Abdomen mich

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Abdomen mich

  1. 1. The digestive system or tract is basicallya long tube that begins with the mouth or oral cavity, and ends at the anus. There are five function under the digestive system, each function corresponds toeach organ of the systems. These are the following. INGESTION, SECRETION, DIGESTION, ABSORPTION and EGESTION ( DEFECATION)
  2. 2.  Ingestion is the process of carrying food into the digestive tube through the oral cavity, organs under this process are ( oral cavity, tongue, teeth, salivary glands, esophagus). Secretion is the process wherein different chemicals and enzymes are being released by the organs to aid in digestion and absorption of nutrients, organs under this function are( stomach, liver, gall
  3. 3.  Digestion is the process wherein the food is being process by the stomach to be absorbed by the body, organ under this process is the stomach. Absorption is the process of absorbing all the nutrients provided by the food that is being ingested, organs under this process are small intestine { duodenum, jejunum, ileum } and the large intestine { appendix and colon {ascending, transverse and
  4. 4.  The GI tract is a 23- to 26-foot-long pathway that extends from the mouth through the esophagus, stomach, and intestines to the anus THE FOUR BASIC TUNICS ON THE TUBE ( MUCOSA + SUBMUCOSA + MUSCULARIS + SEROSA) esophagus -is located in the mediastinum in the thoracic cavity, anterior to the spine and posterior to the trachea and heart(25 cm long) stomach -is situated in the upper portion of the abdomen to the left of the midline, just under the left diaphragm. It is a distensible pouch with a capacity of approximately 1500mL.
  5. 5.  Stomach- can be divided into four anatomic regions: the cardia (entrance), fundus, body, and pylorus (outlet). small intestine- is the longest segment of the GI tract, accounting for about two thirds of the total length. small intestine- is divided into three anatomic parts: the upper part, called the duodenum; the middle part, called the jejunum; and the lower part, called the
  6. 6. ORGANS AND FUNCTIONS large intestine - consists of an ascending segment on the right side of the abdomen, a transverse segment that extends from right to left in the upper abdomen, and a descending segment on the left side of the abdomen. The terminal portion of the large intestine consists of two parts: the sigmoid colon and the rectum. The rectum is continuous with the anus.
  7. 7.  The liver is situated in the top part of the abdomen on the right side of the body next to the stomach. It is the largest gland in the body, weighing almost 2 kg. is the major detoxicating organ in the body; it destroys harmful organisms in the blood, produces clotting agents, secretes bile, stores glycogen and metabolises proteins, carbohydrates and fats
  8. 8.  gall bladder- a sac situated underneath the liver, in which bile produced by the liver is stored. Pancreas- a gland which lies across the back of the body between the kidneys. It has two functions: the first is to secrete the pancreatic juice which goes into the duodenum and digests proteins and carbohydrates; the second function is to produce the hormone insulin which regulates the use of sugar by the body
  9. 9.  Spleen - an organ in the top part of the abdominal cavity behind the stomach and below the diaphragm, which helps to destroy old red blood cells, form lymphocytes and store blood. Appendix- a small tube attached to the caecum which serves no function but can become infected, causing appendicitis.
  10. 10. ABDOMENAbdominal Quadrants
  11. 11. ABDOMENOrgans of the Abdominal Cavity
  12. 12. ABDOMENAbdominal Quadrants and the Underlying Organs
  13. 13. ABDOMEN
  14. 14. ABDOMENNine Abdominal Regions
  15. 15. ABDOMENLandmarks Commonly Used to Identify Abdominal Areas
  16. 16. ABDOMEN NORMAL FINDINGS ` DEVIATION FROM NORMALInspect the abdomen Unblemished skin. Presence of rash or otherfor skin integrity lesions. Uniform color Tense, glistening skin Silver-white striae (may indicate ascites, (stretch marks) or edema). surgical scars Purple striae (associated with Cushing’s disease)
  17. 17. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALInspect the Flat, rounded (convex), Distendedabdominal or scaphoid (concave)contour (profileline from the ribmargin to thepubic bone) whilestanding at theclient’s side whilethe client is indorsal recumbentpositionInspect for an No evidence of Evidence of enlargementenlarge liver or enlargement of the of the liver or spleenspleen liver or spleen•Ask client to take adeep breath and holdbreath to observe fororgan enlargementsand abdominaldistention
  18. 18. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALAssess the symmetry Symmetric contour Asymmetric contourof contour while (localized protrusionsstanding at the foot around the umbilicus,of the bed inguinal ligaments, or scars) possible hernia• If distention is present, or tumor.measure abdominal girth,by placing tape measurearound the umbilicus
  19. 19. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALInspect the Symmetric movements Limited movement dueabdominal caused by respirations. to pain or diseasemovements process.associated with Visible peristalsis inrespirations, very lean people Visible peristalsis inperistalsis, or aortic nonlean clients (withpulsations Aortic pulsation in thin bowel obstruction) person at the epigastric areaObserve vascular No visible vascular Visible venous patternpatterns pattern (dilated veins) associated with liver disease, ascites and venocaval obstruction.
  20. 20. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALAuscultate the Audible bowel sounds. Absent, hypoactive, orabdomen for bowel hyperactive bowelsounds, vascular Absence of bruits. sounds.sounds, and Loud bruit over aorticperitoneal friction Absence of friction rub. area (possiblerub. aneurysm). Bruit over renal or iliac arteries.
  21. 21. Sites for Auscultating the Abdomen
  22. 22. AUSCULTATING THE ABDOMEN•Warm the hands and the stethoscope diaphragms.•FOR BOWEL SOUNDS – Use the flat disc diaphragm. Intestinal sounds are relatively high pitched and best accentuated by the flat disc diaphragm. – Ask when the client last ate. Shortly after or long after eating, bowel sounds may normally increase. They are loudest when a meal is long overdue. 4-7 hours after a meal, bowel sounds maybe heard continuously over the ileocecal valve area while the digestive system empty through the valve into the large intestine. – Listen for active bowel sounds ---irregular gurgling noises occurring about every 5 to 20 seconds – Normal bowel sounds are described as audible, 5-34 bowel sounds per minute – High pitched, loud, rushing, sounds that occur frequently (e.g. every 3 seconds) also known as BORBORYGMI – True absence of sounds (none heard in 3 to 5 minutes) indicates cessation of intestinal motility.
  23. 23. AUSCULTATING THE ABDOMEN – Hypoactive bowel sounds indicate decreased motility and are usualy associated with manipulation of the bowel during surgery, inflammation, paralytic ileus or late obstruction. – Hyperactive bowel sounds indicate increased intestinal motility and are usually associated with diarrhea, an early bowel obstruction or the use od laxative•FOR VASCULAR SOUNDS – Use the bell of the stethoscope over the aorta, renal arteries, iliac arteries, and femoral arteries – Listen for bruits ( blowing sound due to restricted blood flow through narrowed vessels)•FOR PERITONEAL FRICTION RUB – Peritoneal friction rub are rough, grating sounds like two pieces of leather rubbing together. – Friction rubs may be caused by inflammation, infectious or abnormal growths
  24. 24. ABDOMEN
  25. 25. ABDOMEN
  26. 26. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALPercuss several Tympany over the Large dull areasareas in each of the stomach and gas-filled (associated withfour quadrants. bowels; dullness, presence of fluid or especially over the liver tumor)•Begin in the LLQ  and spleen or fullRLQ  RUQ LUQ bladder
  27. 27. ABDOMENMEN NORMAL FINDINGS DEVIATION FROM NORMALPercuss span of liver Normal liver span is Firm edge of cirrhosisdullness in the 4-8 cm in midsternal Increased inmidclavicular line line and 6-12 cm in hepatomegaly(MCL) right midclavicular line
  28. 28. ABDOMENPERCUSSING LIVER SPAN
  29. 29. ABDOMEN 4-8 cm in midsternal line 6-12cm in right midclavicular line
  30. 30. Percussing the Area Over the Symphysis Pubis
  31. 31. DEVIATION FROM ABDOMEN NORMAL FINDINGS NORMALPerform light No tenderness, relaxed Tenderness andpalpation followed by abdomen with smooth, hypersensitivity.deep palpation of all consistent tension. Superficial masses.four quadrants Tenderness maybe Localized areas of present near the increased tension xiphoid process, over Generalized or cecum, and sigmoid localized areas of colon tenderness Mobile or fixed masses.
  32. 32. PALPATING THE ABDOMENLIGHT PALPATION•To check for muscle tone and tenderness• Place the hand with fingers together parallel to the area beingpalpated. Press down 1 to 2 cm. Repeat in ever-widening circles until thearea to be examined is covered.• If patient is excessively ticklish, begin by pressing your hand on top ofthe client’s hand while pressing lightly. Then slide your hand off theclient’s and onto the abdomen to continue the examination.DEEP PALPATION•To identify abdominal organs and abdominal masses.•Palpate sensitive areas last.•With fingers together, approach the area to be examined at a 60 degreeangle and use the pads and tips of the fingers of one hand to press in 4cm.
  33. 33. ABDOMENLIGHT PALPATION
  34. 34. ABDOMENTWO-HANDED DEEP PALPATION
  35. 35. ABDOMENAssess for Peritoneal inflammation1. Before palpation, ask the patient to cough and determine where the cough produced pain.2. Then, palpate gently with one finger to map the tender area.• Abdominal pain on coughing or with light percussion suggests peritoneal inflammation
  36. 36. ABDOMEN3.If not, look for rebound tenderness. Press your fingers in firmly and slowly, and then quickly withdraw them.4.Watch and listen to the patient for signs of pain.5.Ask the patient (A) to compare which hurt more, the pressing or the letting go, and (B) to show you exactly where it hurt.Pain induced or increased by quick withdrawal constitutes rebound tenderness. Rebound tenderness suggests peritoneal inflammation.
  37. 37. ABDOMEN ABDOMEN Normal Deviation form NormalPalpate the liver.Feel the liver edge,as the No enlargement of the Firm edge of cirrhosispatient breathes in. liverNote any tenderness ormasses No tenderness Tender liver 0f hepatitis or congestive heart failure;tumor mass
  38. 38. ABDOMENPALPATING THE LIVER
  39. 39. ABDOMEN ABDOMEN Normal Deviation form NormalPalpate the spleen.Place the patient in a supine No enlargement and splenomegalyposition and let her lay on tenderness of the spleenthe fight side with legsflexed at the hips and knees
  40. 40. ABDOMENPALPATING THE SPLEEN
  41. 41. ABDOMENPALPATING THE SPLEEN
  42. 42. ABDOMEN ABDOMEN Normal Deviation form NormalPalpate each kidney A normal right kidney may Enlargement from cysts, be palpable, especially in cancer, hydronephrosis. thin, well-relaxed women Bilateral enlargement suggests polycystic disease Tender in kidney infection Non-tender.Check for costovertebralangle (CVA) tenderness
  43. 43. ABDOMENPALPATION OF THE RIGHT KIDNEY
  44. 44. ABDOMEN PALPATING FOR CVATENDERNESS
  45. 45. ABDOMEN Normal Deviation form NormalASSESSING ASCITES In a person without In ascites, dullness shifts to ascites, the borders thePalpate for shifting between tympany and more dependent side,dullness. dullness while tympany usually stay relatively shifts to the top constant.Map areas of tympany anddullness with patient supinethen lying side
  46. 46. ABDOMEN Tympany Tympany Dullness Dullness TEST FOR SHIFTING DULLNESS
  47. 47. ABDOMEN Normal Deviation form NormalASSESSING ASCITESCheck for a fluid wave. Negative for fluid wave. An easily palpable impulse (No impulse is transmitted suggestsAsk patient or an assistant when you tap one flank ascites.to press edges of both sharply)hands into the midline ofabdomen. Tap one side andfeel for a wave transmittedto the other side.
  48. 48. TEST FOR A FLUID WAVE
  49. 49. ABDOMENASSESSING FOR POSSIBLE IN CLASSIC AppendicitiS:APPENDICITISAsk:Where did the pain begin? Near the umbilicusWhere is it now? Right lower quadrantAsk the patient to cough:”where doesit hurt?” Right lower quadrantPalpate for local tenderness. RLQ tendernessPalpate for muscular rigidity. RLQ rigidity
  50. 50. ABDOMENCheck for Rovsing’s sign and for referred Pain in the right lower quadrantrebound tenderness. during left-sided pressure suggests appendicitis (a positive Rovsing’s sign). So(Press deeply and evenly in the left lower does right lower quadrant pain onquadrant. Then quickly withdraw your quickwithdrawal (referred reboundfingers.) tenderness).Look for a psoas sign. Increased abdominal pain on either maneuver constitutes a positivePlace your hand just above the patient’s psoas sign, suggesting irritation ofright knee and ask the patient to raise the psoas muscle by an inflamedthat thigh against your hand. appendix.Alternatively, ask the patient to turn ontothe left side. Then extend the patient’sright legat the hip. Flexion of the leg at the hipmakes the psoas muscle contract;extension stretches it.
  51. 51. ABDOMENLook for an obturator ‘s sign. Right hypogastric pain constitutes a positive obturator sign, suggesting irritation of the obturatorFlex the patient’s right thigh at the hip, muscle by an inflamedwith appendix.the knee bent, and rotate the leginternally at the hip. This maneuverstretches the internal obturator muscle.
  52. 52. ABDOMEN Normal Deviation form NormalASSESSING ASCITESCheck for a fluid wave. Negative for fluid wave. An easily palpable impulse (No impulse is transmitted suggestsAsk patient or an assistant when you tap one flank ascites.to press edges of both sharply)hands into the midline ofabdomen. Tap one side andfeel for a wave transmittedto the other side.
  53. 53. SPECIAL CONSIDERATIONS
  54. 54. NEWBORN AND INFANT
  55. 55. ABDOMEN Normal Deviation form NormalInspect :A. abdomen with the infant protuberantlying supineB. newborn’s umbilical cord two thick-walled umbilical A single umbilical artery arteries and one larger but may be thin-walled umbilical vein, associated with congenital which is usually located at anomalies, the 12 o’clock position but also occurs in normal infants as an isolated anomaly
  56. 56. ABDOMEN Normal Deviation form NormalC. Area around the No redness or swelling Umbilical hernias in infantsumbilicus for redness or are dueswelling to a defect in the abdominal wall, and can be up to 6 cm in diameter and quite protuberant when intraabdominal pressure is increased .
  57. 57. ABDOMEN Normal Deviation form NormalAuscultate for bowel There is an orchestra of An increase in pitch orsounds musical tinkling bowel frequency sounds every 10 to 30 of bowel sounds is heard seconds. with Gastroenteritis or, rarely, with intestinal Obstruction. A silent, tympanic, distended abdomenPercuss an infant’s Note greater tympanitic suggests peritonitis.abdomen as you would for sounds due to the infant’san adult propensity to swallow air
  58. 58. ABDOMEN Normal Deviation form NormalPalpate the infant’s liver.Start gently palpating the liver Palpable 1-2 cm below the An enlarged tenderof infants low right costal margin liver may be due toin the abdomen, moving congestive heartupwards with your failurefingers .
  59. 59. ABDOMENABDOMINAL ASSESSMENT OF AN INFANT
  60. 60. ABDOMEN EARLY AND LATE CHILDHOOD,AND ADOLESCENCEToddlers and young children commonly have protuberant abdomens, most apparent when they are upright. The examination can follow the same order as for adults, except that you may need to open your bag of tricks to distract the child during the examination.
  61. 61. ABDOMEN GERIATRICSSame assessment as the adult
  62. 62. PREGNANT CLIENT
  63. 63. ABDOMEN Normal Deviation form NormalInspect any scars or striae, Purplish striae and linea Scars may confirm the typethe shape and contour of nigra are normal in of priorthe abdomen, and the pregnancy. surgery, especiallyFundal height. cesarean section. The shape and contour may indicate pregnancy sizePalpate the abdomen for:A. Organs or masses. The mass of pregnancy is expected.
  64. 64. B.Fetal movements. These can usually be If movements cannot be felt by the examiner felt after 24 weeks, after 24 weeks consider error in (and by the mother at calculating gestation, 18–20 weeks) fetal death or morbidity, or false pregnancyC. Uterine contractility.. The uterus contracts Prior to 37 weeks, irregularly after 12 regular uterine weeks and contractions with or often in response to without pain palpation during the or bleeding are third trimester abnormal, suggesting preterm labor.
  65. 65. ABDOMENMEASUREMENT OF THE FUNDAL HEIGHT
  66. 66. ABDOMEND. Measure the fundal After 20 weeks, If fundal height is moreheight with a tape measure measurement in than 2 cm higher thanif the woman is more than centimeters should expected, consider20 weeks’ pregnant roughly equal the weeks multiple gestation, a big of gestation. baby,Holding the tape as extra amniotic fluid, orillustrated and following the uterine myomata. If it ismidline of the abdomen, lower than expected bymeasure from the top of more than 2 cm,the symphysis pubis to the consider missed abortion,top of the uterine fundus. transverse lie, growth retardation, or false pregnancy.
  67. 67. ABDOMEN 36 wks 32 wks 28 wks 24 wks 20-22 wks 16 wks 12-14 wks EXPECTED HEIGHT OF THEUTERINE FUNDUS BY MONTH OF PREGNANCY
  68. 68. ABDOMEN Normal Deviation form NormalAuscultate the fetal heart, The rate is usually in the Lack of an audible fetalnoting its rate (FHR), 160s during early heart maylocation, and rhythm. pregnancy, and then slows indicate pregnancy ofUse either: to the 120s to 140s near fewer weeks term. After 32 to 34 than expected, fetal weeks, the FHR should demise, or increase with fetal false pregnancy.A doptone, with which the movement.FHR is audible after 12 FHR that drops noticeablyweeks, or near term with fetal movement A fetoscope, with which it could indicate pooris audible after 18 weeks placental circulation.
  69. 69. ABDOMENDOPTONE (LEFT) AND FETOSCOPE (RIGHT)
  70. 70. ABDOMENMODIFIED LEOPOLD’S MANEUVERSThese maneuvers are important adjuncts to palpation of the pregnant abdomen beginning at 28 weeks of gestation.They help determine where theA. fetus is lying in relation to the woman’s back (longitudinal or transverse)B. what end of the fetus is presenting at the pelvic inlet (head or buttocks),C. where the fetal back is located, how far the presenting part of the fetus has descended into the maternal pelvisD.the estimated weight of the fetus.
  71. 71. ABDOMENFIRST MANEUVER (UPPER POLE).Stand at the woman’s side facing her head. Keeping the fingers of both examining hands together, palpate gently with the fingertips to determine what part of the fetus is in the upper pole of the uterine fundus.
  72. 72. ABDOMENFIRST MANEUVER
  73. 73. ABDOMENSECOND MANEUVER (SIDES OF THE MATERNAL ABDOMEN)Place one hand on each side of the woman’sabdomen, aiming to capture the body of the fetus between them. Use one hand to steady the uterus and the other to palpate the fetus.
  74. 74. ABDOMENSECONDMANEUVER
  75. 75. ABDOMENThird Maneuver (Lower Pole).Turn and face the woman’s feet.Using the flat palmar surfaces of the fingers of both hands and, at the start, touching the fingertips together, palpate the area just above the symphysis pubis. Note whether the hands diverge with downward pressure or stay together. This tells you whether or not the presenting part of the fetus, head or buttocks, is descending into the pelvic inlet.
  76. 76. ABDOMENTHIRD MANEUVER
  77. 77. ABDOMENFourth Maneuver (Confirmation of the Presenting Part).With your dominant hand grasp the part of the fetus in the lower pole, and with your nondominant hand, the part of the fetus in the upper pole. With this maneuver, you may be able to distinguish between the head and the buttocks.
  78. 78. ABDOMENFOURTH MANEUVER
  79. 79. Source:BATES’GUIDETOPHYSICALEXAMIN A T I O N A N D H I S T O R Y T A K I NG
  80. 80. PREPARED BY:EMIL ANTHONY LUCAS, R.N. GAYLE BERONGOY, R.N.
  81. 81. Blood tests are ordered initially. Common blood tests include complete blood count (CBC), carcinoembryonic antigen (CEA), liver function tests, serum cholesterol, and triglycerides. Test findings may reveal alterations in basal metabolic function and may indicate the severity of a disorder
  82. 82. SPECIAL PREPARATION CONFIRM THE DOCTORS ORDER INSTRUCT THE PATIENT FOR THE PROCEDURE ( NOTHING PER OREM FOR HOW MANY HOURS DEPENDING ON THE KIND OF BLOOD WORKS e.g 8 hours, 10 or 12 hours )
  83. 83. COMPLETE BLOOD COUNT Number of white blood cells (WBC) Total amount of hemoglobin in the blood (Hgb). Fraction of blood composed of red blood cells (Hct). Volume of Hgb in each RBC (MCV [mean corpuscularvolume]). Weight of the Hgb in each RBC (MCH [mean corpuscularhemoglobin]). Proportion of Hgb contained in each RBC (MCHC [meancorpuscular hemoglobin concentration]). Number of platelets, which are critical to clot formation
  84. 84. LIVER FUNCTION TEST A panel of tests used to evaluate liver function. Includes: ◆ Alanine aminotransferase (ALT) ◆ Alkaline phosphatase (ALP) ◆ Aspartate aminotransferase (AST) ◆ Bilirubin ◆ Albumin ◆ Total protein
  85. 85. ■ Used in the evaluation of symptoms associated with liver disease (jaundice, nausea, vomiting and/or diarrhea; loss of appetite; ascites, hematemesis, melena; fatigue or loss of stamina; history of alcohol or drug abuse
  86. 86.  Fecal Occult Blood (FOB, Stool for Occult Blood)(Negative) Stool sample Used to detect microscopic bleeding into the GI tract. Routine screening test for patients over 50 years old. Positive in ulcers, polyps, hemorrhoids, tumors, inflammatory bowel disease, diverticulosis, and other disorders of the GI tract.
  87. 87.  Stool Culture (Stool for C&S, Stool for Ova and Parasites [O&P]) Normal intestinal flora Small amount of stool specimen in a sterile container with a screw-top lid. Evaluate cause of diarrhea.
  88. 88. SPECIAL CONSIDERATION ENSURE CLEANLINESS OF THE SPECIMEN CUP ALWAYS USE GLOVES IN COLLECTING THE SPECIMEN SEND IT IMMEDIATELY TO THE LABORATORY AFTER GETTING THE SPECIMEN NOTE FOR THE DIET OF THE APTIENT FOR THE PAST 24 HOURS
  89. 89. Imaging studies include x-ray and contrast studies, computed tomography (CT) scans, magnetic resonance imaging (MRI), and scintigraphy (radionuclide imaging).
  90. 90.  Upper Gastrointestinal Tract StudyX-rays can delineate the entire GI tract after the introduction of a contrast agent. A radiopaque liquid (eg, barium sulfate) is commonly used. The patient ingests this tasteless, odorless, nongranular, and completely insoluble (hence, not absorbable) powder in the form of a thick or thin aqueous suspension for the purpose of studying the upper GI tract
  91. 91. NURSING INTERVENTIONS The patient may need to maintain a low-residue diet for several days before the test. He or she should receive nothing by mouth after midnight before the test. The physician may prescribe a laxative to clean out the intestinal tract. Because smoking can stimulate gastric motility, the nurse discourages the patient from smoking on the morning before the examination. In addition, the nurse withholds all medications.
  92. 92. Lower Gastrointestinal Tract Study When barium is instilled rectally to visualize the lower GI tract, the procedure is called a barium enema. The purpose of a barium enema is to detect the presence of polyps, tumors, and other lesions of the large intestine and to demonstrate any abnormal anatomy or malfunction of the bowel
  93. 93. Computed TomographyCT provides cross-sectional images of abdominal organs and structures. Multiple x-ray images are taken from many different angles, digitized in the computer, reconstructed, and then viewed on a computer monitor. Indications for abdominal CT scanning are diseases of the liver, spleen, kidney, pancreas, and pelvic organs.
  94. 94. NURSING INTERVENTIONS The patient should not eat or drink for 6 to 8 hours before the test. The practitioner may prescribe an intravenous or oral contrast agent. Therefore, the nurse should question the patient about contrast dye allergies.
  95. 95. Magnetic Resonance ImagingIt is a noninvasive technique that uses magnetic fields and radiowaves to produce an image of the area being studied. The use of oral contrast agents to enhance the image has increased the application of this technique for the diagnosis of GI diseases. It is useful in evaluating abdominal soft tissues as well as blood vessels, abscesses, fistulas, neoplasms, and other sources of bleeding.
  96. 96. NURSING INTERVENTIONS The patient should not eat or drink for 6 to 8 hours before the test. Before the test, the patient must remove all jewelry and other metals. It is important to warn patients that the close-fitting scanners used in many MRI facilities may induce feelings of claustrophobia
  97. 97. ULTRASOUND A NON INVASIVE PROCEDURE THAT USE HIGH FREQUENCY SOUND THAT CAN ESTABLISH THE STRUCTURE, SIZE OF ORGAN OF THE ABDOMENNURSING INTERVENTIONS WIPE OF THE EXCESS LUBRICANT OVER THE EXAMINED AREA
  98. 98. Endoscopic procedures used in GI tract assessment include fibroscopy/ esophagogastroduodenoscopy, anoscopy, proctoscopy, sigmoidoscopy, colonoscopy, small-bowel enteroscopy, and endoscopy through ostomy.
  99. 99. Upper Gastrointestinal Fibroscopy/EsophagogastroduodenoscopyFIBROSCOPY of the upper GI tract allows direct visualizationof the esophageal, gastric, and duodenal mucosa through alighted endoscope.ESOPHAGOGASTRODUODENOSCOPY (EGD), is especially valuablewhen esophageal, gastric, or duodenal abnormalities or inflammatory,neoplastic, or infectious processes are suspected.This procedure also can be used to evaluate esophageal and gastricmotility and to collect secretions and tissue specimens for furtheranalysis.
  100. 100. Anoscopy, Proctoscopy, and SigmoidoscopyThe lower portion of the colon also can be viewed directly toevaluate rectal bleeding, acute or chronic diarrhea, or change in bowel patterns and to observe for ulceration, fissures,abscesses, tumors, polyps, or other pathologic processes
  101. 101. Fiberoptic Colonoscopy Direct visual inspection of the colon to the cecum is possible by means of a flexible fiberoptic colonoscope
  102. 102. PARACENTESIS procedure of draining fluid from a cavity inside the body using a hollow needle, either for diagnostic purposes or because the fluid is harmful. Also called tappingBiopsythe process of taking a small piece of living tissue for examination and diagnosis The biopsy of the tissue from the growth showed that it was benign

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