NURS 550 Final Set Tested Questions With Revised Correct Answers CLEAR IMAGES INCLUDED Guaranteed Pass!!

NURS 550 Final Set Tested Questions With Revised Correct Answers CLEAR IMAGES INCLUDED Guaranteed Pass!! HIDA scan- to visualize the flow of bile Murphy's sign- abdominal pain Emergent Causes of Abdominal Pain • Abdominal Aortic Aneurysm (AAA) • Myocardial Infarction (MI) • Ectopic Pregnancy • Obstruction • Mesenteric Ischemia • Appendicitis • Perforated Peptic Ulcer • Splenic Rupture • Cholecystitis • Peritonitis Physical Examination General appearance • Vital signs including temperature and pain scale - 0-10 at onset and present • Abdominal Assessment - Inspection • Cullen sign • Turner sign - Auscultation - Percussion - Palpation Classification of Abdominal Pain - Visceral pain: when hollow organs (stomach, colon) forcefully contract or become distended. Solid organs (liver, spleen) can also generate this type of pain when they swell against their capsules. Visceral pain is usually gnawing, cramping, or aching and is often difficult to localize (hepatitis) - Parietal pain: when there is inflammation from the hollow or solid organs that affect the parietal peritoneum. Parietal pain is more severe and is usually easily localized (appendicitis) - Referred pain: originates at different sites but shares innervation from the same spinal level (gallbladder pain in the shoulder) Rebound tenderness • Palpate deeply in the periumbilical area and both lower quadrants. Rebound tenderness occurs if pain increases when the examiner decreases the pressure against the abdomen cullen sign turner sign Organs in LUQ: Spleen, left kidney, stomach, majority of pancreas, small intestine Organs in RUQ: Gallbladder, Liver, Pancreas (small portion), right kidney Physical Examination of the Abdomen: Landmarks Physical Examination of the Abdomen: Auscultation Always auscultate before palpating or percussing the abdomen • Listen in all 4 quadrants • Begin in the RLQ, using diaphragm • Note frequency and character Abnormal Sounds can be: • Hyperactive -Loud, high pitched, rushing sound -Signals increased motility, gastroenteritis, early intestinal obstruction, or hunger • Hypoactive or absent Decreased bowel sounds occur with surgery, peritonitis , or paralytic ileus -Absent bowel sounds, referring to an inability to hear any bowel sounds after 5 minutes of continuous listening, are typically associated with abdominal pain and rigidity and are a surgical emergency Place the bell of stethoscope over the aorta, renal, iliac, and femoral arteries to assess for bruits • Vascular sounds resembling the whooshing of heart murmurs • Bruits over arteries - An abnormal blowing sound - Result from narrowing of an artery or turbulent blood flow - Occurs with aortic aneurism • Screening for Abdominal Aortic Aneurysm (AAA) Palpation when the aortic diameter reaches greater than 3 cm (normal size *** Thumb and finger • Palpate the aortic pulsation in upper abdomen slightly to left of midline • Normal: - 2.5-4 cm wide - May see pulsation in thinner person • Abnormal: - widened due to aneurysm Percussion: Kidneys Indirect fist percussion of posterior thorax along the costovertebral angle (CVA) - Place one hand on the back over 12th rib at the costoverbral angle - Thump hand with the ulnar edge of your other fist • Normal: nontender "thud" • Abnormal: CVA tenderness or sharp pain Costovertebral Angle tenderness (CVA): The costovertebral angle is formed by the lower border of the 12th rib and the transverse processes of the upper lumbar vertebrae. Assesses for kidney tenderness (UTI) Charcot's triad: jaundice, RUQ pain, and fever/chills common with obstruction of bile duct seen in cholesystitis +Murphy's sign Murphy's Sign