Week 10: GI/GU

Question 1

Anatomy Abdomen

Answer 1

• From diaphram to pelvis
• Persilatsis smooth contractions move food down along tract
• 4 quadrants and nine regions
  -RUQ: Liver, gallbladder, duodenum, right kindey and adernal , colon parts
  LFQ: Stomach, spleen, Pancreas, left kidney, parts of colon , and adernal
  RLQ: Cecum, appendix, reproductive
  LLQ: descednig colon, signoid, left side of female reproductive

Question 2

Acute Assessment

Answer 2

Right upper chest pain, lower left pain,

Question 3

Subjective Data Collection

Answer 3

OPQRSUV Pain viseral or parietal pain
- Diet/Appetite
- Dyshapgia (swallow)
- Allergies/medications
- Nasuea and vomit
- Bowel habits and consistency
- Past history and familly
- Void and flatus
- Repductive issues
- Alcohol and smoke

Question 4

Objective Data Collection

Answer 4

Drape and prepare visible abdominal area
Pt. should be flat with knees up positon
I-A-P-P ( ascultation prior to palaption allows accurate bowl sounds and does not stimulate false movement)

Question 5

1. Inspection

Answer 5

Stand on right side look at abdominal region: scars/lesions, pulsations, bluges, viisble persilatic, distention in chest, movements skin, symmetry, smooth surface and color.
Contour: Flat, rounded, scaphoid, Protrubant
Scahoid may indicvate extereme weight loss while protuberant also not normal.

Question 6

2. Ascultation

Answer 6

• Listen 5 min each quadrant
• Divide into 4 Quadrants of lower abdominal region
• Midline is midsternal line
• Using diaphram gentle listen starting in Right lower quad. and work clockwise around each area.
• Should hear high pitchched irregualr gurgling 5-30 per mintue ( normal, hyperactive, hypoactive)
• Hyperactive ( loud, higher pitched ruslting tinkiling indcate bowl obstruction –> Borbygmus growling) indcate increased motlity
• Hypoactive/absent sounds after surgery or inflammation
• Listen to vascualr sounds for bruits

Question 7

3. Percussion

Answer 7

General Tympany: Dullness, over liiver, massess, feces , fluid
Percuss and palpate mideline above pubic for bladder distention
Check for pain
Percuss regions
Dulness ( solid, air filled)
Tymanu ( hollow organs)
Ressoance ( air filled)
Flat ( dense bones)

Question 8

4. Palpation

Answer 8

Bend knees and begin lower to abdomen and ask pt to relax
- Light palpation assessing for texture, temperature, moisture, swelling, rigittiy, pulsations, tender, firm/soft , pain.
- If mass not the sizie and area
- If ticklish pt: keep hand under your own curled over fingers

Question 9

Light palpation

Answer 9

• 4 fingers depress skin 2cm
• Gentle rotations and slide
• Move and lift fingers to next location clockwise
• Skin surface, muscle distention, tender
• Examine tender areas last, asss for relaxation, any vol guarding or invol discomfort
• Deep palpation ( 6cm)

Question 10

Abnormal Bow Sounds

Answer 10

Hypoactive bowl: consitpation
Hyperactive: dirreah

Question 11

Older Adults

Answer 11

• Suprapubic fat in women, adominal fat in men
• Decreased salivia, gastric secretions, deleayed swallow
• Dehydration
• Renal function issues
• Constipation
• Poor bowl control, slower persitalsis

Question 12

Reproduction

Answer 12

• Last exam
• Maximize comfort
• Need for professional and nonjudgement care
• Priavcy and comfort
• Explore feeligs of discomfort
  Obtain pt hsitory when dressed

Question 13

Objective Data

Answer 13

• Pt comfort, dignity , ask to begin, gender requests, examiner should not be present when undressing
• If erection occur: reasssure normal response
• Inspection and Palpation: genitla area, lymph nodes
• Drape, gown ensure pt is safe and dignity prior
• Encourage questions to be asked

Question 14

Male exam

Answer 14

• Testicular exam: performed after shower, gentle row tesicle side to side, lumps on sides
• Older adults: less testostrone, dripping, poor bladder habits

Question 15

Acute Reproductive Assessment

Answer 15

• Vaginal bleeding, pain, pelvic infal
• After menpoause it is a concern
  -Common during child bearing years
  Infection, ectopic pregancy, carcinoma
  STI: lead to inferility, lower adominal pain, sexual partners

Question 16

Subjective Data

Answer 16

Risk factors: family history, personal age, menpause, infection, PAP, incontinece , build rapport
Risk factors: STI and sexual active
Pain assesment

Question 17

Female Exam

Answer 17

Drape, ensure comfort
- Inspection of external gentilia and palpation
- Speculum exams
- Yeast infections: white discharge, pruituis, dysparenia skin irritation

Question 18

Older women

Answer 18

• Low amounts of ensstrogen risk for bone weakness
• Meopause
• vaginal dryness

Question 19

Repro. Health Promotion

Answer 19

• Intimacy concerns
• Prone to UTI’s for older adults
• Breast exam, PAP, hygine
• Prevent bladder infections: avoid bubbles, void before and after sex, hydrtation

Question 20

Bowl Eleminatation Assessment

Answer 20

Common concerns include: constipaption, diarrhea, incontinece

Question 21

Urination

Answer 21

• Diease conditons
• Fluids
• Muscle tone
• 30cc/hr indcate renal issues
• Should be pale yellow color

Question 22

GU Assessment

Answer 22

• Bowl habits
• Health History: stroke, diabetic, spinal cord, medications, mobility
• Note color and frequency of urination
• Buring, urgency, incontinece, hematuria ( blood urine)

Question 23

GU Physical Assessment

Answer 23

Note skin tugor, skin breakdown, pain, bladder, urine output and test, hydrtation test

Question 24

GU System Health Promotion Older Adults

Answer 24

Lifestyle
Client education , hygeine importance and fluids
Effective hygine practice
Proper baldder and bowl elemnation
Bladder training and skin intergrity

Question 25

Gastro-urinary Conditions

Answer 25

- Anuria: lack of urine production , or no urine - Dialysis- removes body fluids when unabel to - Diuresis ( exessive urine) - Dysuria (painful uriation) - Hematuria (blood urnie) - Nocturia ( night urinartion)