NURS 6035 Exam 3
Patients with __ writhe in bed. They squirm constantly and can find no comfortable
position. - answer renal or biliary colic
Lipase - answer released by pancreas to break down fats
amylase - answer break down carbs into sugars
trypsin - answer released by pancreas to help break down proteins
pepsin - answer release by stomach to break down protein
diffuse rigidity indicates? - answer diffuse peritonitis abdomen is board like
localized rigidity indicates? - answer inflamed appendix or gallbladder
rigidity is indicative of? - answer peritoneal irritation
When assessing the abdomen what should you ask about? - answer changes in
appetite
pain
nausea/vomiting
abdominal pain/cramping/bloating/gas
inquire about typical bowel movements, any change in function (color, consistency,
frequency)
female pts ask menstrual hx, consider possible pregnancy
what is the first step of the abdominal assessment? - answerinspection is always first
auscultation is second
palpation is third
percussion is fourth
Inspection is first what are you looking for? - answerinspect the controls fo the abdomen
(use a pen light, look from all sides)
,distended? concave? striae? umbilicus inverted?
any surgical scars
look for hernias, pulsations
look at the sclera of the eyes, color cast of the skin (jaundice?)
look in the mouth
when you are inspecting for hernias, pulsations what position is the patient in and how
do you assess? - answerpatient is supine
ask them to cough while you gently lay hand on abdomen around the umbilicus and
again at the inguinal regions
melanin deposition around and in the oral cavity, especially the buccal mucosa
suggest? - answerpeutz-jeghers syndrome
Auscultation is the second step of the abdominal assessment what do you do? -
answerassess bowel sounds in all 4 quadrants
normoactive? hyperactive? hypoactive?
abdominal bruits
do you use the diaphragm or bell when assessing for abdominal bruits? - answerbell for
bruits you don't want to hear
What arteries are you assessing for abdominal bruits? - answerright and left renal
arteries
aortic arteries
femoral arteries
iliac arteries
Palpation is the third step in the abdominal assessment what are you assessing? -
answerlight palpation- all four quadrants
deep palpation- all four quadrants
spleen
liver
,femoral arteries
radial to femoral pulse comparison
____ palpation is used to detect tenderness and areas of muscular spasm or rigidity -
answerlight
____ palpation is used to determine organ size, as well as the presence of abnormal
abdominal masses. - answerdeep
how do you assess the spleen when palpating? - answerone hand behind and deep
palpate with the other
should you be able to feel the spleen upon palpation? - answershould never feel!
how do you palpate the liver? - answercan percuss to find the upper border
finger hook technique
one hand behind and deep palpate with the other
when palpating the radial to femoral pulse comparison are they asynchronous or
synchronous? - answersynchronous
What are special tests you can use to assess the appendix? - answerrebound
tenderness
McBurney's point
Roysings sign
Illiopsoas test
Obrturator test
how do you assess rebound tenderness? - answerdeep palpation then the palpating
hand is then quickly removed
the sensation of pain on the side of the inflammation that occurs on release of pressure
is rebound tenderness (positive)
what are you assessing rebound tenderness for? - answerit will trigger peritoneal
irritation if positive
, how do you assess roysings sign - answerdeep palpate LLQ
pain felt in RLQ - positive roysings
describe the illiopsoas test - answera special test performed when there is suspicion of
intra-abdominal inflammation is the illipsoas test
irritation for the right psoas muscle by an acutely inflamed appendix produces a right
psoas sign
left side lying, ask pt to extend leg at hip joint against resistance, if pain, positive
describe the obturator test - answerpt is supine, examiner flexes the patient's thigh at
the hip with the patient's knees bent, and rotates the leg internally and externally at the
hip
if there is an inflammatory process adjacent to he obturator muscle, pain is elicited
How do you assess for kidney stones? - answerCVA tenderness
posterior torso at the kidney
if ___ is present, dullness shifts to the more dependent position; the area around the
umbilicus that was initially tympanic becomes dull. - answerascites
what are the two position options for rectal exam? - answerstanding and bent over table
left side lying aka sims position
steps in the rectal exam? - answerindex finger
lubricants
insert
palpate the prostate
rectum inspections:
1. rotate the finger from 6 o'clock to 9 o'clock to 12 o'clock
2. turn away from the pt rotate finger from 6 o'clock to 3 oclock to 12 o'clock
Percussion is the fourth step in the abdominal assessment what are you assessing for?
- answertympany over air cavities
dullness over organs
Patients with __ writhe in bed. They squirm constantly and can find no comfortable
position. - answer renal or biliary colic
Lipase - answer released by pancreas to break down fats
amylase - answer break down carbs into sugars
trypsin - answer released by pancreas to help break down proteins
pepsin - answer release by stomach to break down protein
diffuse rigidity indicates? - answer diffuse peritonitis abdomen is board like
localized rigidity indicates? - answer inflamed appendix or gallbladder
rigidity is indicative of? - answer peritoneal irritation
When assessing the abdomen what should you ask about? - answer changes in
appetite
pain
nausea/vomiting
abdominal pain/cramping/bloating/gas
inquire about typical bowel movements, any change in function (color, consistency,
frequency)
female pts ask menstrual hx, consider possible pregnancy
what is the first step of the abdominal assessment? - answerinspection is always first
auscultation is second
palpation is third
percussion is fourth
Inspection is first what are you looking for? - answerinspect the controls fo the abdomen
(use a pen light, look from all sides)
,distended? concave? striae? umbilicus inverted?
any surgical scars
look for hernias, pulsations
look at the sclera of the eyes, color cast of the skin (jaundice?)
look in the mouth
when you are inspecting for hernias, pulsations what position is the patient in and how
do you assess? - answerpatient is supine
ask them to cough while you gently lay hand on abdomen around the umbilicus and
again at the inguinal regions
melanin deposition around and in the oral cavity, especially the buccal mucosa
suggest? - answerpeutz-jeghers syndrome
Auscultation is the second step of the abdominal assessment what do you do? -
answerassess bowel sounds in all 4 quadrants
normoactive? hyperactive? hypoactive?
abdominal bruits
do you use the diaphragm or bell when assessing for abdominal bruits? - answerbell for
bruits you don't want to hear
What arteries are you assessing for abdominal bruits? - answerright and left renal
arteries
aortic arteries
femoral arteries
iliac arteries
Palpation is the third step in the abdominal assessment what are you assessing? -
answerlight palpation- all four quadrants
deep palpation- all four quadrants
spleen
liver
,femoral arteries
radial to femoral pulse comparison
____ palpation is used to detect tenderness and areas of muscular spasm or rigidity -
answerlight
____ palpation is used to determine organ size, as well as the presence of abnormal
abdominal masses. - answerdeep
how do you assess the spleen when palpating? - answerone hand behind and deep
palpate with the other
should you be able to feel the spleen upon palpation? - answershould never feel!
how do you palpate the liver? - answercan percuss to find the upper border
finger hook technique
one hand behind and deep palpate with the other
when palpating the radial to femoral pulse comparison are they asynchronous or
synchronous? - answersynchronous
What are special tests you can use to assess the appendix? - answerrebound
tenderness
McBurney's point
Roysings sign
Illiopsoas test
Obrturator test
how do you assess rebound tenderness? - answerdeep palpation then the palpating
hand is then quickly removed
the sensation of pain on the side of the inflammation that occurs on release of pressure
is rebound tenderness (positive)
what are you assessing rebound tenderness for? - answerit will trigger peritoneal
irritation if positive
, how do you assess roysings sign - answerdeep palpate LLQ
pain felt in RLQ - positive roysings
describe the illiopsoas test - answera special test performed when there is suspicion of
intra-abdominal inflammation is the illipsoas test
irritation for the right psoas muscle by an acutely inflamed appendix produces a right
psoas sign
left side lying, ask pt to extend leg at hip joint against resistance, if pain, positive
describe the obturator test - answerpt is supine, examiner flexes the patient's thigh at
the hip with the patient's knees bent, and rotates the leg internally and externally at the
hip
if there is an inflammatory process adjacent to he obturator muscle, pain is elicited
How do you assess for kidney stones? - answerCVA tenderness
posterior torso at the kidney
if ___ is present, dullness shifts to the more dependent position; the area around the
umbilicus that was initially tympanic becomes dull. - answerascites
what are the two position options for rectal exam? - answerstanding and bent over table
left side lying aka sims position
steps in the rectal exam? - answerindex finger
lubricants
insert
palpate the prostate
rectum inspections:
1. rotate the finger from 6 o'clock to 9 o'clock to 12 o'clock
2. turn away from the pt rotate finger from 6 o'clock to 3 oclock to 12 o'clock
Percussion is the fourth step in the abdominal assessment what are you assessing for?
- answertympany over air cavities
dullness over organs
