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41 Cards in this Set
- Front
- Back
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Where, and with what do you assess bowel sounds? What is normal? |
Assess in all 4 quadrants. Use the diaphragm of the stethoscope. Normal: Active bowel sounds every 5-20 seconds. Abnormal: Hypoactive (1/minute), Hyperactive/Borborygmi (every 3 seconds), Absence of bowel sounds. |
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Where, and with what do you assess vascular sounds? |
Use the bell of the stethoscope. refer to text for landmarking. Normal: No sounds/bruits. May hear aortic pulse in epigastric area in quite thin individuals. Abnormal: You hear the pulse. |
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Peritoneal friction rub - what is it, and where can you hear it? |
All areas of the peritoneum, especially over the liver/splenic areas. Use the diaphragm of the stethoscope. You should not hear it at all! |
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Where can you find the stomach, liver, spleen, and bladder? |
Stomach: LUQ, left hypocondriac. Liver - RUQ, LUQ (most on the right), R Hypocondriac. Spleen - R Hypocondriac Bladder - Hypogastric, behind symphis pubis. |
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How will you do abdominal percussions? Whats normal? |
Indirectly. Follow a pattern from LLQ, up and around, finishing in RLQ. Why? That's how feces travels through the intestines, and it can help locate blockages. Normal: Tympany over bowels/stomach, Dullness over liver/spleen/full bladder. Abnormal - large dull areas (tumours, fluid). |
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What factors impact normal bowel functions? |
Development Diet - bulk, fibre (25-35g/day) Fluids (1500-3000ml) Activity Psychological Factors Defecation Habits Medications/Pain (opiod constipation, not wanting to go due to pain) Diagnostic Procedures Surgery/anesthesia Positioning Pathological Conditions Hormones |
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What will you inquire about with Mrs. Brown, a 78 year old, prior to conducting an abdominal assessment? |
Abdominal pain (onset, location, sequence, frequency, associated symptoms) Constipation, diarrhea - what does this mean to them? Foods in the last 24H. Change in appetite and food intolerance? Specific S&S - flatus, eructation, hemoemetis, blood/mucous in the stools) Previous problems Diagnostic procedures |
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What are characteristics of normal feces? |
Colour: Brown (adults), more yellow (kids), varies (babies) Consistency: formed, soft, semisolid, moist Shape: Cylindrical, around 2.5cm in adults Amount: varies 100g-400g a day Odour: Aromatic, affected by ingested food and bacterial flora. Constituents: small amounts of roughage, sloughed dead bacteria, fat, protein, inorganic matter. |
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Abnormal stool colours associated with blood |
Frank Red - undigested blood = bleed distal in the digestive process. Tarry black - (maleena) = bleed higher in the digestive tract Coffee ground stool = bleed before/in the stomach that is digested. |
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What level of the abdomen do you measure abdominal girth? |
The level of the umbilicus |
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Why don't we assess "IPPA" with the stomach? |
Palpating before auscultating can increase bowel motility and cause false positive results. |
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What type of palpation is used when assessing the abdomen? Why? |
Light palpation - down 1 cm. Deep palpation can cause damage. |
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Lifespan considerations for infants? |
Umbilical hernias may be palpable at birth Liver is 1-2cm below the right costal margin. Organs are proportionally larger |
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Lifespan considerations for children? |
May look pot-bellied Peristaltic waves are more visible Children may not be able to pin-point pain Children may have very light urine. Liver is still proportionally larger - 1-2cm below R costal margin. |
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Lifespan considerations for older adults? |
Rounded stomach due to increase in fat and decrease in muscle tone. Abdominal wall is slacker and thinner GI pain and heart pain may be hard to differentiate, but you must do it. Stool passes slower. Incontinence may occur. Colon cancer is an increased risk. |
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What factors impact normal urinary function? |
Medications Fluid intake Environment - problems with toileting, public "pee shyness" Longterm catheters Stress Disease of the heart, diabetes, prostate cancers, etc. Diagnostic procedures Beets may change colour, asparagus may change odour, hormones and vitamins may alter it. |
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What are normal characteristics for urine? |
1200-1500 ml/24 hours Straw-amber colour, translucent Faint aroma - not acidic, pungent, abnormally sweet No glucose, blood, ketone bodies |
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What urinary output amount indicates low blood volume or kidney function and must be reported immediately? |
Oligouria of 30ml/hr or less. |
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Hypoactive bowel sounds |
Extremely soft and infrequent sounds, around 1/minute |
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Hyperactive bowel sounds |
high pitched, loud, rushing sounds, every 3 seconds |
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True absence of bowel sounds |
No sounds heard for 3-5 minutes |
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Feces |
excreted waste products |
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defecation |
the process of pushing feces from the anus |
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constipation |
less than 3 bowel movements a week, passage of small, dry stools |
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chyme |
partly digested food, from stomach to the intestines |
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flatus |
"passing gas" mostly air and byproducts of card digestion |
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Eructation |
belcing sound of expulsed gasses thru the mouth |
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fecal incontinence |
loss of voluntary ability to hold and control feces/gaseous discharge |
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micturition/voiding/urination |
process of emptying the urinary bladder |
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urinary retention |
accumulation of urine in the bladder, and the inability of the bladder to empty itself |
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urinary incontinence |
the inability to hold urine by the external sphincter |
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oligouria |
low urine output less than 500ml/day or 30ml/hour |
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anuria |
no urine production |
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polyuria |
abnormally large amounts of urine 3+ litres/day |
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Urinary frequency |
voiding at frequent intervals (more than 6 times a day) |
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Nocturia |
awakening at night to urinate (more than twice a night) |
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Dysuria |
painful/difficult urination |
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enuresis |
discrete episodes of urinary incontinence |
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nocturnal enuresis |
urinary incontinence during sleep in kids 5 years and older. |
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urinary urgency |
sudden, strong desire to urinate |
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hemorrhoid |
distended veins in the rectum |
