ADN 213: Assessment & Reasoning GI System Peggy Scott, 48 years old (latest complete solution)

GI/GU: Inspection: skin (coloration, vascularity, striae, scars, lesions, rashes)  Contour from 2 angles – (flat, rounded, scaphoid, protuberant/distended)  Note symmetry, color, veins, lesions, scars, hair distribution  Umbilicus – contour; Note: inguineal or umbilical hernias  Symmetry (relaxed, supine position)  Abdominal movement during breathing  Aortic pulsations Auscultation: (completed before palpation/percussion to not alter bowel sounds)  Bowel sounds – 1 minute per quadrant up to 5 minutes with the diaphragm  Intensity, pitch, frequency  Vascular sounds – listen for bruits in abdominal aorta with bell. Palpation:  Light palpation to all quadrants – 1 to 2 cm to detect tenderness  Deep palpation to all quadrants – 5 to 6 cm for masses (location, size, shape, pulsatility, mobility, tenderness)  Palpate bladder- light palpation ONLY; you only want to assess to see if it is distended  Check for costovertebral angle tenderness Make Learning Active!  Role play or go through the interview/body assessment process – student to student or as a group.  Review the case study as an application exercise in small groups or together as a class.  Depending on your program, some content in the case study may not have been taught. Do not let that prevent you from utilizing this case study! Use it to promote learning by having students identify what they do not yet know and guide where they can find the information in the textbook or on the internet to address knowledge gaps. This is educational best practice and another way to scaffold knowledge!