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Terms in this set [112]
no specific cause identified, but risk factors include increased age, history of Adenoma's, high red-meat diet, high fat and low fiber diet, smoking, alcohol consumption, obesity, first degree relatives, inflammatory bowel disease, crohn's disease
change in bowel habits, abdominal pain, pressure, or cramping, iron deficiency anemia due to blood loss, weakness, weight loss, rectal pressure and/or bleeding, mass in RLQ, rectal bleeding, pain, blood in stools, change in bowel habits, alternating constipation and diarrhea, nausea and vomiting
What's the first thing you must ask the patient before starting the assessment?
urinate or eliminate waste first
Where must you drape the clothing to examine the stomach?
Drape client at xiphoid process and symphsis publis to expose abdomen.
Then make sure the client is comfortable in a supine position with knees flexed over a pillow or position client so that the arms are either folded across the chest or at sides to ensure abdominal relaxation.
Where must you be to perform you assessment with the patient?
Stand to the right side of client for exam.*******
Have your client point to the areas that bothers them.
use the two handed "sandwich" technique for ticklish patients
Abdominal order of the assessment:
Inspection
Auscultation
Percussion
Palpation
What do you perform auscultation initially for abdominal assessment?
performed second because palpation and percussion could alter bowel sounds.
Abdominal inspection and landmarks
Notice that the abdominal is broken down into 4 main areas:
RLQ
RUQ
LUQ
LLQ
or
Epigastric, Umbilical, and Hypogastric or Supraublic
Abdominal Inspection: What are you observing?
Observe the coloration of the skin.
Note the vascularity of the skin: scattered fine views, dilated superficial capillaries.
Note stiae [stretch marks]
Inspect for scares
Observe umbilical location: midline at later line
What for peristaltic waves, normally not seen, although ay be seen in very thin people as slight ripple.
Abdominal Inspection: Contour
Normal abdomen is:
Flate or rounded
Abnormal abdomen is:
Scaphoid or protuberant.
Auscultate for bowel sounds--the process
place the diaphragm lightly on abdominal wall beginning in the RLQ.
Note intensity, pitch and frequency of bowel sounds
Listen for 1 min in an abdominal quadrant before concluding that bowel sounds are absent [5 mins total!!]
Auscultate for Bowel Sounds
Normal: a series of intermittent, soft clicking or gurgles heard at a rate of 5-30/min
Hyperactive: >2-3 sounds or >30 loud, prolonged gurgles charactersitic of stomach growling [Borboygymi]
Hypoactive: indicate decreased motility of the bowels [ sharp pain in area of inflammation
Ilipsoas Muscle test
R/O appendicitis
Tests for Appendicitis
Rebound tenderness
McBurney's sign
Illiopsoas Muscles Test
Obturator Muscular Test
When is the best time to measure abdominal girt?
Measure abdominal girth at same time each day. Ideally in the morning just after voiding.
Ideal position is patient standing. Otherwise client should be in supine position.
Place take measure behind client and measure and umbilicus.
What is happening the abdomen of the older adult
Esophageal emptying is delayed increased risk for aspiration
Abdominal musculature loses much of its tone
Increased fat deposition in abdominal area.
Gastric acid decreases which may interfere with vitamin B12 absorption
Mucosal lining of GI tract becomes less elastic, and changes in gastric motility result in alterations in digestion and absorption.
Blood flow through the liver is decreased by 55% which can impair drug metabolism.
Increased complains of gas or constipation
Increased incidence of GI malignancy. Intestines subject to ischemia related to atherosclerosis.