capillaries of the kidneys, which filters more than 1 liter of fluid per minute
What are the landmarks of the Urinary System
1) CVA
2) Rectus Abdominis
3) Symphysis Pubis
What are the landmarks of the abdomen
1) Xiphoid Process
2) Umbilicus
3) Costal Margin
4) Iliac Crest
5) Pubic bone
What happens for patients age 75 and above?
Loss of nephrons occurs leading to less glomerular filtration leading to susceptibility to DRUG toxicity
What occurs at the age of 85 and above with BPH (benign prostatic hypertrophy)
95% of men will have BPH resulting in urinary retention or trickling in voiding
Describe Urolithiasis or Renal Calculi
Stones that block the urinary tract. Most common among Caucasian.
Nursing responsibilities:
1) Strain all urine
2) Report to MD
What is an associated risk factor for Urolithiasis
Family History
What should a client with urolithiasis do?
Encourage intake at least 3 liters of fluid per day if the client is not on fluid restrictions
Describe mapping of the abdomen or reference point
The process of dividing the abdomen into quadrants or nine regions for the purpose of the exam
What are the main organs in the right upper quadrant of the abdomen
Liver and Gallbladder
What are the main organs in the left upper quadrant of the abdomen
Stomach and Spleen
Where is the appendix located?
In the right lower quadrant
What is lower left quadrant pain usually associated with?
Diverticular Diseases
What sound is heard on percussion over the liver and through the RUQ/ RMCL?
Dullness
What is the strict sequence of the abdominal assessment?
1) Inspection
2) Auscultation
3) Percussion
4) Palpation
What does strong abdominal pulsation indicate?
Possible AAA, on inspection and must be reported to the doctor ASAP
Where should auscultation of the abdomen begin and where sounds are usually present?
In the right lower quadrant
What is the best position when assessing abdominal distention?
Supine position with small pillow under the head is the best position
What assessment technique is used when assessing for bladder distension?
Indirect percussion
Describe abdominal contour for skinny person.
Flat
Describe the abdominal contour for a very skinny person.
Scaphoid
Describe the abdominal contour of a fat/ obese person.
Rounded and/ or Protuberant
Describe the abdominal contour of infants.
Rounded and/ or Protuberant
Who can have an abdomen that appear protuberant.
Abdominal contour of 3rd trimester pregnant client or client with ascites
What does a large hematoma on the CVA usually indicate?
Injury to the kidney
What and when is blunt percussion used in the abdominal assessment?
Used to assess for CVAT or Costovertebral Angle Tenderness
What does pain or discomfort during & after Blunt Percussion?
Suggest kidney failure
Kidneys are rarely palpable except….
In the presence of neoplasm or polycystic diseases
Where are the kidneys located and what does a hematoma in this area indicate?
Kidneys are in the right and left CVA. A hematoma in this area indicates injury of the kidneys
What assessment technique is used for a distended bladder?
Indirect percussion
What is usually associated with bladder cancers and who is it most common in?
Smoking and men
Describe uremia
Urine product build-up in the blood leading to kidney failure, which is the hall mark of Chronic Renal Failure
Describe uremic frost
Crystallized urea on the skin
Describe Azotemia
High level of nitrogen compound in blood due to inefficient functioning of the kidneys
What does it mean when urine output is less than intake?
This means the client is retaining fluid
What does it mean when the urine output is more than the intake?
That means that the client is excreting too much fluid, common in Diabetic client (polyuria)
Explain Enuresis (bedwetting)
Involuntary urination especially at night, common in 5-year-old and younger. Has familial tendency and is more common in boys.
Describe dysuria
painful urination
Describe nocturia
Frequent urination at night common in DM client
Describe anuria
Less than 100 cc of urine output in a 24-hour period
Describe oliguria
Less than 400 cc of urine in a 24-hour period
Describe glucosuria
sugar in the urine
Describe hematuria
Blood in the urine
What is the normal range of urine output in a 24-hour period
800 cc- 2,000 cc
Describe renin
Enzyme that is released by kidneys that helps regulate BP, when BP drops down
Describe Hepatitis
Inflammation of the liver caused by viruses, bacteria, chemicals, and drugs
Describe Hepatitis A
Most common type of Hepatitis in children because they usually do not wash their hands before eating
Describe Hepatitis E
Most common type of Hepatitis in people traveling to underdeveloped countries, due to dirty water supply
Describe Hepatitis B
Transmitted sexually, by blood & parentally
Describe Hepatitis C
The most common type of Hepatitis in people with tattoos. Transmitting by blood & parentally
Describe Hepatitis D
Transmitted sexually, by blood and parentally
Describe Chron’s Disease
Chronic inflammation of the intestine. Can involve any part of the lower intestine from the ileum to the colon
What are the S/S of Crohn’s Disease
1) Abd pain
2) Diarrhea
3) Cramping
4) Minute blood in stool
5) Bowel obstruction
6) Rectal and vaginal fissure can occur
7) Remission. No medical or surgical interventions needed
Describe Splenomegaly (Inflammation of the spleen)
Inflammation and ulceration of the colon.
What are the S/S of Ulcerative Colitis
1) Abd pain
2) Diarrhea
3) Blood and Mucous on stool
4) Hemorrhage
5) Megacolon- may require long term interventions
Dehydration can be fatal in children. What are the most accurate indicators of dehydration on children?
1) Low level of consciousness
2) Weight loss
3) Low urine output
What is the indication of an aneurysm?
A widened Aorta. More than 3 cm.
Describe the McBurney’s Point
Middle 3rd of the imaginary line from umbilicus to right inguinal area. Pain in this area will indicate peritonitis.
A positive (+) Blumberg sign indicates what?
Stabbing pain as compressed abdomen returns to non-compressed state indicating Peritonitis and Appendicitis.
Describe a positive (+) Murphy’s Sign
An indication for Cholecystitis. A sharp pain at the upper right quadrant when palpating the lower border liver
Describe a positive (+) Rovsing Sign
Pain at the right lower quadrant of the abdomen when palpating the left lower quadrant. An indication for Peritonitis and Appendicitis.
Describe a positive (+) Psoas Sign
the patient is in supine position while right leg is raised up with resistance from the Nurse & Client has pain at the right lower quadrant of the abdomen
Describe Cullen’s Sign
Ecchymosis or bruising at the periumbilical area indicates bleeding in the abdomen. Ex. A ruptured ectopic pregnancy
Describe BUN
A laboratory test that is expected to be ordered by the MD, when the client has acute kidney injury
What is Cystitis?
Suspected in the elderly, client complains of sudden onset of urinary incontinence.
Describe Wilms Tumor
Malignancy of the kidney in infants. Stop palpation when mass is palpated in the abdomen because palpation can disseminate seeds into the abdomen.
What is a sign of constipation?
cigar shaped soft mass palpated at the left lower quadrant is a sign of constipation
In children when should an umbilical hernia be resolved?
Resolved before age 5, if persist, surgery is indicated
What are the sounds and quantity for normal bowel sounds?
In each quadrant of the abdomen, 5-30 times per minute. Regular, High Pitched, and Gurgling Quality.
Describe Borborygmi
Strong bowel sounds when a person has not eaten for 5-7 hours. Can be normal with no other symptoms present. Abnormal when accompanied by other symptoms such as abdominal pain, cramping, bloating, etc….
