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43 Cards in this Set

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acute abdomen
A condition of sudden onset of pain within the abdomen, usually indicating peritonitis; immediate medical or surgical treatment is necessary
appendicitis
Inflammation of the appendix

Localization of pain - Right lower quadrant (direct), around navel (referred); Rebounding pain (pain felt on the rebound after palption)
cholecystitis
Inflammation of the gallbladder

Localization of pain: Right upper quadrant (direct); right shoulder (referred)
cystitis
Inflammation of the bladder

Localization of Pain: Lower mid abdomen (retropubic)
diverticulitis
Inflammation in small pockets at weak areas in the muscle walls

Localization of Pain - Lower left quadrant
emesis
vomiting
guarding
involuntary muscle contractions (spasm) of the abdominal wall; an effort to protect the inflamed abdomen
hernia
The protrusion of a loop of an organ or tissue through an abnormal body opening.

Reducible hernias go back into the body cavity. Incarcerated hernias cannot be pushed back within the body.

Localization of Pain: Anywhere in the abdominal area
ileus
paralysis of the bowel, arising from any one of several causes; stops contractions that move material through the intestine
kidney stones
Solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing in the urine; may become tapped anywhere along the urinary tract.

Localization of Pain: Right or left flank, radiating to the genitalia
pancreatitis
Inflammation of the pancreas

Localization of Pain: Upper abdomen (both quadrants back)
peritoneum
The membrane lining the abdominal cavity (parietal peritoneum) and covering the abdominal organs (visceral peritoneum)

The parietal peritoneum is supplied by the same nerves from the spinal cord that supply the skin of the abdomen, therefore it can perceive the same sensation.

Visceral peritoneum is supplied by the autonomic nervous system and is less able to localize sensation. Pain can either be described as a deep pain or a referred pain
peritonitis
Inflammation of the peritoneum. Peritonitis is associated with a loss of body fluid into the abdominal cavity.

Localization of Pain: Anywhere in the Abdominal Area
referred pain
Pain felt in an area of the body other than the area where the cause of pain is located
strangulation
Complete obstruction of blood circulation in a given organ as a result of compression or entrapment; an emergency situation causing death of tissue
uremia
severe kidney failure resulting in the buildup of waste products within the blood. Eventually brain functions will be impaired
urinary tract infection (UTI)
An infection, usually of the lower urinary tract (urethra and bladder) that occurs when normal flora bacteria enter the urethra and grow.
Stomach
main organ of the digestive system. most digestion takes place in the stomach where gastric juices break the food down into a form that can be used by the body
Intestines
small intestine and large intestine (colon)
Spleen
Part of the lymphatic system. It assists in the filtration of blood, aids in the development of red blood cells and serves as a blood reservoir. The spleen also produces antibodies
Liver
The liver secretes bile which aides in the digestion of fats.

Liver filters toxic substances of digestion, creates glucose stores and produces substances necessary for blood clotting and immune function.
Gall Bladder
Acts as a reservoir for bile
Pancreas
Creates amylase which is resonsible for breaking down starches into sugars
Kidney
Play a role in regulation of acidity and blood pressure. The kidneys rid the body of toxic waste.
What is the technique for physical exam of the abdomen?
1. ADVISE the patient of the assessment actions prior to performing the examination.
2. INSPECTION - Look for abnormalities, listen to bowel sounds.

3. PALPATION - Place the patient in a supine position with the legs drawn up and flexed at the knees. Ask patient where the pain is most intense and palpate that area last. Look for pain with light palpitation or rebound tenderness. Palpate in a clockwise direction. Note whether the pain is localized or diffuse.
Normal findings for GI Exam
Soft/non Tender
Abnormal GI findings
C. Abnormal Findings
1. Nausea/vomiting
a. Excessive
b. Hematemesis - vomiting of blood.
2. Change in bowel habits/stool
a. Constipation
b. Diarrhea
c. Dark tarry stool
3. Urination
a. Pain
b. Frequency
c. Color
d. Odor
4. Weight Loss
5. Belching/flatulence
6. Concurrent Chest Pain - cardiac event can be perceived as abdominal pain
7. Pain, tenderness, guarding, distension
General Management for Patients With an Acute Abdomen
A. Scene Safety and Standard Precautions
B. Airway, Ventilatory, and Circulation - check pulses in both arms as a difference may be caused by AAA
C. Position - (place in a position of comfort)
D. Provide Emotional Support
Ulcerative Diseases
PUD - Peptic ulcer disease, the protective layer is eroded allowing the acid to eat into the organ. Most ulcers are the result of infection with Helicobacter pylori (HELL-uh-koh-BAK-tur py-LOH-ree)

Chronic use of NSAIDs - nonsteroidal anti-inflamatory drugs can cause this too.

Pain is referred to upper mid abodmen or upper part of the back
Pediatrics Differences
A. Anatomic and Physiologic Differences in Children
B. Pathophysiology
C. Assessment
1. History
2. Physical findings
a. Vomiting causes dehydration
b. Appendicitis common in children
c. Abdominal pain from constipation
d. Vomiting
e. GI Bleeding
3. Management

Pediatrics -- vomiting/diarrhea can cause shock
Geriatric
1. May not exhibit rigidity or guarding
2. Abdominal pain related to cardiac conditions (abdominal pain may be related to heart attack)
Communication and Documentation for Patients With an Abdominal or Gastrointestinal
Condition or Emergency
Contact medical control with a radio report. many hospitals require additional personnel and a separate treatment area. Include a thorough description of the NOI and the position the patient was found in. Include treatments performed and the patient response. Be sure to document the patient's distress, answers to your questions and any changes in patient status and time. Document the reasoning for your treatment and the patient's response.
Transport Decisions
If the patient has an airway or breathing problem, signs and symptoms of bleeding, or other life threats, treat the patient immediately and transport, performing the secondary assessment en route to the hospital
Gastrointestinal Bleeding (Causes, Assessment findings and symptoms, Management)
1. Causes - This is a symptom of another disease, not the disease itself.

2. Assessment findings and symptoms
a. Bloody vomit (color is red or looks like coffee grounds)
b. Blood in stool (color is red or black)
c. Signs of shock (pallor/diaphoresis)

3. Management
a Standard precautions
b. Airway –
c. suction if needed
d. Oxygenation/ventilation
i. administer oxygen
ii. assist with ventilation if indicated
e. Position - elevate patients legs 6 to 12 inches by placing a pillow or blanket underneath the knees and lower legs.
History taking for GI emergencies
Nausea and vomiting - Do you feel nauseous? Have you vomited? How many times? Over what period of time? Was there red blood? Did it look like coffee Grounds?

Changes in bowel habits - Has there been any change in your bowel habits? Have you been constipated? Did the stool look dark and tarry? Have you had diarrhea was there any red blood in it?

Urination. Have you been urinating more or less often? Is there pain when you urinate? Is the color dark or unusual? Is there an unusual odor?

Weight loss. Have you lost weitght recently? How many pounds?

Belching or flatulence. Have you experienced belching or flatulence? For how long?

Pain. What does the pain feel like? How long have you had this pain? Is the pain constant or intermittent?

Other. Are there any other changes you have noticed that may be contributing to your pain?

If the patient reports chest pain do OPQRST (onset, provocation/palliation, quality, region/radiation, severity and timmig of pain)
Localization of Pain for an Abdominal Aortic Aneurysm (ruptured or dissecting)
Localizing of Pain: Low part of back and lower quadrants
Localization of Pain for a Kidney Infection
Localization of pain: Costovertebral Angle

The costovertebral angle is the angle formed between the twelfth rib and the vertebral column.
localization of pain for pneumonia
Localization of Pain: Referred pain to the upper abdomen
Esophageal Varices
This occurs when the amount of pressure within the blood vessels surrounding the esophagus increases.

Alcohol use is the main cause in developed countries and hepatitis is the main cause in developing countries.
Mallory-Weiss Syndrome
In this syndrome the junction between the stomach and the esophagus tears.