NUR 2102: Abdomen and Gastrointestinal Assessment Test 2023 Graded

NUR 2102: Abdomen and Gastrointestinal Assessment Test 2023 Graded. Spleen* ø Not normally palpable ø DO NOT palpate if enlarged, tender or bruising noted in area- may rupture Abdominal Quadrants - Right Upper Quadrant (RUQ) - ø Liver ø Gallbladder ø Duodenum ø Head of Pancreas ø Right kidney and adrenal ø Hepatic flexure of colon ø Part of ascending and transverse colon Left Upper Quadrant (LUQ) - ø Stomach ø Spleen ø Left lobe of liver ø Body of pancreas ø Left kidney and adrenal ø Splenic fixture of colon ø Part of transverse and descending colon Right Lower Quadrant (RLQ) - ø Cecum ø Appendix ø Right ovary and tube ø Right ureter ø Right spermatic cord Left Lower Quadrant (LLQ) - ø Part of descending colon ø Sigmoid colon ø Left ovary and tube ø Left ureter ø Left spermatic cord Midline - ø Aorta ø Uterus (if enlarged) ø Bladder (if distended) Assessment of Risk factors - ø Assess current problem first, using symptom analysis *(OLDCARTS)* ø Assess personal and family history to assess genetic risk factors ø Assess other risk factors perform teaching about those that may be modified > alcohol, drugs, smoking ø Assessment then linked to health promotion and teaching > diet Assessing Risk Factors - *Current Problems* ø Abdominal problems now? ø Unplanned changes in weight >crohn's/ulcerative colitis ø Special dietary needs or concerns >sudden onset of food allergy ø Fever or chills >infection ø Dizziness *Family History (Genetics/Genomics)* ø Colorectal cancer in 1° relative ø GERD, PUD, IBD, IBS, celiac disease *Personal History* ø Age ø Blood transfusion before mid-1980 ø Vaccinated against Hep B ø History of endometrial, ovarian or breast cancer ø Varicella Subjective Data Collection - ø Comprehensive history normally precedes the physical assessment ø Involves asking the patient about their health status ø Broad range questions discern possible problems associated with each organ and system within the abdomen ø Approach the history from a head to toe perspective ø A well developed health history can point to a diagnosis 80% to 90% of the time *Important Health Information* ø Past health history >GI functioning, pain, nausea, diarrhea, constipation, ulcer, bleeding, hepatitis, colitis, cancer ø Medications >prescribed GI meds, over the counter meds, supplements, NSAIDS > NSAIDS - harsh on stomach/can cause stomach bleeding ø Surgery of GI system Common Abdominal Symptoms - ø Indigestion ø Anorexia ø Nausea, vomiting, hematemesis ø Abdominal pain ø Dysphagia, odynophagia ø Changes in bowel function: constipation, diarrhea ø Jaundice/icterus ø Urinary/renal symptoms - urinary incontinence, kidney or flank pain, ureteral colic Preparation - ø Environment warm and private ø Adequate lighting ø Empty bladder ø Supine with arms at sides ø Use of a sheet for draping ø Explain what you are doing ø Perform assessment systematically, slowly, without quick movements ø Observe patients face for signs of discomfort > stoicism; esp. in teen boys Objective Assessment - ø Inspection ø Auscultation ø Percussion ø Palpation > Light > Deep *Always auscultate before palpation; you can creat