NURSING > QUESTIONS & ANSWERS > Chapter 21 Abdominal assessment (ASSURED A) (All)

Chapter 21 Abdominal assessment (ASSURED A)

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Chapter 21 Abdominal assessment (ASSURED A) 1. What are the names when diving the abdomen into nine sections? What abt when dividing it into 4 sections? o Epigastric, Umbilical, hypogastric/suprepubic o oo o Right and left Upper quadrant, and Right and Left lower quadrant. 2. Where are the following organs locater? quadrant and region? appendix Colon Gallbladder Liver Pancreas Small intestine Spleen Stomach o Appendix: Right Lower Quadrant -- Hypogastric o Colon: ALL -- Unbelical (large part of it) o Gallbladder: RUQ -- Epigastric o Liver: RUQ -- Epigastric o Pancreas: RUQ -- Epigastric o Small intestine: RUQ & LUQ -- umbilical o Spleen: LUQ -- Epigastric o Stomach: LUQ -- Epigastric 3. what is a sign which confirms the presence of peritonitis (inflammation of the peritoneum) is? Rebound tenderness. 4. What is the preferred order for examination of the abdomen? Inspection, auscultation, percussion, palpation. 5. When auscultating the abdomen, you would ...? Use the diaphragm for high-pitched bowel sounds and the bell for low-pitched vascular sounds. 6. What are normal clicks and gurgles when auscultating a pt? What is hyperactive? hypoactive? or absent? What could they mean? o Normal: A gurgles every 2-10 secs o Hyperactive: Less than 2-10 secs gastroenteritis, early obstruction, hunger. o Hypoactive: more than 10 sec, Peritonitis or paralytic ileum. o Absent: Inability to hear any sounds after 5 minutes of continuous listening. 7. What is Borborygmi? Very loud, stomach growling (hunger sounds) 8. The predominant percussion sound over the abdomen is? Tympany (air-hallow organs) 9. Where would you find Tympanic percussion sounds in the body? Resonance? Dullness? o Tympany: musical note, higher pitch, hollow, over air-filled viscera (whole abdomen pretty much) o Hyperressonance: pitch b/t tympany and resoncance, base of lungs gaseous distention of bowel. o Resonance: Sustained note of moderate pitch, over (air) lung and sometimes stomach. o Dullness: short, high pitched, over solid organs, distended bladder, mass (organs, mass, something solid) 10. How can you determine the border of the liver? what about the top border? How do you palpate for the liver? o Percussess up the right midclavicular line until impanel changes to dullness. o Same for the top but starting from top. o 3 ways to palpate for liver. o A: fingers are extended, with tips on right midclaviculine below the dullness and pointing to the head. o B: Fingers parallel to the costal margin. hands in like a duck position. o C: Hook your fingers over the right costal margin below the border of liver dullness.

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