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168.362 > week 2 > Flashcards

week 2 Flashcards

1
Q

What are common signs and symptoms of acute abdominal pain?

A
  • Pain
  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Flatulence
  • Fever
  • Bloating
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2
Q

What is in the Right Upper Quadrant (RUQ)?

A
  • Liver
  • Gallbladder
  • Duodenum
  • Head of pancreas
  • Right kidney and adrenal
  • Hepatic flexure of colon
  • Part of ascending and transverse colon
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3
Q

What is in the Left Upper Quadrant (LUQ)?

A
  • Stomach
  • Spleen
  • Left lobe of liver
  • Body of pancreas
  • Left kidney and adrenal
  • Splenic flexure of colon
  • Part of transverse and descending colon
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4
Q

What is in the Right Lower Quadrant (RLQ)?

A
  • Cecum
  • Appendix
  • Right ovary and tube
  • Right ureter
  • Right spermatic cord
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5
Q

What is in the Left Lower Quadrant (LLQ)

A
  • Part of descending colon
  • Sigmoid colon
  • Left ovary and tube
  • Left ureter
  • Left spermatic cord
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6
Q

How do you assess abdominal pain?

A

Old Carts:

  • Onset
  • Location
  • Duration
  • Characteristics
  • Aggravating factors
  • Relieving factors
  • Timing
  • Severity
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7
Q

What is the aetiology (types ) of GI inflammation?

A
  • Gastroenteritis
  • Appendicitis
  • Pancreatitis
  • Diverticulitis
  • Cholecystitis
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8
Q

What are life threatening effects of inflammation?

A
  • Risk of perforation and peritonitis
  • Fluid shifts to area of inflammation
  • Unable to ingest fluid
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9
Q

What can the life threatening effects of inflammation cause?

A
  • Septic shock

- Hypovolaemic shock

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10
Q

What is the aetiology of peritonitis?

A

Perforated peptic ulcers

  • Ruptured diverticula
  • Ruptured appendix
  • Intestinal perforation
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11
Q

What are life threatening effects of peritonitis?

A
  • Overwhelming infection
  • Fluid shifts to area of inflammation
  • Unable to ingest fluid
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12
Q

What can the life threatening effects of peritonitis cause?

A
  • Septic shock

- Hypovolaemic shock

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13
Q

What are life threatening effects of obstruction?

A
  • Strangulation risk
  • Fluid trapped in bowel
  • Fluid shifts to interstitial space
  • Unable to ingest fluid
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14
Q

What can the life threatening effects of internal bleeding cause?

A

Hypovolaemic shock

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15
Q

Types of pain?

A

Nociceptive:
- Somatic
- Visceral
Neuropathic

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16
Q

What is the nursing assessment you would undertake of a patient who presents to the ED complaining of acute abdominal pain?

A
  • Pain assessment
  • Patient Hx/ Family Hx
  • Diet
  • Medications
  • Constipation
  • ABCD
  • Vital signs
  • Intake and output
  • LOC
  • Skin colour/temp
  • Abdominal assessment
  • Pregnancy test
17
Q

What are diagnostic studies for abdo pain ?

A
  • Complete history and physical examination
  • FBC and Lytes
  • ? X-match
  • Urinalysis
  • ? stool spec
  • ECG
  • AXR
  • USS
  • CT scan (+/- contrast)
  • Pregnancy test
18
Q

What is appendicitis?

A
  • Inflammation of the appendix

- Most common cause is obstruction of the lumen by faeces, foreign body or tumour

19
Q

What are signs and symptoms of appendicitis?

A
  • Periumbilical pain
  • Anorexia
  • Nausea and vomiting
  • Persistent pain , eventually shifting right lower quadrant and localising at McBurney’s point
  • Localised tenderness, rebound tenderness and muscle guarding
  • Patient may lie still often with the right leg flexed
20
Q

What is peritonitis?

A
  • Localised or generalised inflammatory process of peritoneum
  • Results in massive fluid shifts and adhesions as body attempts to wall off infection
21
Q

What are signs and symptoms of peritonitis?

A
  • Abdominal pain
  • Rebound tenderness
  • Muscular rigidity
  • Spasm
  • Patient has shallow respirations
  • Abdominal distension
  • Fever
  • Tachycardia, tachypnoea
  • Nausea and vomiting
22
Q

What is intestinal obstruction?

A
  • Intestinal obstruction (partial or complete) occurs when intestinal contents cannot pass through the GI tract
  • Requires urgent treatment
23
Q

What are types of intestinal obstruction?

A
  • Mechanical (90% of admissions)

- Non- mechanical

24
Q

What are symptoms of a small intestinal obstruction?

A
  • Onset - Rapid
  • Vomiting - Frequent and copious
  • Pain - Colicky, cramp like, intermittent pain
  • Bowel movement - Faeces for a short time
  • Abdominal distension - Greatly increased
25
Q

What are symptoms of a large intestinal obstruction?

A
  • Onset - Gradual
  • Vomiting - Rare
  • Pain - Low-grade, cramping abdominal pain
  • Bowel movement - Absolute constipation
  • Abdominal distension - Increased
26
Q

What is the nursing assessment for intestinal obstruction?

A
  • Hx
  • Early recognition of deterioration
  • Assessment of abdo
  • Hydration/nutrition status- input/output
  • Pain- coldspa
  • Need for surgery
  • Anxiety
27
Q

What is cholelithiasis?

A

Stones in gallbladder

28
Q

What is cholecystitis

A

Inflammation of the gall bladder

29
Q

What is the care of cholelithiasis and acute cholecystitis?

A
  • Pain control
  • Antiemetic
  • Antibiotics
  • Maintain fluid and electrolytes
  • Potentially NBM
30
Q

What are symptoms of total obstruction?

A
  • Jaundice
  • Dark amber urine
  • Clay-colored stools
  • Pruritus
  • Intolerance of fatty foods
  • Bleeding tendencies
  • Steatorrhoea
31
Q

What are signs and symptoms of cholelithiasis and acute cholecystitis?

A
  • Pain
  • Indigestion
  • Fever
  • Jaundice
  • Nausea and Vomiting
  • Restlessness
  • Diaphoresis
  • Inflammation
32
Q

What are (etiological) factors that cause acute pancreatitis?

A
  • Alcohol
  • Biliary tract disease
  • Trauma
  • Infection
  • Drugs
  • Postoperative GI Surgery
  • Unknown
33
Q

What complications can acute pancreatitis lead to?

A
  • Activation of pancreatic enzymes

- Injury to pancreatic cells

34
Q

What is nursing care for peritonitis?

A
  • Analgesics
  • NBM
  • Respiratory assessment
  • Oxygen therapy
  • Antibiotic therapy
  • Fluids and electrolytes
35
Q

What are signs and symptoms of acute pancreatitis?

A
  • Abdominal pain – LUQ radiating to the back
  • Aggravated by eating, relieved by vomiting
  • Abdominal tenderness with muscle guarding
  • Paralytic ileus
  • Greys Turners spots
  • Cullen’s sign
  • Signs of shock
  • Watch for respiratory distress – ARF to ARDS
  • D.I.C.
  • Clots
  • Tetany
36
Q

What is treatment of pancreatitis?

A
  • pain relief
  • Prevention of or treating shock
  • maintain Fluid and electrolyte
  • potentially NBM w/ NG
  • Antacids, PPI’s to neutralise gastric secretions and decrease hydrochloric acid stimulation
  • Antibiotics and antispasmodics
  • Removal of precipitating cause if possible

168.362 (4 decks)

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