Abdominal assessment and bowel elimination Flashcards

Question

Some causes of acute abdominal pain Cholecystitis?

Answer 1

- pain in the right upper quadrant (toward the eoigastruc area) that may radiate to the shoulder or back - nausea and vomiting may occur - biliary colic (pain that increases over 2 to 3 min us sustained for 20 min or more - positive murphy sign

Answer 2

- possible colicky to shapr pain that can mimic appendicitis - the patient may have diffuse tenderness on palpation as well as palpable stool

Answer 3

- left lower quadrant pain, often worse after eating and improved after defecation - possible fever - possible diarrhea or constipation - abdomen may be distended and tympanic and tender to palpation over the left lower quadrant.

Answer 4

- diffuse pain that comes in cramping waves lasting 5 to 15 min - nausea, followed by vomiting when the bowel obstructs - stool may be passed distal to the obstruction and may also involve diarrhea - abdomen may be distended with high pitched bowel sounds - diffuse tenderness and guarding

Answer 5

- pain in the RUQ to epigastric area, possible radiating to the back; can be associated with nausea and vomiting, as well as fever - possible ileus - in severe cases, shock, jaundice, and pleural effusion are present - rare signs include grey turner and cullen signs

Answer 6

- Usually epigastric pain 1 to 3 hours after meals and often associated with nighttime awakenings - sudden and severe pain with radiation to the right shoulder, along with peritoneal signs; may indicate perforation - hematemesis or melena suggests hemorrhage

Answer 7

- acute diffuse abdominal pain that may be associated with fever, nausea, and vomiting - pain increases with any motion - abdominal distension and rigidity - rebound tenderness is present but in appendicitis, its diffuse rather than localized - guarding may be present - possible signs and symptoms of shock

Answer 8

- draw a line between the right anterior superior iliac spine and the umbilics. - location the junction of the lateral and middle third of the line - typically this area is of greatest discomfort in acute appendicitis.

Answer 9

-DysphaGIa is defined as difficulty swallowing any liquid (including saliva) or solid material DysphaSia is defined as Speech disorders in which there is impairment of the power of expression by speech, writing, or signs or impairment of the power of comprehension of spoken or written language Remember the G=GI and the S=speech

Answer 10

- constipation/impaction - diarrhea - flatulence - blood in stook - diseases of GI tract (e.g irritable bowl syndrome; diverticulitis; colon CA) - fecal incontinence - hemorrhoids

Answer 11

- pain - nausea/vomiting - change in bowl movement - rectal bleeding - abdominal distention ask about change in appetite, change in weight, food intolerance, dysphagia, current medications

Answer 12

Onset: eg. sudden, gradual Location: eg quadrants, superficial, deep, change over time Duration: e.g intermittent, chronic, acute Aggravating: e.g food, no food, meds ,rest relieving: e.g food, no food, meds, rest Timing: e.g relationship to internal or external stressors/bodily functions (menses, time of day, medications) Severity: e.g impact of functionality, ADLs; if pain -rating on scale.

Answer 13

- health promotion: good diet, exercise and screening - fiber 20-30 g/day - fluids 2,000ml/day unless contraindicated - promote nornal defecation through position - dont delay defecation - pharmacological interventions such as.. - cathartics/lacatives - anti-diarrheals - enemas - digital stool removal - Nasogastric tube (through nose into GI tract)

Answer 14

- diarrhea reflects increased water content of the stool, whether due to impaired water absorption and or active water secretion by the bowel - severe infectious diarrhea: number of stools may reach 20 or more per day with defecation occurring every 20 to 30 mintues , the total daily volume of stool may exceed two liters with resultant electrolyte imbalances especially volume depletion and hypokalemia.

Answer 15

-prevalence: patients greater than 65 are greater risk Etiology - improper diet (lack of fiber) - lack of exercise - medications (opiodis, anti cholingergics, iron, calcium channel blockers, diurectics) - disease states (e.g diabetic gastroparesis; IBS) - emotional stress - pregnancy - surgery - spinal cord injury

Answer 16

- decreased frequency of stools - hard, dry, formed stools - straining while stooling; painful defecations - reports of rectal fullness or pressure - reports of incomplete bowl evacuations - abdominal pain, cramps, or distensions - anorexia, nausea - headchae

Answer 17

action: increased the fluid, gaseous or solid bulk in the intestines teaching info: may take 12 or more hours to act, sufficient fluid must be taken. Safe for long-term use, slow -acting may take several days

Answer 18

actions: softens and delays the drying of the feces; permits fat and water to penetrate feces

Answer 19

actions: irritates the intestinal mucosa or stimulates nerve endings in the wall of the intestine, causing rapid propulsion of the contents patient teaching: acts more quicly than bulk, forming agents

Answer 20

actions: irritates the intestinal mucosa or stimulates nerve endings in the wall of the intestine, causing rapid propulsion of the contents patient teaching: acts more quicly than bulk, forming agents

Answer 21

Lubricates the feces in the colon Patient teaching: prolonged use inhibits the absorption of some fat-soluble vitamins.

Answer 22

action: draws water into the intestine by osmosis, distends bowl and stimulates peristalsis teaching : can cause fluid and electrolyte imbalance, particularly in older people and children with cardiac and renal disease. should not be used by older clients prolonged use inhibits the absorption of some fat-soulble vitamins.

Answer 23

patient teaching: a new laxative that is helpful in the treatment of constipation in children. it is a powder that is tasteless when mixed in a flavored liquid such as juice. It is a prescription drug and cost more than OTC laxatives.

Answer 24

-straining to have a bowel movement can be dangerous for patients with coronary artery disease, HTN, cerebral edema, heart failure patient inspires deeply and holds breathe while contracting abdominal muscles and bearing down, intra-abdominal and intra thoracic pressure, venous return to heart, transient bradycardia, BP, CO paitent relaces, intra abdominal and intra thoracic pressure sudden flow of blood to heart tachycardia, BP can be fatal for patient unable to compensate for sudden hemodynamic changes may also cause dysrhythmias

Answer 25

- gas (flatus) in lumen intestines - product of bacterial activity (methane, hydrogen sulfide, etc) - average: individual produces 1/2 liter of gas/day; more depending on diet bacterial interaction - if isnt passed, may cuase distension and severe pain (like shrek says, better out than in) - post op patients; passing gas is a goof thing

Answer 26

- prolapsed varricose veins of the rectum - increased venous pressure r/t constipation; straining, pregnacy weight lifiting - result in bleeding (bright red), pain, itching treatment approaches - avoid constipation - warm sitz bath - cortisone cream/ suppository - sclerotherapy - Hemorrhoidectomy

Answer 27

reasons for ostomies/ bowel diversion - cancer - tramua - bowl disease (crohns) - Blockage - Diverticulitis Ostomies Location determines stool consistency due to the varying time for GI contents to digest and absorb H20 can be permanent or temporary, depending on underlying reason for ostomy Stoma: intestinal opening

Answer 28

Location of ostomies Duodenum: small intestine nearest stomach Jejunum- middle section of small intestine between duodenum and ileum lleum- end of the small intestine colon

Answer 29

changes fecal consistency based on processes that normally occur before/after location large intestine reabsorbs water the more of large intestine removed the less water reabsorbed the softer the feces. Loop colostomy: a loop of colon is pulled out through a cut in your tummy. The loop is opened up and stitched to your skin to form an opening called a stoma. The stoma has 2 openings that are close together. One is connected to the functioning part of your bowel, where waste leaves your body after the operation.

Answer 30

-Detects GI bleeding (most commonly from colorectal CA); routine screening for age > 50 yrs. ``` Relatively insensitive (< 30% carcinomas bleed sufficiently to be detected by this test), but if done in concert with colonoscopy/sigmoidoscopy mortality ``` - normal= negative - Collection: diet free of exogenous peroxidases (fish, horseradish, turnips), no vitamin C, no medicines that irritate GI tract (e.g NSAIDS) - patient collects 2-3 consecutive stool specimens; uses a wooden stick to place sample on assay card (rectal exam sample may also be used)

Answer 31

-Abnormal= positive -Colon or rectal polyps or cancer, hemorrhoids, anal fissures, esophageal or gastric cancer, peptic ulcers, ulcerative colitis, Crohn’s disease, GERD, esophageal varices False positive -Recent dental procedure with bleeding gums, eating red meat within 3 days of test, fish, turnips, horseradish, high doses of Vitamin C, NSAIDs

Answer 32

decrease in salivary secretion tooth enamel and dentin erode contributing to tooth loss and gum erosin greater incidence of hiatal hernia and gastroesophageal reflux increased gastric emptying time liver decreases in weight and size and liver blood flow decreases increased incidence of gallstones decrease production of intrinsic factor contributing to development of pernicious anmeia constipation becomes more common but probably more a result of lifestyle factor than physiological change absorption of proteins, fats, minerals and some vitamins occurs more slowly some delay in gastric mobility and emptying weakening of intestinal walls with greater incidence of diverticulitis decreased acid production contributing to achlorhydria decreased esophageal mobility taste buds decrease in number.

Abdominal assessment and bowel elimination Flashcards

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