Gastrointestinal

JULLIANNE DANDAN · 43問 · 2年前

通報

問題一覧

Clinical Manifestations

> Abdominal pain/tenderness > Diarrhea > Constipation > Nausea/Vomiting > Bloody stool/vomitus > Bloating/distention

Ask Client about History of Pre-Existina GI Conditions

> Gl conditions > Past surgery > Family History

inspect Abdomen for Skin Integrity (Normal______)

Pale skin tone

inspect Abdomen for Skin Integrity ASSESS FOR

> Discoloration > Contour, symmetry > Vascularity, striae > Pulsation > Visible peristalsis

Flat, evenly rounded, symmetric

Normal

Cachexia, wt loss, starvation, terminal illness, cancer

Sunken (Scaphoid)

flat, feces, fetus/pregnancy, fluid, flatulence, fibroids, mass, cyst, tumor

Abdominal distention

organ enlargement, large mass, bowel obstruction

Assymetric

Normal: Pale, pinkish skin tone, @midline

Inspect Umbilicus

Deviated laterally > Abdominal pressure > Mass, fluid, hernia > Organ enlargement

Inspect Umbilicus

1. Yellowish discoloration (bilirubin) 2. skin, eyes, mucuos memb., palms, sole 3. liver diseases, gall bladder disorder

JAUNDICE

1. ecchymosis, bluish to purplish discoloration, bruising on the flanks 2. pancreatitis, internal hemorrhage, abdominal bleeding, abdominal trauma

GREY TURNER SIGN

Characteristics- Taut skin, rounded and bulging abdomen Other signs- (+) fluid wave, shifting dullness Cause- Fluid accumulation, build up in abdomen Clinical Indication- liver cirrhosis, heart failure

ASCITES

Characteristics- Stretch marks

STRIAE

pregnancy, weight gain, obesity, ascites

Old silvery white

Cushing syndrome

Pink/Dark blue

Observe Vascular Pattern, Peristalsis, Pulsation - Slight pulsation in epigastrium

Normal

- Intestinal obstruction

Increase/Visible Peristalsis

- abdominal aortic aneurysm

Wide exaggerated bounding pulsating mass

- normally, visible and scattered fine veins.

Normal

- liver cirrhosis, carcinoma, ascites, portal hypertension

Dilated veins (Caput medusae)

- liver cirrhosis, portal hypertension

Spider angioma

Auscultate for Bowel Sounds - 5-30 clicks/gurgles per minute

NORMAL

- growling sound, Increase bowel motility, diarrhea, gastroenteritis, early BO

Hyperactive (Borborygmic)

- Decrease bowel motility, late BO

Hypoactive

- No bowel motility, paralytic ileus, peritonitis

Absent

Auscultate for Abnormal Bowel Sounds - bowel obstruction

Tinkling

- splenic infection, infarction, abscess, tumor

Rub (left lower costal)

- hepatic abscess, metastasis

Rub (right lower costal)

- murmur, arterial occlusion, renal artery stenosis, aneurysm

Bruit

- collateral circulation, portal hypertension, liver cirrhosis

Venous hum (epigastric)

PERCUSS THE ABDOMEN Begins - ________

LLQ, RLQ, RUQ, LUQ ((ends)

- air in abdomen

Tympany

- decrease tympanic sound Liver, spleen, organ enlargement, mass, ascites, bladder distention

Dullness

- increase tympanic sound, gaseous abdominal distention

Hyperresonance

PERCUSS THE LIVER - 6-12 cm (Midclavicular line), 4-8 cm (Midsternal line)

Normal liver span

- liver atrophy

Decrease liver span

- hepatomegaly, tumor, cirrhosis and abscess

Increased liver span

PALPATE ABDOMEN - LLQ, LUQ, RUQ, RLQ ((ends)

Begins

- relaxed, smooth, soft, even, nonrigid, nontender, no abdominal guarding

Light palpation (1 cm)

- no tenderness, nontender, no palpable mass

Deep palpation (Bimanual)

- nodules, firm, hard,

Abnormal

A positive ________ is when significant pain is elicited by palpating this area in the RLQ. This could mean appendicitis.

McBurney's Sign

- a.k.a. rebound tenderness - Pain upon removal of pressure rather than application of pressure to the abdomen - Peritonitis and/ or appendicitis

BLUMBERG'S SIGN

is when there is brief worsening of pain after releasing pressure while palpating This indicates possible peritonitis,

REBOUND TENDERNESS

Pain elicited in RLQ Suggestive of acute appendicitis

Rovsing's Sign

P.E

Ans.

Latin Abbreviations

Latin Abbreviations

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Week 3

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Week 5

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Week 8 and 9

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Abbreviations

Abbreviations

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