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N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
N 295 lecture 11   abdominal student copy
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N 295 lecture 11 abdominal student copy

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  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams 5 to 32 normal frequency
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • N252 Abdominal Assessment Prof. Adams
  • Transcript

    • 1. ABDOMINAL ASSESSMENT spring 2012
    • 2. History - Subjective Data <ul><li>Abdominal pain </li></ul><ul><li>Appetite </li></ul><ul><li>Food intolerances </li></ul><ul><li>Dietary problems </li></ul><ul><li>Weight change </li></ul><ul><li>Dysphagia </li></ul><ul><li>Flatulence, belching </li></ul><ul><li>Bloody emesis (hematemesis) </li></ul><ul><li>Black tarry stools (melena), </li></ul><ul><li>Heartburn, diarrhea, constipation </li></ul><ul><li>Cramping </li></ul>spring 2012
    • 3. History - Subjective Data <ul><li>Bowel habits, stool character </li></ul><ul><li>Medication Hx including OTC </li></ul><ul><li>Nausea and Vomiting </li></ul><ul><li>Changes in micturation: </li></ul><ul><ul><li>Amount and color of urine </li></ul></ul><ul><ul><li>Obstruction of the urinary tract </li></ul></ul><ul><ul><li>Urinary Incontinence </li></ul></ul><ul><ul><li>Urinary tract pain </li></ul></ul><ul><li>Female: ask about pregnancy </li></ul><ul><li>Past hx (surgery, trauma, kidney dx, alcoholism, HTN, heart dx </li></ul><ul><li>Review History and evaluate Hepatitis risk </li></ul>spring 2012
    • 4. Common Conditions Producing Abdominal Pain <ul><li>Appendicitis </li></ul><ul><li>Cholecystitis </li></ul><ul><li>Pancreatitis </li></ul><ul><li>Perforated gastric or duodenal ulcer </li></ul><ul><li>Intestinal obstruction </li></ul><ul><li>Leaking abdominal aneurysm </li></ul><ul><li>Ectopic pregnancy </li></ul><ul><li>Pelvic inflammatory disease </li></ul><ul><li>Renal stones </li></ul><ul><li>Common collaborative problems </li></ul><ul><li>Peritonitis </li></ul><ul><li>Ileus </li></ul><ul><li>Intestinal bleeding </li></ul><ul><li>Bowel obstruction </li></ul><ul><li>Urinary obstruction </li></ul><ul><li>Hepatic failure </li></ul><ul><li>Peptic Ulcer Disease </li></ul><ul><li>GERD </li></ul>spring 2012
    • 5. Sequence for Abdominal Exam <ul><li>Inspection </li></ul><ul><li>Auscultation </li></ul><ul><li>Percussion </li></ul><ul><li>Light Palpation </li></ul><ul><li>Deep Palpation ? </li></ul>spring 2012
    • 6. Physical Exam-INSPECTION <ul><li>INSPECTION </li></ul><ul><ul><li>Observe client’s movement and position </li></ul></ul><ul><ul><li>Have the client supine </li></ul></ul><ul><ul><li>Ask the client to locate tender areas </li></ul></ul><ul><ul><li>Inspect for distension </li></ul></ul><ul><ul><li>Inspect for normal respiratory movements </li></ul></ul><ul><ul><li>Note presence of peristaltic movement or aortic pulsation by looking across the abd </li></ul></ul>spring 2012
    • 7. Physical Exam -AUSCULTATION <ul><li>AUSCULTATION </li></ul><ul><ul><li>Start @ _______ </li></ul></ul><ul><ul><li>listen for ______ amount of time </li></ul></ul><ul><ul><li>Listen in _________ </li></ul></ul><ul><ul><li>Note frequency and character </li></ul></ul><ul><ul><li>Auscultate for vascular sounds </li></ul></ul><ul><ul><li>If bruits are heard, DO NOT PALPATE the abdomen </li></ul></ul>spring 2012
    • 8. Normal Findings: Percussion <ul><li>Tympany over stomach and intestines </li></ul><ul><li>Dullness over liver, spleen, pancreas, kidneys and distended bladder </li></ul><ul><li>Liver border </li></ul>spring 2012
    • 9. Physical Exam - PALPATION <ul><li>PALPATION </li></ul><ul><ul><li>Light palpation ½ inch -1 (1-2 cm) </li></ul></ul><ul><ul><ul><li>Palpate the abdomen lightly in all 4 quadrants </li></ul></ul></ul><ul><ul><ul><li>Observe for any signs of discomfort </li></ul></ul></ul><ul><ul><ul><li>Get the client to relax </li></ul></ul></ul><ul><ul><ul><li>Avoid quick jars during palpation </li></ul></ul></ul><ul><ul><ul><li>- Deep Palpation </li></ul></ul></ul>spring 2012
    • 10. Common Abnormalities <ul><li>Multiple Abdominal Bruises </li></ul><ul><li>Engorged Prominent Veins </li></ul><ul><li>Generalized Symmetric Distension </li></ul><ul><li>Bluish Discoloration around the umbilicus (Cullen’s sign- intra peritoneal hemmorhage) </li></ul><ul><li>Protruding Umbilicus </li></ul><ul><li>Absent or hyperactive bowel sounds </li></ul><ul><li>Palpable liver </li></ul>spring 2012
    • 11. Special Procedures <ul><li>Eliciting Abdominal Pain: </li></ul><ul><ul><li>Rebound Tenderness </li></ul></ul><ul><ul><li>Iliopsoas Sign </li></ul></ul><ul><ul><li>Obturator Sign </li></ul></ul><ul><ul><li>Murphy’s Sign </li></ul></ul>spring 2012
    • 12. Developmental Considerations: Geriatric/Older Adult <ul><li>Increased fat deposit over abdominal area </li></ul><ul><li>Muscle tone more lax </li></ul><ul><li>Reduced GI peristalsis </li></ul><ul><li>Constipation common </li></ul><ul><li>Thinner abdominal wall </li></ul><ul><li>Abdominal contour is often rounded </li></ul><ul><li>Impaired digestion and food intolerances </li></ul><ul><li>Liver size decreases after age 50 </li></ul>spring 2012
    • 13. Health Promotion <ul><li>Nutrition </li></ul><ul><li>Immunization </li></ul><ul><li>Food poisoning </li></ul><ul><li>Lead poisoning </li></ul><ul><li>OTC Drugs </li></ul><ul><li>Excessive laxative or enemas </li></ul>spring 2012
    • 14. Nursing Diagnoses <ul><li>Constipation </li></ul><ul><li>Diarrhea </li></ul><ul><li>Urinary retention </li></ul><ul><li>Altered tissue perfusion (renal, GI) </li></ul><ul><li>Altered nutrition (less or more than body requirements) </li></ul>spring 2012

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