Abdominal Assessment

Question 1

abdominal structures (7)

Answer 1

1) gastrointestinal system (GI)
2) urinary tract
3) reproductive tract
4) part of cardiovasc
5) parts of nervous ex/ spinal cord
6) blood forming organs ex/ spleen
7) immune system

Question 2

abdominal landmarks

Answer 2

1) right upper quad
2) left upper quad
3) right lower quad
4) left lower quad

Question 3

right upper quad contains what (5)

Answer 3

1) liver & gallbladder
2) duodenum
3) head of pancreas
4) right adrenal gland & right kidney
5) ascending & transverse colon (portions)

Question 4

left upper quad contains (6)

Answer 4

1) liver (left lobe)
2) stomach*
3) spleen*
4) body of pancreas
5) transverse & descending colon (portions)
6) left adrenal & kidney

Question 5

right lower quad (6)

-what complication can occur here

Answer 5

1) appendix*
2) cecum
3) right kidney (portion)
4) ovary (right) & fallopian tube
5) ascending colon
6) ureter (right)
- APPENDICITUS

Question 6

left lower quad (5)

-what complication can occur here

Answer 6

1) left kidney
2) descending colon*
3) sigmoid colon*
4) ovary (left) & fallopian tube
5) ureter (left)
- DIVERTICULITIS: inflammed pocket of colon

Question 7

abdominal history

Answer 7

• appetite and weight
• difficulty swallowing/chewing
• pain/tenderness (OLDCART)
• nausea & vom
• food intolerance
• alcohol
• health care occupation
• hep b exposure

Question 8

abdominal history cont

Answer 8

• usual bowel habits “how often”
• rectal probs
• past abdominal history (surgeries, trauma, diagnostic tests)
• current meds: NSAIDS (ibuprofen, motrin, aspirin), steroids, antibiotics
• current nutrition “can you recall what you ate in the last 24 hours”

Question 9

bowel elimination

• natural laxatives
• characteristics of stool

Answer 9

• patterns vary widely 1-2 x’s a day to 2-3 x’s a week
• natural laxatives: prune juice, bran & fiber
• characteristics of stool: consistency (amount, color, shape, odor & presence of unusual matter ex/ blood)

Question 10

color of stool

Answer 10

black: iron or upper GI bleed
red: low GI bleed or hemorrhoids
black tarry-melena: blood in GI tract
white or clay-color: lack of bile

Question 11

factors affecting bowel function (9)

Answer 11

• age
• life-style
• diet (fiber intake)
• exercise
• meds, anesthesia (slows down GI motility, increase constipation)
• pain
• tissue inquiry
• hydration
• habits

Question 12

alterations in bowel functions (6)

Answer 12

1) constipation
2) diarrhea
- liquid watery stool; electrolyte loss
3) incontinence
- loss of bowel control
4) flatulence
5) fecal impaction
6) distention
- acidic fluid collected in belly (bloating)

Question 13

urinary elimination

Answer 13

-5 x’s day while awake
-look at color, odor, amount
if <30 cc/hr, CALL DOC

Question 14

factors affecting urinary elimination (4)

Answer 14

1) fluid intake
2) age
3) health status ex/ diabetes
4) emotional state

Question 15

alterations in urinary elimination (lots)

Answer 15

-incontinence (loss of urine / bowel)

Question 16

enuresis

Answer 16

bed wetting

Question 17

nocturia

Answer 17

increase urination at night

Question 18

oliguria

Answer 18

urinary output of <420 ml in 24 hours

Question 19

polyuria

Answer 19

increase urination

Question 20

retention

Answer 20

can get UTI’s; when you pee do you have to go soon after

Question 21

dysuria

Answer 21

difficulty / pain w/ peeing

Question 22

pyuria

Answer 22

puss in urine

Question 23

anuria

Answer 23

no urine output

Question 24

stress incontinence

Answer 24

cough / sneeze -> pee a little

Question 25

nutritional disorders (4)

Answer 25

1) kwashiokor 2) marasmus 3) cachexia 4) anorexia nervosa / bulimia

Question 26

cachexia

Answer 26

malnutrition/wasting; most often secondary to cancer | -muscle wasting = human skeletons

Question 27

kwashiokor

Answer 27

malnutrition that develops when babies are weaned form breast milk w/ out proper protein intake

Question 28

maramus

Answer 28

secondary to protein & calorie deficiency - gradual starvation - may be secondary to acute illness

Question 29

order done on a physical exam

Answer 29

1) inspect 2) auscultate 3) percuss 4) palpate - if push then listen = produce false bowel sounds

Question 30

inspection | -skin

Answer 30

- scars - striae: stretch marks d/t weight loss, prego, ect.; purple color) - rashes, lesion, or masses

Question 31

inspection | -contour

Answer 31

normal: slightly convex or flat obese: rounded abnormal: swollen, distended, bulging (bulging can indicate hernia; when cough can see)

Question 32

inspection | -muscle tone & symmetry

Answer 32

- color - contour - location - visible peristalis - pulsations (super thin ppl) - signs of pain: GUARDING *always indicated sever probs*

Question 33

auscultation - diaphragm assesses what - bell assesses what

Answer 33

always auscultate BEFORE palpate for abdominal diaphragm: bowel soudsn bell: vascular sounds over aorta

Question 34

in abdominal assessment; where do you being?

Answer 34

RIGHT LOWER QUAD

Question 35

bowel sounds - active - absent

Answer 35

active: gurgling, high-pitched occur about 5-35 times/min absent: may be secondary to bowel obstruction, abdominal surgery, paralytic ileum (dont move efficiently as should) or peritonitis (inflammation of perotilic cavity; very tender stomach)

Question 36

how long should you listen in each quad

Answer 36

min of 1 minute each if absent bowel sounds

Question 37

hypoactive bowel sounds

Answer 37

decreased, diminished bowel sounds may be due to: | -surgery, NPO status, inflammation or fluid imbalance

Question 38

hyperactive bowel sounds

Answer 38

increased bowel sounds, often w/ | -diarrhea, could be early sign of obstruction

Question 39

borborygmi

Answer 39

``` stomach growling (outloud) -increase frequency/intensity of bowel sounds w/ diaherra, hunger, inflammation, bleeding, anxiety ```

Question 40

palpation

Answer 40

- note size, position, mobility, consistency, tension of major organs - tenderness (leave most tender for last)*

Question 41

light palpation | -purpose

Answer 41

- press gently 1/2 inch | purpose: localize pain, mases, or tender organs

Question 42

deep palpation | -purpose

Answer 42

- press firmly 1-3 inches * when can feel organs* - use 1-2 hands, for pressure & palp purpose: to indicate abdominal organs, enlarged organs, locate abdominal masses