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Summary Shadow Health Gastrointestinal Physical Assessment Review Questions

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Review QuestionsActivity Time: 10 min Which of the following physical exam tests could be used if you suspected cholecystitis in Tina? Correct: Positive Murphy’s sign is indicative of cholecystit... is. To perform the test, palpate the inferior liver border while asking the patient to take a deep breath. During inspiration, the descending liver pushes against the inflamed gallbladder onto the examining hand. The patient feels sharp pain and abruptly stops breathing.  Rovsing’s sign  Rebound tenderness  Murphy’s sign (Correct Response)  McBurney’s sign Suppose that you were concerned that Tina may have had an enlarged spleen. How would you have proceeded? Correct: The most accurate assessment for splenomegaly is percussion of the left anterior axillary line. The percussion of dullness, especially a change from tympany to dullness when a patient takes a deep breath, is indicative of splenic enlargement.  Palpate along the left costal margin  Assess for bulging flanks  Palpate for bulging flanks  Percuss in the left anterior axillary line (Correct Response) During a gastrointestinal exam, the purpose of light palpation of the abdomen is to: Correct: The purpose of light palpation is to assess for tenderness. This method avoids pain and the resulting rigidity that would obscure deep palpation later in the examination.  Assess for tenderness (Correct Response)  Determine if deep palpation is needed This study source was downloaded by 100000831988016 from CourseHero.com on 05-06-2022 05:57:27 GMT -05:00 https://www.coursehero.com/file/32612856/Tina-Jones-GI-Lifespandocx/  Assess for abdominal masses  Determine organomegaly If you had heard bowel sounds occurring about 15 times per minute in 1-2 quadrants while examining Tina, what would have been the significance of this finding? Student Response: Bowel sounds occurring irregularly between 5 to 30 times per minute is a normal finding. Model Note: Bowel sounds occurring irregularly between 5 to 30 times per minute is a normal finding. It is not necessary to listen to or document bowel sounds in all 4 quadrants, especially in a patient without GI complaints. Imagine that you had heard a swishing sound while auscultating Tina’s epigastric region. Identify where this bruit would have been likely to originate. Student Response: Bruits heard in the epigastric area are most likely irregular blood flow in the abdominal aorta or renal artery. Model Note: Bruits heard in the epigastric area are most likely caused by turbulent blood flow in the abdominal aorta or a renal artery. Suppose that after examining Tina, you were concerned she may have peritonitis. How would you have assessed Tina to confirm your diagnosis? Student Response: By performing a rebound tenderness test for positive Blumberg's sign and a heel jar test to look for positive Markle sign. Another way is to check for abdominal pain with guarding,abdominal rigidity and absent bowel sounds, nausea and vomiting. Model Note: To identify peritonitis, assess for common symptoms such as shallow breathing, nausea and vomiting, abdominal pain with guarding, abdominal rigidity, and absent bowel sounds. You can also perform a rebound tenderness test to look for a positive Blumberg’s sign and a heel jar test to look for a positive Markle sig [Show More]

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