NURS 550 final Questions and 100%
Correct Answers | Grade A+
What order to assess the abdomen
Ans: 1.) Inspect
2.) Auscultate
3.) Percuss
4.) Palpate
• Where would the pain be in?
o Hepatitis:
Ans: RUQ discomfort
o Where would the pain be in?
Cholecysitis:
Ans: RUQ pain
Cholecystitis
,Ans: Definition: Acute cholecystitis is inflammation of the gallbladder wall.
Ninety percent of the time acute cholecystitis is caused by gallstone obstruction of cystic
duct.
Common presentation: "female, fat, and forty."
Attacks are intermittent and may be related to consumption of a large, fatty meal. Onset of
pain is gradual and pain may be epigastric, and/or radiate to right shoulder or interscapular
area. Pain is aggravated by jarring and/or deep breathing. "Female, fat, and forty" is a
mnemonic used to describe a common presentation, although acalculous cholecystitis can
occur in younger and older people after surgery, burns, sepsis, or critical illness. It is more
likely in people with a positive family history. A drastic weight loss diet, extremely low in fat
and calories, is a risk factor for cholecystitis.
Clinical Manifestations: Signs/Symptoms
Ans: Acute, colicky or steady, aching RUQ pain
Nausea/vomiting
Low grade fever
Anorexia
Positive Murphy's sign (peritoneal inflammation)
,Slightly elevated neutrophil count
Acute cholecystitis usually improves in 2-3 days and resolves within a week. Recurrences are
common. Jaundice is usually not present unless the common bile duct is obstructed.
Assessment Skill/Techniques /Labwork /Procedure used to diagnose clinical problem
Ans: Murphy's sign-
increase in RUQ tenderness with palpation,
or from ultrasound probe, and inspiration
CBC- increased neutrophils
liver function tests- increased AST/ALT, increased amylase with CBD obstruction
Gallbladder ultrasound- non-visualization of the gallbladder and wall thickening
HIDA scan- to visualize the flow of bile
Murphy's sign-
Ans:
abdominal pain
Ans:
, Emergent Causes of Abdominal Pain
Ans: • Abdominal Aortic Aneurysm (AAA) • Myocardial Infarction (MI) • Ectopic
Pregnancy • Obstruction
• Mesenteric Ischemia • Appendicitis • Perforated Peptic Ulcer • Splenic Rupture •
Cholecystitis • Peritonitis
Physical Examination
Ans: 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
Ans: - 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)
Correct Answers | Grade A+
What order to assess the abdomen
Ans: 1.) Inspect
2.) Auscultate
3.) Percuss
4.) Palpate
• Where would the pain be in?
o Hepatitis:
Ans: RUQ discomfort
o Where would the pain be in?
Cholecysitis:
Ans: RUQ pain
Cholecystitis
,Ans: Definition: Acute cholecystitis is inflammation of the gallbladder wall.
Ninety percent of the time acute cholecystitis is caused by gallstone obstruction of cystic
duct.
Common presentation: "female, fat, and forty."
Attacks are intermittent and may be related to consumption of a large, fatty meal. Onset of
pain is gradual and pain may be epigastric, and/or radiate to right shoulder or interscapular
area. Pain is aggravated by jarring and/or deep breathing. "Female, fat, and forty" is a
mnemonic used to describe a common presentation, although acalculous cholecystitis can
occur in younger and older people after surgery, burns, sepsis, or critical illness. It is more
likely in people with a positive family history. A drastic weight loss diet, extremely low in fat
and calories, is a risk factor for cholecystitis.
Clinical Manifestations: Signs/Symptoms
Ans: Acute, colicky or steady, aching RUQ pain
Nausea/vomiting
Low grade fever
Anorexia
Positive Murphy's sign (peritoneal inflammation)
,Slightly elevated neutrophil count
Acute cholecystitis usually improves in 2-3 days and resolves within a week. Recurrences are
common. Jaundice is usually not present unless the common bile duct is obstructed.
Assessment Skill/Techniques /Labwork /Procedure used to diagnose clinical problem
Ans: Murphy's sign-
increase in RUQ tenderness with palpation,
or from ultrasound probe, and inspiration
CBC- increased neutrophils
liver function tests- increased AST/ALT, increased amylase with CBD obstruction
Gallbladder ultrasound- non-visualization of the gallbladder and wall thickening
HIDA scan- to visualize the flow of bile
Murphy's sign-
Ans:
abdominal pain
Ans:
, Emergent Causes of Abdominal Pain
Ans: • Abdominal Aortic Aneurysm (AAA) • Myocardial Infarction (MI) • Ectopic
Pregnancy • Obstruction
• Mesenteric Ischemia • Appendicitis • Perforated Peptic Ulcer • Splenic Rupture •
Cholecystitis • Peritonitis
Physical Examination
Ans: 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
Ans: - 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)
