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45 Cards in this Set
- Front
- Back
Solid Viscera
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viscera that don't change shape on daily basis
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Solid viscera examples
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liver, uterus, kidneys, adrenals, pancreas, spleen, ovaries
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Hollow Viscera
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viscera that change shape on a daily basis
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Hollow Viscera examples
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stomach, gall bladder, intestines, bladder, colon
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Why visceral pain refers
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brain has no felt image for internal organs ... pain is referred to a site where the organ was located in fetal development
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Abdominal Changes due to Age
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fat accumulation - salivation decreases - decreased gastric motility - (-) gastric acid secretion - (+) incidence of gallstones, (-) liver size, constipation
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(-) gastric acid secretion puts older adult at risk for ...
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anemia due to less acid to break down B12
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issues with decreased liver size
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still works yet blood flow to liver decreases ... which decreases how fast body metabolizes meds ... may cause toxicity due to delayed metabolism
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Cultural Considerations ... abdominal
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lactose intolerance ... NA, AA, Asians --- bloating, increased gas, discomfort, diarrhea
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emitis
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vomit
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Lifestyle Risks ... abdominal
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ETOH - other drugs - fast foods - stress (appetite changes) - infectious disease exposure
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Abdominal Subjective data
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appetite - dysphagia - food intolerance - abdominal pain - N/V/D - bowel habits - meds - PMH - nutritional assessment
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occult blood
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blood can't see
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black tarry stool
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upper GI bleed
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rectal blood in stool
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frank red blood
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what does stool look like w/ hepatitis
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gray stool
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screening vs diagnostic
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screening .. have risk factor but no S & S ---- diagnostic .. have S & S using to determine/ confirm problem
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Objective Data Collection - Abdominal
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Inspect ... THEN auscultate ... palpate ... percuss
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Abdominal Inspection
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shape - symmetry - color - lesions or scars - pulsations (aortic) - level of comfort
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scaphoid
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convex abdomen when supine - under nourished
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protuberant
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distended abdomen
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Reasons for Protuberance
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fat - fetus - feces - flatus - fibroid - fluid - fetal growth
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pyrosis
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heartburn
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Describe Abdominal Ascultation
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bowel sounds - hyper active, normal, hypo active (none for 5 minutes) ... start at RLQ work around clockwise ... bowel sounds usually return 12 hrs after surgery
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where listen for bruit in abdomen
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aorta, renal, illiac, femoral --- listen w/ diaphragm --- turbulent flow when atherosclorosis present
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What expect to hear when percuss abdomen
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tympany ... hollow --- hear dullness over organ
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liver span
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percuss to check -- normal 6-12cm
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hepatamegally
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enlarged liver -- >12cm
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When can adjust location of liver?
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pregnancy, ascites, pulmonary edema
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Percussing Spleen
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at anterior axillary line ... change in percussion from tympany to dull with full inspiration = (+) spleen percussion sign.......splenomegaly
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CVA Tenderness
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Costal Vetebral Angle Tenderness ---- indirect fist percussion causes tissue to vibrate as opposed to making a sound. Sharp pain occurs on percussion w/ kidney inflamation
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Abdominal Palpation
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moving clockwise from RLQ light palpation 1-3cm feeling for surface abnormalities ... then 2nd pass deep palpation --- if pain present palpate last
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Blumberg's Sign
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Rebound Tenderness ... on opposite side from pain, press in with fingertips ... ? more pain when press or when release. More pain on release w/ peritenitis & appendisitis
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Rebound Tenderness
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same as Blumberg's sign
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Murphy's Sign
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palpating for inflammation of gallbladder ... hold fingers under liver boarder & ask person to take deep breath .... (+) test is presence of pain
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Everted Umbilicus present with ...
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pregnancy; ascites or underlying mass; umbilical hernia
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Bluish Periumbilical color occurs w/
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intraabdominal bleeding
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Abdominal dullness occurs w/
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distended bladder, adipose tissue, fluid or a mass
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Hyperresonant abdominal sounds occur with
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gaseous distention
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Palpate Aorta where?
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upper abdomen just to left of midline
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RUQ organs
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Liver - gallbladder - duodenum - R kidney & adrenal - ascending & transverse colon - hepatic flexure of colon
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LUQ organs
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Stomach - spleen - L lobe of liver - pancreas - L kidney & adrenal - transverse & descending colon - splenic flexure of colon
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RLQ organs
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Cecum - appendix - R ovary - R ureter - R spermatic cord
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LLQ organs
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Descending colon - sigmoid colon - L ovary - L ureter - L spermatic cord
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Midline organs
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Uterus - bladder - aorta
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