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NURS 6512 AdvANced HeAltH
ASSeSSmeNt – lAb ASSigNmeNt:
ASSeSSiNg tHe AbdomeN (2025) |
FUlly completed ANd veRiFied A+
gRAded SUbmiSSioN witH
compReHeNSive SUbjective &
objective FiNdiNgS, cliNicAl
ReASoNiNg, ANd SoAp NoteS QUeStioNS
ANd veRiFied ANSweRS.
colon - -- <> ---major component of the large intestine which is divided into 4 parts (ascending, transverse, descending, and sigmoid) esophogus - -- <> ---tube that transports food from the pharynx to the stomach gallbladder - -- <> ---small, saclike structure that stores bile produced by the liver
gums - -- <> ---pale pink tissues attached to jaw bones and teeth, provides supporting structure for the mouth large intestine - -- <> ---approx 5 foot canal extending from the ileum to the anus liver - -- <> ---organ that produce bile for the digestion of fats; performs many other functions that support digestion and metabolism mouth - -- <> ---opening through which food passes into the body; breaks food into small particles by mastication (chewing) and mixing with saliva pancreas - -- <> ---organ that secretes multiple enzymes necessary for digestion; also secretes insulin for carbohydrate metabolism pharynx - -- <> ---performs swallowing action that passes food from the mouth into the esophogus rectum - -- <> ---last part of the large intestine connecting to the anus sigmoid colon - -- <> ---S-shaped section of the large intestine leading into the rectum small intestine - -- <> ---20 foot tube extending from the stomach to the large intestine where most of the nutrients are absorbed; has three sections: duodenum, jejunum, ileum
enter/o - -- <> ---intestines (the small intestine) esophag/o - -- <> ---esophogus gastr/o - -- <> ---stomach gingiv/o - -- <> ---gums gloss/o, lingu/o - -- <> ---tongue hepat/o - -- <> ---liver ile/o - -- <> ---ileum jejun/o - -- <> ---jejenum or/o - -- <> ---mouth pancreat/o - -- <> ---pancreas peps/o - -- <> ---digestion phag/o - -- <> ---swallowing, eating
proct/o, rect/o - -- <> ---rectum sigmoid/o - -- <> ---sigmoid colon algia - -- <> ---pain cyst/o - -- <> ---bladder, sac lith/o - -- <> ---stones, calculus cele - -- <> ---hernia, protrusion centesis - -- <> ---surgical puncture to remove fluid ia - -- <> ---diseased state, condition of iasis - -- <> ---condition itis - -- <> ---inflammation megaly - -- <> ---enlargement
gastric - -- <> ---pertaining to the stomach gastritis - -- <> ---inflammation of the stomach gastroenteritis - -- <> ---inflammation of the stomach and intestines gasteroenterologist - -- <> ---physician who studies and treats diseases of the stomach and intestines gastroenterology - -- <> ---study of the stomach and intestines gastroesophageal - -- <> ---pertaining to the stomach and esophagus gastroscope - -- <> ---instrument used for visual examination of the stomach gastroscopy - -- <> ---visual examination of the stomach gastrostomy - -- <> ---creation of an artificial opening into the stomach gingivalgia - -- <> ---gum pain gingivitis - -- <> ---inflammation of the gums
glossitis - -- <> ---inflammation of the tongue laparotomy - -- <> ---incision into the abdomen appendectomy - -- <> ---excision of the appendix appendicitis - -- <> ---inflammation of the appendix cholecystectomy - -- <> ---excision of the gallbladder cholecystisis - -- <> ---inflammation of the gallbladder cholelithiasis - -- <> ---condition of gallstones colectomy - -- <> ---excision of the colon colitis - -- <> ---inflammation of the colon colonoscopy - -- <> ---visual examination of the colon colostomy - -- <> ---creation of an artificial opening into the colon CT colonography - -- <> ---radiographic imaging of the colon
rectal - -- <> ---pertaining to the rectum rectocele - -- <> ---hernia of the rectum sigmoidoscopy - -- <> ---visual examination of the sigmoid colon, the rectum, and the anal canal bariatric surgery - -- <> ---surgical reduction of gastric capacity to treat morbit obesity barium enema - -- <> ---diagnostic procedure in which a series of radiographic images are taken of the large intestine after the rectal administration of the contrast agent barium cirrhosis - -- <> ---chronic disease of the liver with gradual destruction of cells and formation of scar tissue, commonly caused by alcoholism and certain types of viral hepatitis crohn disease - -- <> ---chronic inflammation of the intestinal tract usually affeting the ileum and colon endoscopic retrograde cholangiopancreatography (ERCP) - -- <> --- endoscopic procedure involving radiographic imaging of the biliary ducts and pancreatic ducts
gastroesophageal reflux disease - -- <> ---disorder characterized by the abnormal backward flow of the gastrointestinal contents in the esophogus parenteral - -- <> ---pertaining to treatment other than through the digestive system peptic ulcer - -- <> ---erosion of mucus membrane of stomach or duodeunum associated with increased secretion of acid from the stomach, bacterial infection, or use of nonsteroidal antiinflmatory drugs polyp - -- <> ---tumorlike growth extending outward from a mucous membrane stoma - -- <> ---surgical opening between an organ and the surface of the body ulcerative colitis - -- <> ---inflammation of the colon What are the major organs in the abdomen? - Liver, stomach, small intestine, and large intestine What organs/structures are in the deep abdomen? - - Kidneys, ureters, uterus,
- Aorta and inferior vena cava How many quadrants is the abdomen split in to? - - Four quadrants
What organs are in the left lower quadrant? - - Part of descending colon, sigmoid colon, eft ovary and tube, left ureter, left spermatic cord What organs are found midline in the body? - - Aorta, Uterus, Bladder What questions should be asked about appetite? - - Any changes in appetite?
- Weight changes? In what period of time? Anorexia: a loss of appetite from a side effect of some meds, pregnancy or mental health disorder What questions should be asked about dysphagia? - - Do you have any difficulty swallowing?
- When did you first notice? Do you have pain with swallowing? It it worse with liquids vs solids? Dysphagia: occurs with a disorder of the throat or esophagus ie; thrush, neurological changes (stroke), or an obstruction (mass/tumor) What questions should be asked for food intolerance? - - What foods can you not eat? What happens if you do? Do you experience an allergic reaction, heartburn, belching, bloating or indigestion?
- Do you use antacids commonly? how often?
Pyrosis: AKA heartburn which is a burning sensation caused by gastric acid being refluxed into the esophagus What questions should be asked about abdominal pain? - - Have the client point to the pain, if they have it
- Is the pain in one spot or does it move around? How did it start? How long have you had it?
- Is the pain constant or does it come and go?
- When does it occur most commonly?
- Is the pain cramping, burning, dull, stabbing or aching? Visceral: from an internal organ; dull, general, poorly localized Parietal: caused by inflammation of the peritoneum; sharp, precisely localized, aggravated by movement Referred: from a disorder in another site; occurs with appendicitis, cholecystitis, bowel obstruction, diverticulitis, vascular occlusion or perforated organ Common pain of gastric ulcers - - occurs on an empty stomach Common pain of duodenal ulcers - - occurs 2-3 hours after a meal
- relieved by more food
- Ulcer can occurs from excessive use of NSAIDS, alcohol, smoking, and Helicobacter pylori infection Nutritional assessment questions - - Tell me the foods you ate yesterday, starting with breakfast.
- Which fresh markets are located in your neighborhood? Aging adult questions:
- How do you acquire your groceries and prepare you meals?
- Do you eat alone or do you share meals with others? inspection of abdomen: contour and symmetry - Contour:
- stand on the person's right side; look down the abdomen
- then stoop or sit to gaze across the abdomen Symmetry:
- Shine a light across the abdomen toward you, or shine it lengthwise across the person
- abdomen should be symmetric bilaterally
- Note any bulges or masses that are seen Inspection of the abdomen: umbilicus and skin - Umbilicus:
- midline and inverted; with no sign of discoloration, inflammation, or hernia
- belly button piercings should not be red or crusted Skin:
- should be smooth and even; no discoloration, should be homogeneous
- good skin turgor reflects healthy nutrition and hydration; gently pinch up a fold of skin and release to note the skins immediate return; no tenting should occur Common skin lesions or structures on the abdomen - Striae: AKA stretch marks
- silvery white; linear
- can be purple if newer Pigmented nevi: AKA moles
- circumscribed brown macular or papular areas
- use ABCDE method to assess moles
- Note any scars; their location and size in cm Inspection of the abdomen: pulsation/movement and hair distribution - Pulsation/movement:
- may see aortic pulsation beneath the skin in the epigastric region
- note abdominal respirations especially in men Hair distribution:
- pubic growth is a diamond in males and inverted triangle in females
- bloating/gas, not passing gas or stool, water diarrhea, abdominal distention, anorexia, N/V, absent bowel sounds Auscultation of vascular sounds - - listen for bruits over aorta, renal arteries, iliac, and femoral arteries
- usually no sound is present
- requires firmer pressure
- important to check in patients with hypertension What is percussion used for? - - used to test for abdominal fluid or masses
- masses will have a dull sound; along with distended bladder or adipose tissue
- normal sound is tympany
- hyperrsonant sounds occur in clients with a lot of gas build up Liver span, splenic dullness, and bladder percussion - - Not recommended anymore
- bladder scan is more accurate
- palpation of the liver and spleen is more accurate How to test for Costovertebral angle tenderness - - used to look for kidney infections; like pyelonephritis
- put fist against person's back over 12th rib; at CV angle
- Hit the hand to vibrate the tissue
- normally should not hurt; if sharp pain is caused then it may indicate a kidney infection
Special procedures: Ascites - - Ascites: free fluid in the peritoneal cavity; caused by HF, portal hypertension, hepatitis, cirrhosis, pancreatitis, and cancer
- Symptoms: distended abdomen, bulging flanks, and a protruding umbilicus that is displaced downward Tests:
- differentiate from gaseous distention with two tests; fluid wave tests and shifting dullness test
- Always check the legs for edema as well Fluid wave test - - stand on clients right side and have them place their hand ulnar edge down firmly on their midline
- place your hand on right flank and give the left flank a firm strike
- if ascites is present you will feel a fluid wave in your right hand
- is distended due to adipose tissue or gas there will be no change Shifting dullness - - have client lay supine and percuss the top of the abdomen
- then move from the top to the sides of the abdomen and listen for tympani
- note when the tympani changes to dullness
- mark the level where you hear the dullness Light palpation technique - - use the first four fingers; depress the skin about 1 cm
