NURS612 EXAM3 NEW UPDATE LATEST 2023/2024 QUESTIONS AND CORRECT ANSWERS KEY POINT TO REVIEW
1 view 0 purchase
Course
NUR612
Institution
NUR612
Key Point to Review
-
Abdomen STUDENT NOTES
What are examples of appropriate history of present illness (HPI) questions you may ask a patient with a
chief complaint
of an abdominal issue? • Onset and duration: when it began; sudden or gradual; persistent, recurrent, intermitte...
What are • Onset and duration: when it began; sudden or gradual; persistent, recur
examples of intermittent
appropriate
history of • Character: dull, sharp, burning, gnawing, stabbing, cramping, aching, co
present illness • Location: of onset, change in location over time, radiating to another ar
(HPI) questions deep
you may ask a
patient with a • Associated symptoms: vomiting, diarrhea, constipation, passage of flatu
chief jaundice, change in abdominal girth, weight loss or weight gain
complaint
• Relationship to: menstrual cycle, abnormal menses, intercourse, urinatio
of an inspiration, change in body position, food or alcohol intake, stress, time of day, t
abdominal
• Recent stool characteristics: color, consistency, odor, frequency
issue?
• Urinary characteristics: frequency, color, volume congruent with fluid in
stream, ease of starting stream, ability to empty bladder
• Medications: high doses of aspirin, steroids, nonsteroidal anti-inflamma
(NSAIDs)
Describe how Proper steps to examine abdomen: inspection, auscultation, percussion, and palpation
you would
inspect the
abdomen. Using tangential lighting, inspect the abdomen for 4 surface characteristics
1. Observe the skin color. It may vary greatly but should have no jaundice,
redness, bruises, or discoloration
2. Check for nodules and other lesions, which should not be present
3. Note any scars and draw their location, configuration, and relative size o
of the abdomen
4. Assess the venous return. Above the umbilicus, venous return should be
Below the umbilicus, it should be toward the feet
Inspect the abdominal contour and symmetry
• The contour is the abdominal profile from the rib margin to the pubis. It
flat, rounded, or scaphoid. The umbilicus should be centrally located and may be
,Key Point to STUDENT NOTES
Review
-
Abdomen
3. Note any aortic pulsation in the upper midline. Although pulsation may be visible in a
marked pulsation suggest a disorder.
Abnormal:
• Jaundice or cyanosis
• Ascites: a glistening, taut appearance
• Redness may indicate inflammation
• Cullen sign: bluish periumbilical discoloration that may indicate intraabd
• Striae: result of weight gain or pregnancy
• GI diseases often produce skin changes: inspect for lesions or nodules
• Sister Mary Josephs’ nodule: a pearl-like, enlarged and sometimes painf
nodule can indicate abdominal malignancy
• Distension from umbilicus to pubic area may indicate ovarian tumor, pre
fibroids, or distended bladder
• Distension of upper half above umbilicus may indicate tumor pancreatic
dilation
• Asymmetric distension or protrusion may indicate hernia, tumor, cysts
• Incisional hernia: caused by defect in abdomen musculature that develo
incision
• Umbilical hernia: protrusion of naval
• Rippling movement across abdomen may indicate intestinal obstruction
• Abdomen aortic pulsation may indicate aneurysm
Why do you Auscultate before you percuss or palpate because these techniques can alter bowel soun
auscultate bowel sounds and note their frequency and character.
the
abdomen
before you
percuss or
palpate?
Describe how Using the diaphragm of a warmed stethoscope, listen for bowel sounds and note their fr
and where character
you auscultate
the abdomen.
What are the Expect to hear clicks and gurgles at a rate of 5 – 35 per minute.
three
additional
sounds you Note unexpected findings, such as increased or decreased bowel sounds or high-pitched
assess? What
is normal
,when you auscultate 3. Use the stethoscope bell to assess for a soft, continuous, low-pitched venous hum in the epigastric
the abdomen? What area and around the umbilicus
is abnormal?
Abnormal:
• Borborygmic: loud prolonged gurgles
• Increased bowel sounds: gastroenteritis, early obstruction, hunger
• High-pitched tinkling: intestinal fluid and air under pressure, early obstruction
• Absent bowel sounds for 5 minutes indicates abdominal pain and rigidity and is a
surgical emergency
Key Point STUDENT NOTES
to Review
, Describe Using light palpation, systematically assess all quadrants. But first, try to relax the abdominal muscles. For example
how you place a small pillow under the patient’s head and slightly flexed knees, warm your hands, take a slow and gentle
palpate approach, and save any tender areas for last.
the
abdomen.
What are Press in no more than 1 cm with the palmar surface of your fingers
you
assessing • Expect the abdomen to feel smooth and soft
when you • Note any resistance or tenderness. And watch for guarding, which should alert you to proceed with
perform caution
light,
moderate Using moderate palpation, systematically assess all quadrants in two ways.
and deep
palpation? 1. Palpate with the palmar surface of your fingers. This may elicit tenderness that was not produced b
What are light palpation
the normal
2. Palpate with the side of your hand throughout the respiratory cycle. As the patient inhales, you ma
and
feel the liver and spleen bump gently against your hand.
abnormal
findings?
What do
the Using deep palpation, systematically assess all quadrants with the palmar surface of your fingers. If a patient’s
abnormal obesity or muscular resistance make deep palpation difficult, try bimanual palpation with one hand on top of the
findings other. With either technique, feel for the rectus abdominis muscles, aorta, and portions of the colon. Note any
indicate as tenderness.
possible
differential
diagnoses? If you detect a mass, evaluate its location, size, shape, consistency, tenderness, pulsation, mobility, and movement
with respiration. To see if the mass is superficial or intraabdominal, palpate as the patient lifts his or her head off th
table. A superficial mass will remain palpable; an intraabdominal mass will not.
Palpate the umbilical ring and periumbilical area. The umbilical ring should feel round and regular. The area should
have no bulges, nodules, or granulation.
Light Palpation:
• Avoid problem spot areas
• Palpate all 4 quadrants or all 9 regions Moderate Palpation:
• Useful in assessing organs that move with respirations, liver, and spleen Deep Palpation:
• Useful to detect less obvious masses, may use bimanual with one hand on top of the other for obese
individuals
Key Point to Review STUDENT NOTES
-
Abdomen
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller brendawambui0309. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $20.39. You're not tied to anything after your purchase.
