What is the correct sequence of steps for assessing a patients abdomen quizlet?

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Terms in this set (69)

When performing an abdominal assessment, what is the correct sequence?

Auscultation, inspection, palpation, percussion

A patient reports a long history of changes in bowel patter. Which is the best question to determine normal bowel habits?

What was your bowel pattern before you noticed the change?

When palpating the abdomen, the nurse notices a mass at the anterior right costal margin in the MCL. Which organ is most likely involved?

Liver

What percussion sound is heard over most of the abdomen?

Tympany

A patient with a history of kidney stones presents with complaints of pain, hematuria, and nausea with vomiting. What assessment technique will illicit kidney pain?

Percussion for CVA tenderness
: fist percussion over the costovertebral angle (CVA) is the only technique listed that reflects a technique for assessing the kidney. The remaining techniques are used to assess peritoneal inflammation.

When auscultating the abdomen, the nurse hears a bruit to the right of the midline slightly below the umbilicus. The nurse documents this finding as a bruit of which of the following?

Right iliac artery
: The iliac arteries are located to the left and right of the midline of the abdomen, below the umbilicus. The aorta is midline, the renal artery is above the umblicus, and the femoral artery is located in the groin.

A patient with a history of cirrhosis tells the nurse that his abdomen seems to be getting larger and that he has gained 9.7 kg (20 lbs) in the last 6 months. How will the nurse determine whether the abdominal enlargement is from accumulation of fluid or fat from the weight gain?

By percussing the abdomen for shifting dullness

A patient with a tympanic abdomen complains of pain in the RUQ. Which sign would the nurse expect to be positive?

Murphy sign
: the Murphy sign tests for gallbladder pain. The other signs test for peritoneal irritation in the lower quadrants.

Which assessment technique would best confirm splenic enlargement?

Percussion along the left MAL spleen and gentle palpation

When documenting a finding in the region over the stomach and centered above the umbilicus, the nurse most accurately identifies the region as

epigastric

The nurse has to decrease medicine dosages in consideration of what age group?

Older adults and elderly

Chewing difficulties and limited financial resources can contribute to?

alter dietary choices (less protein and more carbohydrates

Altered dietary choices, reduced muscle mass and tone can contribute to?

Constipation

Why is it more challenging and less accurate to take an abdominal assessment in older adults?

Fat accumulations
women: lower abdominal
men: around waist

Medical dosages should be decreased in older adults and elderly because?

Process medications: Liver decreases in size and function declines
Elimination: renal function declines

Diminished sense of thirst in the hypothalamus can lead to?

lower consumption of liquids-> UTI and Constipation

Decreased liver and renal function in the elderly often results in

lower than normal medication's therapeutic effects

African Americans are more commonly present with

sickle cell anemia: splenomegaly and jaundice
G6PD deficiency
lactose intolerance:abdominal cramping and diarrhea

Obesity is generally higher in ____ and highest in ______

racial and ethnic minorities
non-hispanic black women

Asuab Americans are more commonly associated with

GI cancers (stomach cancer) : complaints of hearburn, indigestion, anorexia, and weight loss
Infection with helicobacter pylori

Jewish community is commonly known to have a higher commonality with

Lactose intolerance and IBD :abdominal cramping, diarrhea, and rectal bleeding

African Americans have the highest incidence with

colorectal cancer

Ashkenazi Jews have a greater risk of

colon cancer (believed to carry a gene linked)

Americans of Greek and Italian descent more commonly present with

lactose intolerance
thalassemia
anemia
illness cause: abdominal cramping, diarrhea, jaundice and splenomegaly

Native americans are more common with

Alcoholism, liver, and gallbladder disease, pancreatitis and diabetes

What disease is common among all cultural groups

Lactose intolerance

African Americans have higher rates of

obesity
HTN
diabetes mellitus
Metabolic syndrome

African American and American Indian/Alaska Native adults are ____as likely to be diagnosed with diabetes than Caucasians

twice

Native Hawaiians are more than _____ to die from complications of diabetes

5.7

Mexican Americans are ____ more likely to be diabetes than Caucasians

1.8

Pacific Islanders are ___ times more likely to be diagnosed with the disease

3

The nurse assesses current problems by

using symptom analysis

Genetic risk factors may be determined by

personal and family history

Risreduction and Health promotion goals may include:

Increase the proportion of adults who receive a colorectal cancer screening examination,
Reduce the rate of new cases of end-stage renal disease (ESRD),
Reduce cirrhosis deaths

Anorexia

loss of appetite and can be related to stress, difficulty with ingestion, socioeconomic issues, age, related issues or dementia

Gastric acid reflux symptom can be

heartburn

Functional constipation results

from inadequate fiber and fluids in the diet

Medications that can cause constipation?

anticholinergics or narcotics

Visceral pain:

hollow organs are distended, stretched, or contract forcefully- difficult to localize

visceral pain can be described as

gnawing, burning, cramping, or aching

Parietal pain results from

inflammation of the peritoneum

Parietal pain can be described as

is usually sever and localized over the involved structure: steady, aching, or sharp especially with movement

Referred pain occurs

in more distant sites innervated at approximately the same spinal level as the disordered structure

Diarrhea is associated with

infection (C. Diff.)
food intolerances
medicinal adverse effect

Jaundice is caused by

obstruction of the common bile duct by gallstones or pancreatic cancer

Stress incontinence:

occurs with coughing, sneezing, or increasing intraabdominal pressure

Urge incontinence:

sudden urge and loss of continence with little warning

Total incontinence:

inability to retain urine

What are lifespan considerations that can affect dietary alterations?

Financial limitations
Meal preparation
Socialization
Bowel movements
Dysphagia
Medications

Striae

scars
stretch marks
veins

Ascites

collection of fluid in the abdomen

Color of stool can indicate

Green emesis: reduced peristalsis with irritation
Coffee-ground emesis: digested blood, bloody emesis (active bleed with undigested blood)
Dark stool can be from iron supplements
Melanotic stool is noted with digested blood from GI bleeding

Borborygmi

increased bowel sounds occur with diarrhea and early intestinal obstruction

Hypoactive bowel

can occur with adynamic ileus and peritonitis

Bruits

swishing sounds that indicate turbulent blood flow resulting from constriction or dilation of tortuous vessel

abdominal reflex is present or absent in patients with upper and lower motor neuron diseases

absent

Blumberg sign

rebound tenderness to check for peritonitis

Murphy sign or inspiratory arrest

to check for inflammation of the gallbladder

Iliopsoas muscle test

performed when appendicitis is suspected

Basic metabolic panel (BMP)

good overview of various changes that can result from malfunction of abdominal organs

Glucose level

indication of pancreatic endovrine function

Electrolytes sodium, potassium, chlorine, and carbon dioxide can point to

hydration affected by vomiting and dehydration

Blood urea nitrogen (BUN) and creatinine levels indicate

basic kidney function

Liver function tests

Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)

Amylase and lipase levels can indicate

exocrine function of the pancreas

Nursing diagnosis (4)

Imbalanced nutrition, less/more than body requirement
Diarrhea
Constipation
Incontinence
and can be fluid volume dificit

Venous hums are conitinuous sounds found in

in the epigastric region and around the umbilicus and caused by portal HTN

Hepatitis A transmitted

oral-fecal

Hepatitis B & C

Body fluids exposure

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