Health Assessment, Abdomen/gi

Front 1

functions of GI system

Back 1

digestion
elimination
absorption
ingestion

Front 2

abdominal pain

Back 2

how long?
describe?
changed location?
affected by eating?
relief?
associated symptoms
women - menstrual cycle, pregnancy

Front 3

Specific areas of assessment of abdomen and GI system

Back 3

abdominal pain
N/V
Indigestion
Abdominal distension
Change in bowel habits
Jaundice
Problems with urination

Front 4

symptom analysis

Back 4

Includes location, quality, quantity, chronology, setting, associated manifestations, and aggravating and alleviating factors

Front 5

Family history of diseases of GI system

Back 5

GERD
peptic ulcer disease
stomach/colon cancer
crohns, ulcerative colitis

Front 6

family history of disease of urinary tract

Back 6

kidney stones
kidney/bladder cancer

Front 7

surface characteristics of abdomen

Back 7

Should be smooth, with centrally located umbilicus (Check for bulges)
Striae, scars, faint vascular network

Front 8

abnormal surface characteristics of abdomen

Back 8

Abnormal: Marked pulsations, visible peristalsis, Cullen’s sign (bluish discoloration periumbilical area), prominent dilated veins (hypertension)

Front 9

contour of abdomen

Back 9

scaphoid, rounded, distended

Front 10

7 F’s of abdominal distention

Back 10

Fat, fetus, fluid (ascites), flatulence, feces, fibroid tumor, or fatal tumor

Front 11

bowel sounds

Back 11

Normoactive, hypoactive, or hyperactive

Front 12

facilitate muscle relaxation for deep palpation

Back 12

breathe slowly through mouth

Front 13

abdominal percussion sounds

Back 13

Tympany
Dullness (liver, mass)
Hyperresonance (gas, extra air)

Front 14

Costovertebral Angle

Back 14

Indirect fist percussion (12th rib, use two hands)
Normal: feels thud
Abnormal: feels pain (indicates kidney inflammation)

Front 15

liver palpation size

Back 15

Liver span correlates with body size and gender (6-12 cm)
Lower border of liver should descend downward 0.75 to 1.25 inches (2 to 3 cm)

Front 16

what is GERD

Back 16

Reflux of acidic gastric contents into lower esophagus
Weakened lower esophageal pressure or increased intraabdominal pressure

Front 17

GERD risk factors

Back 17

Hiatal hernia
Pregnancy and obesity
Irritants
Decreased gastric motility
h. Pylori

Front 18

GERD manifestations

Back 18

Heart burn
Epigastric or chest pain (usually after meals or laying down)
Regurgitation
Dysphagia

Front 19

Esophageal Varices what and why

Back 19

Distended, tortuous collateral veins that develop from prolonged elevation of pressure
Dilated submucosal esophageal veins
Secondary to portal hypertension, alcoholism, post hepatitis cirrhosis

Front 20

esophageal varices manifestations

Back 20

Vomiting dark blood
Melena

Front 21

peptic ulcer disease, forms

Back 21

Deep erosion of the mucosa of the upper GI tract by gastric acid and pepsin
2 major forms of peptic ulcers
Duodenal
Gastric

Front 22

peptic ulcer disease risk factors

Back 22

h. pylori, chronic use of NSAIDs, smoking, family history, alcohol abuse, stress

Front 23

peptic ulcer clinical manifestations

Back 23

Iron deficiency anemia
Projectile vomiting
Epigastric pain/burning or chest pain
Nausea
Weight loss

Front 24

irritable bowel syndrome

Back 24

General term for inflammatory diseases of the bowel of uncertain causes

Front 25

ulcerative colitis

Back 25

Inflammation and damage of the mucosa and submucosa
Starts with involvement of the rectum ascending upward through the colon
r/t abnormal immune response in GI
can progress to colon cancer

Front 26

ulcerative colitis clinical manifestations

Back 26

GI bleeding—rectal bleeding
Anemia r/t loss of blood in stools
Diarrhea
Can be blood and mucousy
Weight loss and anorexia
Nausea and vomiting
Abdominal pain

Front 27

crohn disease what

Back 27

Inflammation of the GI tract extending through all layers of the intestinal wall
May affect multiple portions leaving unaffected segments between affected
Inflammation may occur from mouth to anus
Increased risk of colon cancer

Front 28

crohn disease risk factors/etiology

Back 28

Family history (20%), white race, Jewish ancestry, cigarette use
Most common between ages 20-40
Men and women affected equally
Unknown—Thought to be genetic and autoimmune

Front 29

crohn disease clinical manifestations

Back 29

Abdominal pain
Diarrhea
Fatigue
Weight loss
Nausea and vomiting

Front 30

appendicits

Back 30

Inflammation of the vermiform appendix

Front 31

appendicitis clinical manifestations

Back 31

Abdominal pain—RLQ, can radiate to periumbilical
Fever
N/V
Elevated WBC
CT scan—diagnostic
Appendectomy
Antibiotics

Front 32

diverticular disease

Back 32

Diverticulosis: Outpouchings in the wall of the colon
Herniations of the mucosa and submucosa through the colon
Most common in over 60 years of age

Front 33

diverticular disease manifestations

Back 33

Abdominal pain—often LLQ
Fever
Tachycardia
Constipation
Elevated WBC

Front 34

intestinal obstruction - what/types

Back 34

Partial or complete blockage of the intestinal lumen of the small (90%) or large bowel
Mechanical
Caused by condition that hinders patency of bowel lumen
Functional
Caused by neurogenic or muscular impairment that hinders peristalsis

Front 35

intestinal obstruction clinical manifestations

Back 35

Abdominal pain
Vomiting (constipation – not much coming out)
Dehydration
Electrolyte depletion
Abdominal distention

Front 36

celiac disease

Back 36

Intolerance of gluten that causes bowel inflammation and malabsorption

Front 37

celiac disease clinical manifestations

Back 37

Diarrhea
Steatorrhea
N/V
Abdominal pain
Increases appetite without weight gain
Malnutrition
Immune disorder?

Front 38

celiac disease - what

Back 38

Intolerance of gluten that causes bowel inflammation and malabsorption

Front 39

celiac disease clinical manifestations

Back 39

Diarrhea
Steatorrhea
N/V
Abdominal pain
Increases appetite without weight gain
Malnutrition
Immune disorder?

Front 40

colon cancer - what, risk factors

Back 40

Primary malignant neoplasm of the colon
Risk Factors/Etiology
older age, family history, high fat diet, low-fiber diet, adenomatous polyps, ulcerative colitis, crohn disease
Cause is unknown

Front 41

colon cancer clinical manifestations

Back 41

Black, tarry stools
Obstruction
Abdominal pain/cramping
Change in caliber of stool
Change in bowel habits

Front 42

Acute Cholecystitis - what, risk factors

Back 42

Acute inflammation of the gallbladder

Etiology
Risk Factors:
Cholelithiasis (gallstones) often present (90%)

Front 43

Acute Cholecystitis - Clinical Manifestations

Back 43

Nausea, vomiting
Fever, Leukocystosis
Elevated LFT’s
RUQ abd pain and epigastric pain
Heart burn
Jaundice (blockage of duct causes)
Feels like heart attack
Triggers: fatty foods, spicy foods

Front 44

Acute Pancreatitis - what, risk factors

Back 44

Inflammation of the pancreas
Flow of pancreatic digestive enzymes into duodenum obstructed
Etiology/Pathophsyiology
Causes: Excess alcohol intake, biliary obstruction (gallstones), high trig levels, hypercalcemia, infections

Front 45

acute pancreatitis - clinical manifestations

Back 45

Epigastric or LUQ pain often radiates to back
Nausea and vomiting
Decreased bowel sounds, abdominal distention
Fever
Clients prefer fetal position with knees to chest
Tachycardia, hypotension
Severe cases—shock, respiratory insufficiency

Front 46

viral hepatitis - what, etiology

Back 46

Inflammation of the liver
Etiology:
Viral
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D

Front 47

viral hepatitis - clinical manifestations

Back 47

Jaundice, anorexia, fatigue, fever, vomiting, diffuse abdominal discomfort, hepatosplenomegaly, dark urine, clay-colored stools (elevated bilirubin), elevated liver enzymes, elevated bilirubin

Front 48

cirrhosis - what, causes

Back 48

Chronic degenerative liver disease
Causes include:
viral hepatits
biliary obstruction
alcohol abuse

Front 49

cirrhosis - clinical findings

Back 49

Liver becomes palpable and hard
Associated signs: ascites, jaundice, cutaneous spider angiomas, dark urine, clay-colored stools, and spleen enlargement
End-stage cirrhosis is hepatic encephalopathy and coma

Front 50

UTI - areas, causes

Back 50

Urinary bladder (cystitis)
Urethra (urethritis)
Renal pelvis (pyelonephritis)
Most urinary tract infections (UTIs) result from gram-negative organisms such as Escherichia coli, Klebsiella, Proteus, or Pseudomonas

Front 51

UTI clinical findings

Back 51

Symptoms of urethritis include:
Frequency, urgency, and dysuria
Symptoms of cystitis include:
Above plus signs of bacteriuria and perhaps fever
Clients with pyelonephritis complain of:
Flank pain, dysuria, nocturia, and frequency, fever
Confusion in elderly, CVA, hematuria

Front 52

Nephrolithiasis - what

Back 52

Formation of stones in kidney pelvis
Calculi (Stones) compose of:
Calcium salts, uric acid, cystine, or struvite

Front 53

Nephrolithiasis - clinical findings

Back 53

Fever
Hematuria
Flank pain that may radiate to groin and genitals - acute