Need to finish!! Exam 3: Abdominal assessment and bowel elimination

Question 1

Gastrointestinal tract anatomy

Answer 1

Mouth
Esophagus
Stomach
Small intestine
Large intestine
Anus

Question 2

Natural contour of abdomen

Answer 2

Flat -> rounded (convex)

Question 3

Abdominal distention

Answer 3

Fat, Flatus, Fluid, Fetus, Feces, Fibroid

Question 4

Scaphoid (concave) abdomen

Answer 4

Malnourishment

Question 5

Localized enlargements

Answer 5

hernias (bulge), tumor, cyst, bowel obstruction

Question 6

Visible pulsations

Answer 6

may be normal in epigastric area in some individuals; marked pulsation may indicate AAA

Question 7

Normal abdominal skin

Answer 7

homogeneous color is normal with smooth texture

Question 8

Straie

Answer 8

Stretch marks related to pregnancies, rapid growth, Cushing’s, obesity

Question 9

Cullens sign

Answer 9

periumbilical bleeding

Question 10

Turner’s sign

Answer 10

Flank bleeding

Question 11

Bowel sounds

Answer 11

Movement of air and fluid through the small intestine

Question 12

Bowel sounds are

Answer 12

high pitched, gurgling, cascading sounds, occurring irregularly anywhere from 5 to 30 times per minute

Question 13

How to judge bowel sounds

Answer 13

normal, hypoactive, or hyperactive

Question 14

Hyperactive bowel sounds

Answer 14

Loud, high-pitched, rushing, tinkling sounds signal increased motili

Question 15

One type that is fairly common in hyperactive sounds

Answer 15

the hyperperistalsis (increased motility) when you feel your “stomach growling,” termed “borborygmus”; loud, easily audible

Question 16

Hypoactive or absent sounds

Answer 16

Decreased motility associated with abdominal surgery, ileus, or with inflammation of the peritoneum

Question 17

A silent abdoment is

Answer 17

UNCOMMON! you must listen for 5 minutes before deciding if they are silent

Question 18

Mixed abdominal sounds

Answer 18

Varied sounds based on quadrant and what is happening. Can by hyperactive ABOVE a mass/impaction and be absent below the blockage/stoppage.

Question 19

Rebound tenderness:

Answer 19

press onto the involved area and let go. Pain upon rebound indicates peritoneal tenderness common with appendicitis or peritoneal injury.

Question 20

what should you not do with pulsating abdominal mass

Answer 20

DO NOT palpate

Question 21

Abdominal pain: broad categories

Answer 21

Inflammatory (e.g. appendicitis)
Mechanical (e.g. bowel obstruction)
Neoplastic (e.g. tumor pressing on a nerve)
Vascular (e.g. clot, aneurysm)
Congenital (e.g. hernia)
Traumatic (e.g. blunt trauma)

Question 22

DysphaGIa

Answer 22

defined as difficulty swallowing any liquid (including saliva) or solid material

Question 23

DysphaSia

Answer 23

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.

Question 24

Significant alterations in bowel elimination

Answer 24

Constipation/Impaction
Diarrhea
Flatulence
Blood in stool (frank +/or occult)
Diseases of GI tract (e.g. irritable bowel syndrome; diverticulitis; colon CA)
Fecal incontinence
Hemorrhoids

Question 25

Most common S/S of abdominal disorders

Answer 25

``` Pain Nausea/vomiting Change in bowel movements Rectal bleeding Abdominal distention Ask about: change in appetite, change in weight, food intolerance, dysphagia, current medications ```

Question 26

Diarrhea reflects

Answer 26

increased water content of the stool, whether due to impaired water absorption &/or active water secretion by the bowel

Question 27

Severe infectious diarrhea

Answer 27

: number of stools may reach 20 or more per day, with defecation occurring every 20 or 30 minutes -> the total daily volume of stool may exceed two liters, with resultant electrolyte imbalances, especially VOLUME DEPLETION AND HYPOKALEMIA

Question 28

Etiology of constipation

Answer 28

``` Improper diet (lack of fiber) Lack of fluids Lack of exercise Medications (opioids, anti-cholinergics, iron, calcium channel blockers, diuretics) Disease states (e.g. diabetic gastroparesis; IBS) Emotional stress Pregnancy Surgery Spinal cord injury ```

Question 29

Common symptoms of constipation

Answer 29

``` Decreased frequency of stools Hard, dry, formed stools Straining while stooling; painful defecations Reports of rectal fullness or pressure Reports of incomplete bowel evacuations Abdominal pain, cramps, or distensions Anorexia, nausea Headache ```