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PA > quiz 7 > Flashcards

quiz 7 Flashcards

notes from 11.1-11.4

1
Q

how to calculate an ankle brachial index

A

higher ankle pressure on the side youre testing, divided by the higher arm pressure

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2
Q

ABI ranges

A

normal: 1.00 to 1.29
borderline: 0.91 to 0.99
mid to moderate: 0.41 to 0.90
severe: less than 0.40

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3
Q

procedure for ABI

A
  • patient lies supine for five minutes to prepare
  • BP cuff on right and left arms and an ankle
  • use doppler to measure SBP in right and left arms, and right DP and PT
  • then repeat on the other side
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4
Q

ideal position for inspection of abdomen

A

supine with knees slightly flexed

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5
Q

when assessing dressings

A

do not displace
- CDI or OTA

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6
Q

visially inspect abdomen for…

A

skin color, contour, distention, dressings, dehiscence or evisceration

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7
Q

borborygmi

A

loud, prolonged, gurgles sometimes associated with bowel infection

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8
Q

high pitched tinkling sounds can indicate …

A

bowel obstruction

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9
Q

paralytic ileus

A
  • no peristalsis
  • absent bowel sounds
  • happens post surgery or anesthesia
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10
Q

listen for ? minutes if reporting no bowel sounds

A

five minutes

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11
Q

percussion over stomach or intestines should be

A

tympany

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12
Q

percussion tells you…

A

organ position or massess

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13
Q

patient had abd surgery : do you still palpate?

A

yes

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14
Q

where is an enlarged liver palpated

A

below right rib margin

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15
Q

abnormal findings

A

tenderness
masses
hernia
fluid wave
spasms of muscle wall
hematoma

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16
Q

what to ask after surgery or with ileus /bowel obstruction

A
  • are you passing flatus
  • do you feel like eating or have hunger pains
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17
Q

components of GI surgery specific assessment

A

location and size of incision

flatus? (expected to be none 24-48 hours post-op)

N/V?

abd pain or distension

NG tube to suction for decompression
- low intermittent wall suction (LIWS)
- check for low blood Na+ and K+

IV fluids
- TPN after 2-5 days NPO

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18
Q

PEG tube stands for

A

percutaneous endoscopic gastrostomy tube

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19
Q

if PEG tube is in jejunum…

A

less volume but continuous flow
(as opposed to bolus feedings)

20
Q

salum sump

A

used for suction

21
Q

deefing tube (dobhoff)

A
  • used for tube feeding
  • ND or NJ
22
Q

check residuals…

A

only if ordered

23
Q

hold TF if…

A

residual is 250mL

24
Q

colostomy/ ileostomy

A
  • surgery to remove part of the intestine and bring “cuffed” end out through abd wall
  • creates stoma
  • difference in stool based on location
25
Q

paralytic ileus results from…

A

surgery
ruptured appendicitis

26
Q

S&S of mechanical obstruction

A
  • high pitched tinkling sound over bowels
  • hyperactive BS/visible peristalsis THEN absent bowel sounds
  • N/V increasingly more projectile
  • possible emesis w feces
  • abd pain, cramping, and distention
27
Q

if emesis w feces…

A
  • pt will need surgery
  • make pt NPO
28
Q

GERD

A

gastro esophageal reflux disease
- reflux of gastric secretions up into esophagus
- d/t weak lower esophageal sphincter (LES)

29
Q

S&S of GERD

A
  • heartburn
  • acidic sour taste
  • hoarseness and chronic cough
30
Q

most classic symptom of GERD

A

dry, unproductive chronic cough
tx: PPI and H2 blockers

31
Q

hiatal hernia

A

part of the stomach passed through the hiatus in the diaph. up into the chest

32
Q

S&S of hiatal hernia

A

epigastric pain relieved by sitting upright
- dysphagia– difficulty swallowing
- may be asymptomatic

33
Q

GI bleeding indicated by …

A

bright red blood in stool or emesis

34
Q

hematochezia

A

recent bleeding in the stool
sometimes called currant jelly stools by lay people

35
Q

hematemesis

A

recent bleeding in vomit

36
Q

coffee ground emesis

A

old blood

37
Q

melena

A

black, tarry stool from old blood

38
Q

occult blood

A

not visible
- guaiac test

39
Q

kehr sign

A

referred shoulder pain if blood in peritoneal cavity irritates diaphragm

40
Q

lab sign for anemia

A

decreasing H&H

41
Q

severe GI bleeding…

A

hypovolemia
- BP plummets
- dizzy and weak
- diaphoresis and tachycardia

42
Q

lower GI bleed often d/t

A

colon cancer

43
Q

signs of appendicitis

A

pain
low grade fever
mcburney sign
pain moves from periumbilical to RLQ
guarding
anorexia
rupture
rebound tenderness (if the rupture causes peritonitis)

44
Q

mcburney sign

A

intense pain in RLQ
1/3 the distance from right iliac spine toward the belly button

45
Q

rebound tenderness is caused by…

A

peritonitis caused by a ruptured appendix

46
Q

peritonitis

A

life threatening infection of membrane lining abdomen caused by rupture of bowel or other organs

PA (10 decks)

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