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SUM '20 - Health Assessment > week 3 Highlights of ABD-LF > Flashcards

week 3 Highlights of ABD-LF Flashcards

1
Q

what is the most important part of any patient assessment

how do we do chief complaint

A

patient history. try to stay relevant to current problems.

chief complaints are exactly what patient says

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2
Q

PQRST

A 
precise location
quality/quantity
radiant/referred
severity
time frame
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3
Q

what are the A’s of what else you can tell me about your problem

A

what else can you tell me

associated symptoms
absent symtpoms
alarm symptoms

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4
Q

most common GI diagnosis

A

gerd

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5
Q

review of abdomen exam

A

inspection
auscultation
percussion
palpate (light and deep)

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6
Q

Right Upper Quadrant structures

A 
Liver
Gallbladder
Duodenum
Head of the pancreas
Right kidney and adrenal
Part of the ascending and transverse colon (Umbilical)
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7
Q

Left Upper Quadrant

A 
Stomach (Epigastric)
Spleen
Left lobe of the liver
Body of the pancreas (Epigastric)
Left kidney and adrenal
Part of the transverse and descending colon (Umbilical)
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8
Q

Right Lower Quadrant

A 
Cecum
Appendix
Right ovary and tube
Right ureter
Right spermatic cord
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9
Q

Left Lower Quadrant

A 
Part of the descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord
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10
Q

Suprapubic

A

Bladder

Uterus

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11
Q

visceral pain
parietal pain
referred pain

A

v- pain associated with hollow/solid organs

P-occurs with inflammation of hollow or solid organs that effect the parietal peritoneum

referred-felt at distant sites that share innervation from the spinal level,

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12
Q

Developmental Considerations

Infants and Children

A

Breast feeding vs bottle feeding – formula used
Eating habits of the child
Constipation
Childhood obesity

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13
Q

Developmental Considerations

Elderly

A

ADLS are important to consider – how do they receive and prepare food
Blunting of abd pain is common
Bowel habits
Dentition

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14
Q

why is order important for abdomen exam

A

because if you percuss or palpate before auscultation- it will elicit bowel sounds and does not give an accurate indication of patients condition

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15
Q

inspection of abdomen includes what odd thing that hammon discussed in class

A

tangential lighting for peristalsis and pulsations

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16
Q

name all the places to auscultate on the abdomen

A

bowel sounds each quadrant.

diaphragm over aorta, iliac, femoral - checking for bruits/hums

place diaphragm over liver and spleen to listen for friction rub

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17
Q

where do you percuss
for tympani

dullness

A

tympani- over intestines

dullness -liver, spleen, large stool, or mass.

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18
Q

when should percussion of the spleen be tympanic

A

percussing the lowest interspace in the left anterior axillary lines. then have the patient take a deep breath and repeat.

called splenic percussion sign

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19
Q

deep palpation detects

A

masses

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20
Q

light palpation detects

A

tenderness and guarding

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21
Q

if patient is obese what technique can help locate the liver

A

hooking technique

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22
Q

patient has ascites- what is the presentation?

what will percussing the middle and sides produce

testing fluid wave

A

protuberant abdomen with bulging flanks

tympany in the center. dullness lateral sides

tap the side for fluid wave with hand in the center of abdomen

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23
Q

what are reasons for enlarged spleen

should it be palpable

A

mono
hematological disorders- cause enlargements of spleen

should not be palapble

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24
Q

murphy signs

A

with cholecystitis there is pain when you hold your fingers under the liver border and have the client take a deep breath. The test is positive when the client cannot complete the breath but rather stops the breath abruptly.

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25
Q

pancreas presents with abdominal pain radiating where.

what symptoms are common

A

to the back

n&v

alcoholism accounts for 80% of admissions

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26
Q

school age children who present with stomach pain- suspect what

A

bully at school

anxiety can cause belly pain

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27
Q

what is concerning about the spleen and significant trauma

A

it can easily rupture

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28
Q

stomach

Positive hemoccult

Tenderness

Bruits

A

can indicate upper GI bleed or malignancy- should occur with any epigastric pain

PUD and pancreatitis

abdominal aortic aneurysm

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29
Q

Blumberg’s sign

A

appendicitis

Pushing perpendicular on the abdomen in a site away from the pain. Release of the pressure will cause pain

30
Q

McBurney’s point

A

appendicitis- Mild palpation to RLQ will increase pain significantly

31
Q

Rovsing’s sign

A

appendicitis- (referred rebound tenderness in the right lower quadrant when the left lower quadrant is palpated and released)- can also hit on bottom of foot

32
Q

Psoas sign

A

appendicitis-the patient flexes his thigh against the examiner’s hand; pain indicates a positive sign)

33
Q

Obturator sign

A

flex the patient’s thigh and rotate the leg internally at the hip; pain indicates positive signs hypogastric pain with the hip and knee flexed and hip internally rotated.

34
Q

h pylori testing

A

breath ID- breath into a bag
carbon 13 urea- helps identify the present of h pylori

if h pylori is present carbon 13 gets metabolized in the stomach and you breath it out. otherwise it is naturally eliminated

35
Q

what are polyps considered

A

precancerous

36
Q

colonoscopy at age

A

50 or before with a family history of colon cancer

37
Q

what should you not use on hernias

A

nitrous

38
Q

who do we see umbilical hernias on

A

seen at birth or may be seen in clients with chronic ascites or increased pressure in the adbomen

39
Q

are ovaries palpable in post menopausal women

A

no

40
Q

what is the concern with very large ovaries being removed

A

they can have their own blood supply and bleed alot

41
Q

7 F’S OF ABDOMINAL DISTENTION

A 
Fat- remember, fat is symmetrical
Flatus- after eating? No bowel sounds?
Fluid- ascites, ileus
Fetus- “I can’t believe I am pregnant”
Feces- hmmm
Fetal growth- refer to above
Fibroid- Tumor? asymmetrical
42
Q

what bad habit is highly associated with bladder ca

A

Smoking is highly associated with bladder CA

43
Q

medications- NSAIDS can present with what in the urine

A

protein!

44
Q

male urinary history

A 
ask about stream, start and stop and strength
infant hernia repair
vasectomy
family history
sexual history
45
Q

PID

A

Often presents with pain, bleeding, and discharge

46
Q

Metrorrhagia

A

Bleeding at irregular intervals

47
Q

Menorrhagia

A

Excessive bleeding during the menstrual cycle

48
Q

always check pregnancy status

A

last cycle

all women are presumed pregnant unless proven

49
Q

red glass for GI

A 
Hematuria 
Abrupt onset of testicular pain
Decreased or absent urine
Acute urinary retention
Kidney mass 
Toxic appearing patient with any of the above
50
Q

Red flags for female GYN

A 
Pain is unilateral when doing a bimanual  exam or lower abd 
Uterine bleeding 
Ascites
Post menopausal bleeding or discharge 
Ovaries fixed, hard or nodular
51
Q

Red flags for male reproductive

A 
Sudden onset testicular pain
Cellular or necrotic changes in skin of penis or scrotum 
Erection greater than 30 minutes
Decreased urination
Increased pain or new mass
52
Q

perimenopausal changes

A

FSH and LH may be normal, subjective data for DX, decrease of length and flow and other S/S

53
Q

Amenorrhea
primary
secondary

A

Amenorrhea – primary at age 16, secondary is after 3 months in a woman who had menses

54
Q

uterine bleeding and discharge in peri or post menopausal

A

In young often benign BUT in post or peri-menopausal may be a red flag

55
Q

BV odor

A

fishy

56
Q

chalamydia

A

yellow
no order
origin in cervix

57
Q

GC

A

yellowish no odor

58
Q

what is yeast

A

an overgroth - NOT INFECTION- associated with post antibiotic tx

59
Q

PCOS

A

increased LH

decreased FSH

60
Q

in AA and hispanics PCOS can have what skin condition

A

acanthosis-dark discoloration in body folds

61
Q

Ectopic pregnancy

A

Severe RLQ pain
Amenorrhea
Positive pregnancy test
Rebound tenderness

62
Q

Ovarian Cyst

A

Younger women
Fluid filled
Tenderness increases in cycle

63
Q

Bartholin’s Cysts

A

between vagina and rectum
Swollen and painful
Usually I&D, antibiotic and C&S

64
Q

clap

GH

A

Chlamydia - Yellow discharge no odor

Gonorrhea – purulent discharge

65
Q

Trich

A

Trich -Grayish foul discharge, travels with other STD’s, strawberry spots, macroscopic exam for flagellated protozoa

66
Q

which std’s are bff

A

C and GH

67
Q

BV

A

BV – non infection results from increased pH and change in flora, fishy odor, whiff test

68
Q

Prolapse 1,2,3 degree designation

A

Increased with older women
Increased number of pregnancies
Obesity

Cysto or retro (bimanual and bear down)
Presents with frequency and infection
DX by examination

69
Q

Torsion

A 
6-8 hour window 
Most often in early puberty
Abdominal pain
Nausea and or vomiting 
Scrotal swelling
Unilateral
70
Q

Prostatitis

A

Acute bacterial
Chronic bacterial
Inflammatory/ non inflammatory
Asymptomatic inflammatory

SUM '20 - Health Assessment (17 decks)

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