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28 Cards in this Set
- Front
- Back
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examination sequence |
inspection, auscultation, percussion, palpation |
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liver |
starts around 5 intercostal space on right and goes to costal margin or 2 inches below. |
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spleen |
6-10 intercostal space in anterior axillary line on the left side |
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kidneys |
right kidney is lower than left. small of back |
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region 1, 2, 3, |
epigastric (between ribs) umbilical (belly button) suprapubic (beneath belly button) |
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adhesions |
buildup of scar tissue on inside of abdomen (from surgery, months/ years later adhesions develop) eventually causes partial or total obstruction in alimentary tract. |
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5 F's |
for distention fat, fluid, feces, flatus, full bladder |
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eccymosis, petechiae |
petechiae is a small bruise, micro hemorrhage (platelet deficiency) eccymosis is a bruise, slightly redder |
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flat, scaphoid, rounded, protuberant |
flat is normal, scaphoid is in an emaciated patient where abdomen is concave, rounded is an adult with poor muscle tone or more subcutaneous tissue, also seen in young children protuberant abdomen is excessively rounded (pregnant, starvation, abdominal fluid buildup (ascities)) |
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ascities |
accumulation of serous fluid in peritoneal cavity liver cirrhosis, cancer, peritoneum infection, electrolyte imbalance can see vascular tissue because of fluid pushing against vessels may also look slightly jaundiced. umbilicus is flattened, may be bulging in places |
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increased bowel sounds |
more than 35 per minute hungry, gastroenteritis, early bowel obstruction and body trying to push through the obstruction |
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decreased bowel sounds |
peritonitis hypoactive bowel sounds (less than 5 per minute) peritoneal cavity is inflamed |
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absent bowel sounds |
paralytic ileus bowel is paralyzed emergency need nasogastric tube need to listen in lower right quadrant |
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borborygmi |
hunger sounds loud prolonged gurgles heard with hunger or increased GI motility |
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bruit |
a blowing, whistling sound produced by blood moving through a narrow vessel aneurysm use the bell to auscultate because they are low pitched |
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costavertebral angle tenderness (CVA) |
use blunt percussion kidney inflammation kidney swings back and forth in retroperitoneal space patient should feel pain, but if it hurts than kidney is inflammed. |
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factors affecting nutrition |
illiteracy, gender, health, alcohol abuse, medication/ supplements, economic factors, religion/ culture, meaning of food, language barriers, knowledge of nutrition, lack of caregiver/ social support, social isolation |
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what can you do to stimulate someone's appetite |
take care of personal needs and environment, bring them to the bathroom before lunch/ dinner/ breakfast, they can brush their teeth and wash their hands, brushing teeth helps to stimulate appetite make sure they sit afterwards or in high fowlers to make them feel like they are eating normally clear off bedside table make sure glasses and hearing aids are in |
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urinary output |
about 1500ml per day vomitting, diarrhea, drainage from wound are all outputs of fluid |
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1 oz |
= 30 ml |
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fluid restriction |
number of fluids is limited. need it at pills and before bed spread across 24 hours thirsty and want you to give them more to drink brushing teeth and swishing water around can help sugar candy doesn't help, but sugar free hard candy works chewing gum doesn't really help unless sugar free ice chips are good swabs, (lemonglycerine swabs) if you put them in ice cold swabs are more soothing with the feelings of thirst |
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liquid diets |
clear liquid (at room temperature it is transparent, jello, fat free beef broth, clear juices (cranberry, apple juice, soda, coffee, tea (without milk or cream), popsickles, honey, hard candy), sugar is okay), full liquids (ice cream, not transparent) (liquid but opaque, need easy to digest foods, puddings, custard, eggs, hot cereals)(can also have all the foods on a clear liquid diet) |
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regular diet |
house diet, DAT (diet as tolerated), patient can have whatever they want to eat. pureed or mechanical soft diet |
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skin turgor exam |
pinch skin and see how long it takes to go back to normal elasticity sites: under clavicle, sternum |
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24 hour recall |
patient tells you what they ate the last 24 hours |
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DETERMINE |
disease, eating poorly, tooth loss/ mouth pain, economic hardship, reduced social contact, multiple medicines, involuntary weight gain/ loss, needs assistance in self care, elder (over 80) |
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dysphagia |
difficulty or inability to swallow |
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aspiration |
gastric contents misdirected into trachea |
