Term
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Definition
| a lack or loss of apetite, resulting in the inability to eat. The condition may result from poorly prepared or unattractive food or surroundings, unfavorable company, or various physical and psycological causes |
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Term
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Definition
| an abnormal intraperitoneal accumulation of fluid containing large amounts protein and electrolytes. May be associated to general abdominal swelling, decreased in urinary output, edema. |
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Term
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Definition
| bowel rumbling; an audible abdominal sound produced by hyperactive intestinal peristalisis; very loud gurgling, and tickling noise often heard without stethescope. |
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Term
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Definition
| an abnormal blowing or swishing sound or murmur heard while auscultating a carotid artery, the aorta, organ, or gland, such as the liver or thyroid, and resulting from blood flowing through a narrow or partially occluded artery. |
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Term
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Definition
| one of the two angles that outline a space over the kidneys. The angle is formed by the lateral and downward curve of the lowest rib and vertical column of the spine itself. CVA tenderness to percussion is a common finding in pyelonephritis and other infections of the kidney and adjacent structures |
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Term
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Definition
Often associated with renal disease;Tenderness in these areas indicates renal inflammation, most often an infection.
Costovertebral angle tenderness
) is often associated with renal disease.
Warn the person what you are about to do
Have the person sit up on the exam table
Use the heel of your closed fist to strike the person firmly over the costovertebral angles
Compare the left and right sides
Tenderness in these areas indicates renal inflammation, most often an infection. |
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Term
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Definition
| the seperation of two rectus muscles along the median line of the abdominal wall. In a newborn results for incomplete development. In adult woman the abnormalties are often cause by repeated pregancies or multiple births (delivery of triplets) |
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Term
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Definition
| painful, burning urination, often cause by bacterial infection, inflammation, obstruction, or the urinary tract. |
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Term
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Definition
| the part of the abdomen in the upper zone between the right and left hypochoindriac region |
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Term
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Definition
| belching, the act of drawing up air from the stomach with a characteristic sound through the mouth |
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Term
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Definition
| air or gas in the intestine that is passed through the rectum |
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Term
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Definition
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Term
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Definition
| A test used to determine if the person has ascites. You stand on the persons right. Place the ulnar surface of another examiners hand or the patients own hand firmly on the abdomen in the midline. (This will stop transmission across the skin of the upcomming gap). Place your left hand on the persons right flank. With your right hand, reach across the abdomen and give the left flank a firm strike.If ascites is present, the blow will generate a fluid wave through the abdomen and you will feel a distinct tap on your left hand. If the abdomen is distent from adipose or gas you will feel no change |
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Term
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Definition
| a dry grating sound heard with a stethescope during auscultation. It is a normal finding when heard over the splenic and liver areas. It is usually due to inflammation of the peritoneum |
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Term
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Definition
| a rigid contraction of the abdominal wall muscles usuallly occuring as an involuntary reaction to the pain of a visceral disease or disorder or postoperative discomfort. May result in hypoventilation, and respiratory comlications. |
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Term
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Definition
| the most inferior part of the abdomen in the lower zone between the right and left inguinal regions and below the umbilical region |
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Term
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Definition
| abdominal enlargement of the liver that is usually a sign of disease, often discovered by percussion and palpation as part of a physical examination. The liver is normally palpable below the ribs of the right upper quadrant of the abdomen and may be tender to touch |
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Term
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Definition
| a yellow discoloration of the skin, mucous membranes. and sclera of the eyes caused by greater than normal amounts of bilrubin in the blood. For darker people it is easy seen on the hard palate |
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Term
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Definition
| an excessive serous membrane that lines the entire abdominal wall of the body and is reflected over the contained viscera. It is divided into the pariental peritoneum and visceral peritoneum . The surface is serous fluid that permits the viscera to slide easily against the abdominal wall and against one another. |
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Term
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Definition
| the cordinated, rythmatic serial contractions of smooth muscle that forces food through the digestive tract, bile through the bile , and urine through the ureters. |
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Term
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Definition
| an inflammation of the peritoneum. It is produced by bacteria or irritating substances introduced into the abdominal cavity by a penetrating wound or perforation of an organ in the GI tract or the reproductive tract. |
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Term
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Definition
| pertaining to the area around the umbilicua |
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Term
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Definition
| a painful burning sensation in the esophagus (heartburn) just below the sternum. Heartburn is usually caused by the reflux of gastric content into the esophagus but may result from gastric hyperacidity or peptic ulcer. |
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Term
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Definition
| a sign of inflammation of the peritoneum in which increased pain is elicited by the sudden release of the fingertips pressing on the abdomen. Most examiners check for tenderness opposite of the pain area.Press with the fingers perpendicular to the abdomen. |
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Term
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Definition
| pain felt at a site different from that from an injured or disease organ or body part. Angina, the pain of coronary artery insufficiency, may be felt in the left shoulder, arm, or jaw. |
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Term
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Definition
| an abnormal enlargement of the spleen, as is associated with portal hypertension,hemolytic anemia, malaria, Niemann-Pick disease. |
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Term
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Definition
| a streak or linear scar that often results from rapidly developing tension on the skin, as seen in the abdominal after surgery . Stretch marks. |
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Term
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Definition
| difficulty in passing stools or incomplete or infrequent passing of hard stools. There are many causes both organic and functional. Among the organic causes are intestinal obstruction, or tumors. Functional impairment of the colon may occur in the elderly or bedridden patients who fail to respond to the urge to defecate. For an obstruction which is not organically causes the nurse can encourage a liberal diet of fruits, vegtables and plenty of water, and the patient should be encouraged to exercise. |
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Term
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Definition
| decrease in normal frequency of defecation, accompanied by difficult or incomplete passage of stool and/ or passage of excessively hard/dry stool. |
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Term
| Constipation defining characteristics |
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Definition
| feeling of rectal fullness, feeling of rectal pressure, straining with defecation; unable to pass tool; abdominal pain; abdominal tenderness; atypical presentation in older adults; change in bowel patterns, decrease in frquency; decreased volume of stool, palpable abdominal or rectal mass, percussed abdominal dullness; severe flatus; vomiting, pain with defication |
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Term
| constipation related to factors |
|
Definition
FUNCTIONAL: abdominal muscles weakness, habitual debial, habitual ignoring of urge to defecate, inadequate tolieting, irregular defecation habits, insufficient physical activity
PSYCHOLOGICAL:
depression, emotional stress, mental confusion
MECHANICAL:
Neurological impairment, electroyle imbalance; hemorrhoids; obesity;postsurgical obstruction, prostate enlargement,rectal abcess, rectal anal stictures, rectal ulcer,tumors
PHYSIOLOGICAL
change in eating patterns, change in usual foods; decreased motility of gastrointestinal tract; dehydration; insufficient fiber intake; insufficient fluid intalk, poor eating habits |
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Term
|
Definition
| passage of loose, unformed stools |
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Term
| Diarrhea defining characteristics |
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Definition
| abdominal pain; at least three loose liquid stools per day, cramping, hyperactive bowel sounds; urgency |
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Term
| Diarrhea related to characteristics |
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Definition
PSYCHOLOGICAL:
Anxiety, high stress level
SITUATIONAL:
adverse effects of medications, alcohol abuse, contaminants, travel;laxative abuse, radiation; toxins, tube feedings.
PHYSIOLOGICAL:
infectious processes, inflammation; irritation; malabsorption, protozoal, gastrointestinal disorders |
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Term
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Definition
| Pyrosis- a burning sensation in the esophagus and stomach, from reflux of gastric acid. |
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Term
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Definition
| may be visceral from an internal organ (dull, generally poor localized); pariental from inflammation in the overlying peritoneum(sharp, precisely localized, aggrivated by movement); or reffered pain from a disorder in another site. Acute Pain requiring urgent diagnosis occurs with appendicitis, cholecystiitis, bowel obstruction, or perforated organ |
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Term
| What do you check for with abdominal pain ( symptom analysis) |
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Definition
Abdominal Pain
Timing
Course
Location
Quality
Radiation |
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Term
| what are the characteristics of abdominal pain due to hollow viscera |
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Definition
Often referred to as a "colic“ (cramping)
Quite common.
Characteristics
Crampy/paroxysmal
Often poorly localized
Related to peristalsis
Person often writhes in pain |
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Term
| what are the characteristics of abdominal pain due to Pain from Peritoneal Irritation |
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Definition
More ominous (painful)
Associated with peritonitis from any cause
Peritonitis - infection or irritation of the peritoneum - a sign of profound problems
Characteristics
Steady/constant
Often well localized
Not related to peristalsis
Person lies still with knees up |
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Term
| Describe abdominal pain radiation (referred pain) |
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Definition
Abdominal pain is not always confined to the abdomen
Because of the complex way organs migrate during embryological development, pain pathways are often "crossed" with other areas
Pain which manifests at a site distant from the actual pathology is called "referred" pain |
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Term
| Describe Appendicitis pain |
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Definition
Appendicitis is a serious and relatively common disorder in children and young adults (although it can occur at any age)
The position of the appendix is highly variable
The pain associated with appendicitis varies with the anatomy |
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Term
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Definition
Cholecystitis means literally inflammation ('itis') of the gall bladder."
This is most often due to complete or partial obstruction of the bile ducts by gall stones
It can also include infection and necrosis, both very serious complications |
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Term
|
Definition
The kidneys can harbor stones for many years without causing discomfort
They can become quite large (many cms) and not cause any immediate problem
When a stone or stone fragment becomes lodged in the ureter the person will experience acute renal colic |
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Term
| Describe jaundice , and (r/t) factors |
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Definition
| a yellowish skin color indicates rising levels of bilrubin in the blood. Except for phsycologic jaundice in newborns , jaundice does not occur normally. For noticed in the soft palate in the mouth and in the sclera. Jaundice occurs with hepatitis, cirrhosis, sickle-cell disease, transfusion reaction, hemolytic disease of the newborn. |
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Term
| Describe Nausea with or without vomiting |
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Definition
| is common with GI disease, many medications, and with early pregnancy. Hematemesis occurs with stomach or duedenal ulcers and esophageal varices. Can be associated to colicky pain, diarhea, fever, pains? |
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Term
| What are the characteristics of nausea |
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Definition
| a subjective, unpleasent, wavelike, sensation in the back of the throat, epigastrium, or the abdomen that may lead to the urge or need to vomit. |
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Term
| What are the characteristics of nausea |
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Definition
| aversion to food, gagging sensation, increased salvation, increased swallowing |
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Term
| What are the related to factors of Nausea |
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Definition
| anxiety, fear, noxious odors, pain, psyological factors, unpleasent visual stimulous, gastric irritaion |
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Term
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Definition
| a serious psycological disorder that includes loss of appetite, voluntary starvation, and grave weight loss. The person may augment weight loss by purging (self-induced vomiting) and use of laxatives. Denial of these feelings is common. Though thin, the person insists they look "fat", distgusting. Distorted body image. The person may have healthy activities and exercise but is often hyperactive. |
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Term
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Definition
| difficulty/pain or burining with urinating. Often caused by a bacterial infection, inflammation, or obstruction to the urinary tract. Laboratory urine may reveal presence of blood, bacteria, or WBC's. It is a symptom of prostatitis, urinary tract tumors, urethritis. |
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Term
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Definition
| pain associated with the kidney. The posterior portion of the body betweeen the ribs and ileum. |
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Term
| Diastasis Recti (palpation test) |
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Definition
Diastasis is a separation of the two halves of the rectus abdominis muscle on the middle of the abdomen
Have person in supine position
Place your fingertips 1-2 inches below the umbilicus
Have the person lift her head as high as she can
Feel for a separation and estimate
1 fingerbreadths, 2 fingerbreadths, etc. |
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Term
| Eliceit a focused health history for someone who had dysuria |
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Definition
Any pain or burning with urine?
where is the pain located
How severe is the pain?
When does it usually come about?
How often? Frequent? Duration? |
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Term
| Give a focused health history for someone with constipation |
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Definition
How often do you have a bowel movement?
What is the color? consistancy?
Any diarrea? constipation? how long?
any recent change in bowel habits?
use laxatives? which ones? how often do you use them?
Do you have any problems with producing stools?
How many times do you poop?( less than 3 bowel movements per week)
Do you have any abdominal pain when you poop? ( straining, lumpy or hard stool, feeling of incomplete evacuation, feeling of anorectal blockage, or have to use manual manuevers?).
How often do you exercise, drink water, eat fiber?
Do you have any difficulty ambulating to the toliet, or ever experienced irratable bowel syndrome? |
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Term
| Give a focused health history on a person experiencing diarrea |
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Definition
How often do you have a bowel movement?
What is the color? consistancy?
Any diarrea? constipation? how long?
any recent change in bowel habits?
use laxatives? which ones? how often do you use them?
Do you have any passage of loose unformed stools?
Any abdominal pain; at least three loose liquid stools per day, cramping, hyperactive bowel sounds; urgency? Do you have any stress anxiety |
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Term
| give a focused health history for a person experiencing heartburn (pyrosis) |
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Definition
Are there any foods you can not eat? What happens if you do eat them: allergic reaction, heartburn, belching, bloating, indigestion,
Do you use any antiacids? how often? |
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Term
| Give a focused health history for a person with abdominal pain |
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Definition
Any abdominal pain? Please point to it.
Is the pain in one spot, or does it move around?
How did it start? How long have you had it?
Constant? or does it come and go? Does it come before or after meals? Does it peak? When?
How would you describe the character: cramping (colic type), burning in pit of stomach, dull, stabbing, aching?
Is the pain relieved by food, or worse after eating?
Is the pain associated with menstral period or irregularities stress, dietary indiscretion, fatigue, nausea, vomiting, gas, fever, rectal bleeding, frequent urination, vaginal or penile discharge?
What makes the pain worse: food, position, stress, medication, activity?
What have you tried to relieve pain: rest, heating pad, change in position, medication? |
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Term
| Give a focused health history for someone with jaundice |
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Definition
check to see if they have any inflammation in the liver
-light skinned people: should have yellow in sclera, hard plate, mucoud membranes, and then over skin
-dark skinned people: check Sclera, yellowish fat deposits under the eyelid, check palms, and soft and hard plate |
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Term
| Give someone a focused health history with Nausea with or without vomiting |
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Definition
any nausea or vomiting?how often? How much comes up?What is the color? Is there an odor?
Is it bloody?
Is the nausea and vomiting associated with colicky pain, diarrhea, fever, or chills?
what foods have you eatin in the last 24 hours? Where? At home school, restraunt? Is there anyone else in the family with the same symptoms in the past 24 hours? |
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Term
| Give a focused health history for someone with anorexia |
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Definition
Any change in appetite?Is there a loss of appetite?
Any Change in weight? How much weight gained or loss? Over what time period?
Is the weight loss due to diet?
FOR CHILDREN
what do you eat ar regular meals? Do you eat breakfast? What did you eat for snack?
What is your exercise pattern?
If weight is less than body requirments: how much have you lost? by diet, exercise, or harm?
How do you feel? tired?hungry? how do you think your body looks?
What is your activity pattern?
Is the weight loss associated with any other body change: such as menstraul irregularity?
What do your parents say about your eating? your friends? |
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Term
| Give a focused health history of a person with flank pain |
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Definition
Do you experience any pain ? Where?
What does it feel like, how severe is it?
Does the pain radiate?
When do you normally get the pain, what makes it better what makes it worse?
How long does it usually last, when did it start, how frequent is it?
Do you use any medications? |
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Term
| Define and locate the topographical landmarks of the abdomen |
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Definition
For practical purposes it is easiest to think of the abdomen divided into four quadrants with the umbilicus at the center
Right Upper Quadrant RUQ
Left Upper Quadrant LUQ
Right Lower Quadrant RLQ
Left Lower Quadrant LLQ
Note that the names refer to the person's left or right side
There are additional terms for midline findings
Epigastric- the area between the costal margins
Periumbilical- the area around the umbilicus
Suprapubic- for the area above the pubic bone |
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Term
| General tips before you start examining the abdominals |
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Definition
The person should have an empty bladder
The person should be lying supine appropriately draped
The examination room must be quiet to perform adequate auscultation and percussion
The examiner should be on the person’s right side to most effectively assess the abdomen
Watch the person's face for signs of discomfort during the examination |
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Term
| What are Nurses image of themselves |
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Definition
They appear to be poorer than that of the public. There was a "one word description" study of nursing: Nurses 72% positive image of nursing, the public viewed nursing as positive 84% of the time, and the physicians rated nursing 100% of the time.
-The nurses that are not currently practicing nursing or do not have a high image of themselves are the ones telling kids not to enter nursing
- I also think that the low membership in proffessional organizations (ANA 5-7%) is due to nurses not having a vary valuable image of themselves and so not want to strive for a better image of nursing. |
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Term
| Describe inspection of the abdomen |
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Definition
1.Examine the skin for scars, striae, hernias, vascular changes, lesions, or rashes
2. Examine the general configuration of the abdomen
Look for movement associated with peristalsis or pulsations
Note the abdominal contour. Is it flat, scaphoid, or protuberant?
3.Examine the general configuration of the abdomen
Look for movement associated with peristalsis or pulsations
Note the abdominal contour. Is it flat, scaphoid (concave), or protuberant (convex)?
4.It is particularly important to note any scars and correlate these
with the person's past surgical history,certain disorders(obstruction, adhesions) are more common after abdominal surgery |
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Term
| When should Auscultation be done? |
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Definition
Auscultation should be done prior to percussion and palpation since bowel sounds may change with manipulation
Bowel sounds are transmitted widely in the abdomen, therefore auscultation of more than one quadrant is not usually necessary
If you hear them, they are present, period
HOWEVER
In order to say with certainty that there are NO bowel sounds present you must listen in all 4 quadrants for 5 minutes |
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Term
| what do you do when ausculating for bowel sounds |
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Definition
Place the diaphragm of stethoscope lightly on the abdomen
Note the character and frequency of bowel sounds. Bowel sounds originate from the movement of air and fluid through the small intestine. Depending on the time elapsed since eating, a wide range of normal sounds can occur. Bowel sounds are high pitched ( use diaphram) gurgling, cascading sounds, occuring irregularly any where from 5 to 30 times /per min. Do not count them just judge if they are hyperactive, hypoactive, or normal. |
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Term
| What are normal,increased, and decreased bowel sounds with auscultation |
|
Definition
Normal bowel sounds
Clicks and gurgles
Irregular
Every 5-35 seconds
Increased bowel sounds
Hyperactive
Borborygmi
Decreased bowel sounds
Hypoactive |
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Term
| How many places and what do you listen for when auscultating for vascualr sounds |
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Definition
| you ausculate in 5 places ( make a house ; between intercostal space, where the aorta branches to the kidneys, and where it branches to blatter, listening for BRUITSS |
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Term
| How do you check superficial abdominal reflexes |
|
Definition
Use a blunt object such as a key or tongue blade
Stroke the abdomen lightly on each side in an upward and outward direction above (T8, T9, T10) the umbilicus
Stroke in a downward and outward direction below the umbilicus (T10, T11, T12)
Note the contraction of the abdominal muscles and deviation of the umbilicus towards the stimulus |
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Term
| What is the first step you do when you percuss the abdomen |
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Definition
A useful first survey of the abdomen prior to palpation
Percuss in all four quadrants |
|
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Term
| What are percussion general tones |
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Definition
Categorize what you hear as tympanic or dull
Tympany is normally present over most of the abdomen in the supine position (due to intestinal gas
Unusual dullness may be a clue to an underlying abdominal mass, for example and enlarged liver or impacted stool |
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Term
| What is the first thing you do with palpation of the stomach |
|
Definition
Begin with light palpation.
At this point you are mostly looking for areas of tenderness
Voluntary or involuntary guarding may also be present
The most sensitive indicator of tenderness is the persons facial expression
Soooo - watch the person's face, not your hands!!
use the first four fingers close together, depress skin about 1 cm and do not drag fingers across pick them up and move in clockwise motion. The object is not to search for organs, but notice tenderness, and the overall musculature. |
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Term
| What is the difference between tenderness and pain in palpation |
|
Definition
What is the difference between tenderness and pain?
Tenderness is discomfort caused or increased by their examination (a sign)
Pain on the other hand, is something the person tells you about as part of the history (a symptom) |
|
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Term
| Aftre you have done light palpation on the stomach what is the next thing you do with palpation |
|
Definition
Proceed to deep palpation ( press 5-8cm) after surveying the abdomen lightly
Try to identify abdominal masses or areas of deep tenderness |
|
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Term
| What do you do when palpating the aorta |
|
Definition
Press down deeply just left of the midline above the umbilicus
The aortic pulsation is easily felt on most individuals
A well defined, pulsatile mass, greater than 3 cm across, suggests an aortic aneurysm.
Try to differentiate between an abdominal pulse and a pulsatile abdominal mass
Unless the person is particularly thin, under normal circumstances you should be able to feel an abdominal pulse without any "structure" to it
If you detect an easily palpable, pulsating abdominal mass it is likely to be an aneurysm. |
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Term
| Auscultating vascular sounds |
|
Definition
as you listen to the abdomen, note the presence of any vascular sounds or bruits. Use firmer pressure , check over the aorta, renal arteries, iliac, and femoral arteries, especially in people with hypertension. Usually no such sound is present. However a small number of healthy people usually younger than 40 years may have an abnormal bruit originating from the celiac artery. This is systolic, medium to low pitch, and heard between the xiphoid process and the umbilicus.
* venous hum, and peritoneum friction rub are abnormal listen at 7 spots |
|
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Term
| abdnormal findings with auscultation: hyperactive, hypoactive, and absent bowel sounds |
|
Definition
One type of hyperactive bowel sound is common: The is hyperperistalsis when you hear your stomach growling;borborygmus. A perfectly silent abdomen is uncommon, you must listen 5 minutes by your watch to each quadrant before documenting silent bowel sounds.
* Hyperactive bowel sounds: are loud, high pitched, rushing, tinking sounds that singnal increased motility.
*hypoactive or absent bowel sounds: follow abdominal surgery or with inflammation of the peritoneum |
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Term
| abnormal findings with ausculation: Bruits or venous hum. |
|
Definition
Note location, pitch, and timing of vascular sound
* a systolic bruit is a pulsitile blowing sound and occurs wikth stenosis or occulusion of an artery.
* Venous hum and peritoneal friction rub are rare. Originates from the inferior vena cava. Medium pitch. continuous sound pressur from bell might obliterate it. Occurs with portal hypertension. |
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Term
| Abnormalties with palpation and percussion: tenderness |
|
Definition
Rebound Tenderness
This is a test for peritoneal irritation
Warn the person what you are about to do
Press deeply on the abdomen with your hand
After a moment, quickly release pressure
If it hurts more when you release, the person has rebound tenderness.
Costovertebral angle tenderness (CVAT) is often associated with renal disease.
Warn the person what you are about to do
Have the person sit up on the exam table
Use the heel of your closed fist to strike the person firmly over the costovertebral angles
Compare the left and right sides
Tenderness in these areas indicates renal inflammation, most often an infection |
|
|
Term
| abnormalties with percussion and palpation: masses |
|
Definition
Press down deeply just left of the midline above the umbilicus
The aortic pulsation is easily felt on most individuals
A well defined, pulsatile mass, greater than 3 cm across, suggests an aortic aneurysm
Try to differentiate between an abdominal pulse and a pulsatile abdominal mass
Unless the person is particularly thin, under normal circumstances you should be able to feel an abdominal pulse without any "structure" to it
If you detect an easily palpable, pulsating abdominal mass it is likely to be an aneurysm.
Tympany is normally present over most of the abdomen in the supine position (due to intestinal gas
Unusual dullness may be a clue to an underlying abdominal mass, for example and enlarged liver or impacted stool |
|
|
Term
| Palpation : femoral pulses |
|
Definition
| you should be able to feel a femoral pulse, just below the inguinal ligament halfway between the pubis and the anterior superior iliac spines. if pulse is weak ausculate the site for a bruit |
|
|
Term
| palpation: inguinal lymph nodes |
|
Definition
| palpate the horizontal chain along the groin inferior to the inguinal ligament and the vertical chain along the upper inner thigh. It is normal to palpate an isolated node on occation, it feels small less than 1 cm, soft , descrete, and movable |
|
|
Term
| Developmental variations in infants of the abdomen |
|
Definition
Infants
Synchronous chest and abdominal movements with breathing
Superficial veins seen in premature and thin infants
Pulsations in epigastric area are common
Liver palpable 1-3 cm below costal margin
Abdomen is rounded and protrudes in young children |
|
|
Term
| developmental variations in adolescents of the abdomen |
|
Definition
Tanning lines and fine venous networks are often visible
Flat contour common |
|
|
Term
| developmental variations in pregnant women of the abdomen |
|
Definition
Nausea and vomiting common
Diminished abdominal reflex
Peristalsis decreases
Abdominal striae
Linea nigra
Diastasis recti
Diastasis is a separation of the two halves of the rectus abdominis muscle on the middle of the abdomen
Have person in supine position
Place your fingertips 1-2 inches below the umbilicus
Have the person lift her head as high as she can
Feel for a separation and estimate
1 fingerbreadths, 2 fingerbreadths, etc. |
|
|
Term
| developmental variations in the elderly for the abdomen |
|
Definition
Decreased intestinal motility
Abdominal wall thinner and less firm
Fat pad common
Loss of muscle tone
Midclavicular liver span is decreased
Hepatic blood flow and liver cell # decrease
Some drugs may not be metabolized as well |
|
|
Term
| Abdomen examination checklist |
|
Definition
1. inspection:
contour
symmetrical
umbilicus
skin
pulsation or movement
hair distribution
demeanor ( are they relaxed)
2. Auscultation:
bowel sounds
note any vascular sounds
3. percussion:
percuss all four quadrants
percuss border or liver and spleen
4. palpation:
light palpation in all four quadrants
deep palpation in all four quadrants
palpate for liver, spleen, kidney |
|
|
Term
| Complete assessment of a patient with abdominal pains relevant history |
|
Definition
Personal History
Weight changes and time frame
Current weight
Usual weight
Highest weight
Lowest weight
Changes in appetite
Food allergies or intoleranc
2. Food supplements
Vitamins
Minerals
Herbals
Calorie/protein supplements
Diet
24-hour recall
3 or 7-day food diary
Typical diet
Changes in Appetite
Anorexia
Polyphagia ( overeating)
Problems with digestion
Eructation
Belching
Pyrosis
Heartburn
Nausea with and without emesis
Characteristics of vomitus
Partially digested food
Undigested food
Fecal material
Frank blood
“Coffee grounds”
Timing of emesis
Meals, Activities
Changes in bowel habits
Diarrhea
Constipation
Alternating diarrhea and constipation
Frank blood in stools
Tarry stools
Abdominal Pain
Timing
Course
Location
Quality
Radiation
Pain from Hollow Viscera
Often referred to as a "colic“
Quite common.
Characteristics
Crampy/paroxysmal
Often poorly localized
Related to peristalsis
Person often writhes in pain
Pain from Peritoneal Irritation
More ominous
Associated with peritonitis from any cause
Peritonitis - infection or irritation of the peritoneum - a sign of profound problems
Characteristics
Steady/constant
Often well localized
Not related to peristalsis
Person lies still with knees up |
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