Term
abdomen is the ____ cavity in the body |
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Definition
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Lateral support is provided by |
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Definition
the internal and external oblique muscles |
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Term
external oblique aponeurosis |
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Definition
strong membrane that covers the entire ventral surface of the abdomen and lies superficial to the rectus abdominis |
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Definition
extends from the xyphoid process to the symphysis pubis. |
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alimentary tract is how long |
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Definition
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perisalsis is under control of |
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Definition
the autonomic nervous system |
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Definition
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the esophagus connects to |
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Definition
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the gateway from the esophagus to the stomach |
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Definition
the lower esophageal sphincter |
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stomach is located in the |
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Definition
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what breaks down protein in the stomach? |
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Definition
pepsin; it breaks protein into peptones and amino acids |
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Definition
breaks down fats; convert from triglycerides to fatty acids and glycerol |
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liquified food is passed through the |
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Definition
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once liquid food is passed through the pyloric sphincter it enters the _____ and is termed ______. |
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Definition
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Definition
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small intestine is how long? |
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Definition
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the body gets most of its nutrients through the... |
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Definition
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Term
the fuctional units of the intestine are the |
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Definition
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absorption occurs through the |
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Definition
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the duodenum is how long? |
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Definition
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Definition
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Definition
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what is the ileocecal valve |
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Definition
the gateway to the large intestines; it prevents backflow of fecal material |
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the large intestine is how long? |
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Definition
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Term
the large intestine absorbs |
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Definition
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Term
Feces are formed and evacuated in and from the |
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Definition
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Term
moistens food and begins immediate beakdown of starch |
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Definition
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Term
largest organ in the body weighing 3.5 lbs? |
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Definition
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Term
where is the liver located? |
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Definition
lies underneath right diaphragm but spans across the midline and RUQ from 5th ICS to costal margin so the rib cage covers a substantial portion |
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Term
the liver has how many lobes? |
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Definition
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Term
the functions of the liver include: |
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Definition
bile production and secretion; transfer of bilirubin from blood to gallbladder; metabolized protein carbs and fat; stores glucose in the form of glycogen; produces clotting factors and fibrinogen; detoxification of alcohol and drugs; stores iron copper vitamins A and vitamin B complex; synthesizes plasma proteins; |
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between meals bile is stored in the |
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Definition
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bilirubin is formed by the |
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Definition
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liver turns water insoluble bilirubin into |
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Definition
water SOLUBLE bilirubin and extretes it to bile |
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Term
the majority of bilirubin is excreted in the |
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Definition
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Term
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Definition
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gallbladder is attached to |
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Definition
inferior portion of liver |
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Definition
concentrates and stores bile between meals |
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Term
the cystic duct forms with the _____ duct to form the ____ ____ duct. |
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Definition
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Term
common bile duct drains ____ into the ____ |
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Definition
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Term
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Definition
emulsifies fats and prepares them for further digestion in the small intestine |
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Term
what creates brown color in feces? |
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Definition
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Term
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Definition
LUQ; under left lobe of liver and behind the stomach |
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Definition
Endocrine secretions : insulin, glucagon, and gastrin. Exocrine secretions: bicarbonate and pancreatic enzymes that flow into the duodenum to break down proteins, fats, and carbs for absorption |
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Term
spleen is about the size of... |
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Definition
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Definition
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Definition
LUQ between the stomach and the diaphragm |
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the spleen houses what two systems? |
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Definition
1. lymphoid/lymphatic tissue make up the “white pulp” and venous sinusoids make up the “red pulp” |
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Definition
stores erythrocytes and platelets and removes old ones; activates T and B lymphocytes; |
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where kidneys are located |
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Definition
posterior abdomen around T12 to L3 |
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Term
each kidney is covered by the |
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Definition
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Definition
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Definition
functional unit of the kidney and produces urine |
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Definition
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Definition
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bladder is located in the |
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Definition
symphisis pubis in the anterior part of the pelvis |
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Term
when the bladder accumulates ____ ml of urine, the _____ relaxes (known as the mictruition reflex) |
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Definition
250-300 mL; internal urethral sphincter |
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Term
voiding occurs when what relaxes? |
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Definition
the external urethral sphincter |
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Term
urine exits the urethra and extends to the |
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Definition
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Term
the main portion of the aorta is the |
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Definition
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Term
the descending aorta consists of the: |
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Definition
thoracic and abdominal aorta |
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Term
the descending aorta supplies... |
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Definition
the esophagus, lymph glands, ribs, stomach, liver, intestines, kidneys, spleen, and reproductive organs |
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Term
the descending aorta branches into _____ at the level of the umbilicus |
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Definition
two common iliac arteries |
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Term
blood is returned to the right atrium of the heart from the abdomen via the... |
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Definition
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Term
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Definition
starts at the aortic opening of the left ventricle, rises a short distance, bends over the root of the left lung, descends within the thorax on the left side of the vertebral column, and passes through the aortic hiatus of the diaphragm into the abdominal cavity. It branches into the two common iliac arteries. |
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Term
which organs are located in the RUQ? |
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Definition
the liver and gallbladder |
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Term
risk factors for abdominal cancers |
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Definition
1. age greater than 50 2. males higher risk 3. african american - except for bladder cancer 4. tobacco, alcohol 5. family history 6. diet high in fat and meat 7. Chronic illness- diabetes, obesity, infections |
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Term
examination of the abdomen includes: |
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Definition
Observe clients’ general behavior and position Inspect the abdomen Auscultate the abdomen Palpate the abdomen lightly Palpate the abdomen |
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Term
abnormal findings when examining client: |
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Definition
Abnormal: Emaciation, obesity, restlessness, rigid posture, facial grimacing; Abnormal: jaundice, bruises, engorgement of veins, taut skin, marked concavity, bulges during cough,etc.; : Absence of sound or extremely hyperactive (borborygmi)
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Term
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Definition
extremely hyperactive sounds in abdomen |
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Term
how to auscultate the abdomen for bowel sounds |
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Definition
Use diaphragm of stethoscope Press lightly Follow systematic progression; begin RLQ Normal: Bowel sounds heard every 5-15 seconds; sounds are high-pitched gurgles or clicks Abnormal: Absence of sound or extremely hyperactive (borborygmi |
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Term
how to auscultate the abdomen for arterial and venous sounds: |
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Definition
Use the bell of stethoscope Listen over aorta, renal, iliac, and femoral arteries (*next slide) Normal: Vascular sounds are not heard Abnormal: Bruits; venous hum; low-pitched murmurs |
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Term
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Definition
abnormal, swishing sound that results from blood flowing through a narrow or partially occluded artery |
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Term
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Definition
continuous murmur; a gentle blowing, fluttering, or humming sound; rare; associated with portal hypertension and cirrhosis |
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Term
what sounds may indicate renal artery stenosis?? |
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Definition
Low-pitched murmurs heard over the upper midline or toward the flank or epigastric bruits that radiate laterally |
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Term
abnormal during palpation of the abdomen |
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Definition
rigidity, mass, tenderness or hypersensitivity |
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Term
how deep do you palpate the abdomen? |
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Definition
1-2 cm deep; palpate over area of pain last ALWAYS! |
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Term
when palpating the abdomen deeply: |
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Definition
Palpate 4-6 cm; use distal portion of finger pads Outcomes: Possibly may feel aorta around epigastrium or slightly above and to left of umbilicus Abnormal: patient responds with facial grimaces, c/o pain, masses
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Term
when percussing the abdomen what tones are most common and why? |
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Definition
tympany tones most common because of presence of gas |
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Term
when percussing the suprapubic area teh sound may be ____ when the bladder is distended |
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Definition
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Term
if bladder is not distended the dullness when percussing may indicate a |
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Definition
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Term
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Definition
to determine span and descent |
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Term
when percussing the liver start |
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Definition
at the righ midclavicular line; below the umblilicus; percuss upwards (tympany to dullness should be heard); Over the lung, percuss downards (resonance to dullness should be heard); |
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Term
the liver span is normally how long? |
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Definition
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Term
when percussing the spleen: |
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Definition
percuss in several directions in the lowest intercostal space just posterior to the left midaxillary line---usually the spleen can’t be percussed |
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Term
splenic enlargement means |
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Definition
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Term
Abnormal findings around the umblicus when perscussing can be |
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Definition
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Term
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Definition
is an enlarged liver; it's associated with cirrhosis and hepatitis |
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Term
what do you percuss the spleen to determine? |
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Definition
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Term
Palpate liver for lower border and tenderness (advanced practice): |
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Definition
One technique is to place left hand posteriorly under 11th and 12th ribs while right hand is parellel to the right costal margin. Ask client to take deep breathe. Another technique is “hooking” where you stand on clients right side and face their feet. Curve fingers to hook under costal margin and ask client to take deep breath. |
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Term
abnormal findings when palpating the liver include: |
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Definition
client may complain of pain when taking deep breath or may feel enlarged liver |
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Term
Palpate gallbladder for tenderness (advance practice): |
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Definition
Palpate below liver and right lateral border of rectus abdominis. |
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Term
Abnormal findings when palpating the gallbladder for tenderness: |
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Definition
Palpation means possible cholecystitis. If client abruptly stops inhaling during palpation (Murphy’s sign), cholecystitis is suspected. A nontender enlarged gallbladder suggests common bile duct obstruction. |
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Term
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Definition
when a pt. abruptly stops breathing during palpation of the gallbladder |
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Term
Normally, the gallbladder _____ be palpable. |
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Definition
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Term
Palpate spleen for border and tenderness (AP). |
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Definition
Stand on client’s right side and reach across to place the palm of left hand under client’s left flank and then have patient breath in as you use right hand to palpate for spleen |
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Term
Palpate kidneys for presence, contour, and tenderness (AP): |
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Definition
To palpate for left kidney, complete procedure as for spleen except you want to elevate the client’s flank with your left hand and palpate deeply with your right hand. Switch sides. Normal: occasionally might be able to feel left lower kidney when patient takes inspiration. Should be able to feel right lower kidney. A tenderness is associated with kidney trauma or infection |
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Term
Elicit abdominal reflexes (AP) |
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Definition
Stroke each quadrant. Stroke from umbilicus out. The expected response to each stoke is contraction of the rectus abdominis and movement of the umbilicus toward the side stroked. Abnormal: ABSENT reflexes associated with disease of spinal cord. |
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Term
When percussing the kidneys... |
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Definition
Tap each CVA with the ulnar surface of the dominant fist or use indirect percussion. Abnormal: tenderness or severe pain my indicate pyelonephritis, glomerulonephritis, or nephrolithiasis (kidney stones) |
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Term
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Definition
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Term
Assess the abdomen for fluid (AP): |
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Definition
Shifting dullness: Ask client to lie supine. This causes fluid to shift to lateral areas. Percuss for midline tympany and lateral dullness (created by fluid). Perform percussion with client on left and right sides…noting where sounds change due to fluid shifts. Fluid wave: Client or another nurse placed hand midline abdomen with client supine. Tapping on one side of abdomen produces fluid wave on the opposite side of abdomen. |
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Term
Assess abdomen pain due to inflammation |
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Definition
Rebound tenderness: Press down at 90 degree angle to the abdomen at point away from the point of pain. Release your fingers quickly. “Normal” would be less pain when pressure is released. If rebound tenderness is positive, it indicates peritoneal inflammation. |
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Term
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Definition
A test for appendicitis. Palpate mcBurney point which is half way between umbilicus and right anterior iliac crest. Press firmly into abdomen and then release pressure quickly. Absence of pain in a negative McBurney sign. Positive rebound tenderness indicates appendicitis |
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Term
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Definition
with client supine, place your hand over the lower right thigh. Ask the client to raise the right leg, flexing at the hip. Push down to resist the raising of the leg. When the client reports no pain, the test is negative. If client reports pain, it is positive |
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Term
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Definition
the client lies supine and flexes the right hip and knee to 90 degrees. The nurse, holding the leg just above the knee and at the ankle, rotates the leg medially and laterally. If the client has no pain, the test is negative. Pain indicates a possible ruptured appendix or pelvic abscess. |
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Term
Assess for floating masses (AP) |
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Definition
Ballottement: Place one hand perpendicular to the abdomen and push in toward the mass with fingertips at 90 degree angle. A freely movable mass will float upward and touch the fingertips as fluids and other structures are displaced. May also use bimanual method to ‘capture’ mass between anterior and posterior abdomen. |
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Term
When assessing a client’s abdomen, the nurse uses assessment techniques in which order |
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Definition
Inspection, auscultation, palpation, and percussion
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Term
What is an expected finding of an abdominal examination of an adu |
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Definition
High-pitched gurgles every 5 to 15 seconds on auscultation |
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Term
many age related problems in the abdomen and digestion result from alterations in which systems? |
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Definition
Cardiovascular and Neuro rather than GI |
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Term
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Definition
In the esophagus, there is a decrease in lower esophageal pressure increasing regurgitation. In the large intestine, a decrease in peristalsis and weakened muscles contribute to constipation. Bacterial flora become less biologically active, contributing to food intolerance and impaired digestion; reduced external sphincter control with occasional fecal incontinence due to degeneration of rectal wall’s afferent neurons which detect changes in rectal pressure. The liver decreases in size, storage capacity, and ability to synthesize proteins. The bladder decreases in size, shape and muscle tone. This may lead to more frequent urination and stress incontinence/ leakage of urine.
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Term
Other age related occurances include: |
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Definition
In men, prostate gland atrophies and benign enlargement frequently occurs. Decreased cardiac output/ arteriosclerosis reduces blood flow to abdominal organs. Metabolism of drugs, hormones, and alcohol is less efficient. Often use fiber/laxatives; bowel sounds may be hypoactive. Increased fat deposits over abdomen. Loss of abdominal muscle tone- organ palpation easier
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Term
GERD - gastroesophogeal reflux disease |
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Definition
caused by weakness of LES or increased intraabdominal pressure. Symptoms: heartburn regurgitation, dysphagia aggravated by lying down and relieved by sitting up, antacids. |
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Term
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Definition
caused by muscle weakness in the diaphragm allowing protrusion back into the mediastinal cavity. May be due to pregnancy, obesity, ascites. Symptoms: same as GERD. |
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Term
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Definition
an ulcer occurring in the lower end of the esophagus, in the stomach, or in the duodenum is termed peptic ulcer. Duodenal ulcer is the most common from. May be caused by H. Pylori, stress, medications (corticosteroids, aspirin, NSAIDs). Symptoms: Gastric ulcers: pain 1-2 hours after eating in left epigastrium and back. Duodenal ulcers: Pain 2-4 hours after eating and at midmorning, midafternoon, middle of night. Relieved with food or antacids.
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Term
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Definition
herniations through wall of colon “swiss cheese” appearance |
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Term
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Definition
inflammation/infection, may have fever, pass mucous, cramping, nausea, vomiting, altered bowel habits, distended abdomen, localized tenderness, decreased bowel sounds |
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Term
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Definition
Chronic inflammatory bowel disease Can be present from mouth to anus but is most common in terminal ileum and colon Ulcerations, fistulas, fissures, abscesses Symptoms: severe abd pain, cramping, diarrhea, nausea, fever, chills, weakness, anorexia, weight loss
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Term
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Definition
Chronic inflammatory bowel disease- starts in rectum and progresses through large intestine Mucosa engorged, ulcerated, granulation tissue May progress to colon cancer Symptoms: severe abd pain, fever, chills, anemia, weight loss, profuse watery diarrhea with blood, mucous, pus
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Term
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Definition
Diarrheal disease sometimes found post-antibiotic therapy with C. diff overgrowth. Symptoms: profuse watery, diarrhea, fever, cramping
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Term
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Definition
Increase the proportion of adults who receive a colorectal cancer screening examination. Prevention is possible because most colon cancers originate from adenomatous polyps.
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Term
Health Promotion-Colorectal Cancer |
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Definition
Manage controllable risk factors: Diet, Exercise, Weight Screening recommendations (Age ±50) FOBT annually Flexible Sigmoidoscopy every 5 years Double-contrast BE every 5 years Colonoscopy every 10 years Digital rectal exam with other exams
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Term
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Definition
- abnormally increased motility of small and large intestines of unknown origin. Symptoms: pain in lower abdomen associated with occasional diarrhea. Pain usually relieved by passing flatus or stool. Other diseases must be ruled out.
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Term
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Definition
inflammation of liver. Common clinical findings: anorexia, vague abd. Pain, nausea, vomiting, malaise, fever. Enlarged spleen and liver are classic findings. Liver inflammation may cause jaundice (clay-colored stool, dark amber urine) |
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Term
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Definition
Chronic degenerative liver disease; diffuse destruction/regeneration of hepatic parenchymal cells; lobes of liver become fibrotic / infiltrated with fat |
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Term
Causes and findings associated with cirrhosis |
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Definition
Causes: viral hepatitis, alcoholism, biliary obstruction Clinical findings: liver palpable and hard Associated findings: ascites, jaundice, cutaneous spider angiomas, dark urine, clay-colored stools, spleen enlargement; end-stage cirrhosis is hepatic encephalopathy and coma |
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Term
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Definition
inflammation of the gallbladder |
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Term
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Definition
means "with stones" Caused by bile duct obstruction or stones Symptoms: RUQ colicky pain that may radiate to mid-torso or right scapula, may have indigestion or mild juandice
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Term
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Definition
acute or chronic inflammation from autodigestion; Flow of pancreatic digestive enzymes into duodenum is obstructed so the enzymes act on the pancreas itself -Caused by alcoholism or obstruction of sphincter of Oddi by gallstones -Symptoms: steady, boring, dull or sharp; radiates from epigastrium to back; clients prefer fetal position of knees to chest; nausea, vomiting, weight loss, steatorrhea, and glucose intolerance
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Term
Urinary Tract Infections: |
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Definition
Urethritis- frequency, urgency, dysuria Cystitis- same plus fever, bacteriuria Pyelonephritis- same plus flank pain, nocturia, hematuria
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Term
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Definition
inflammation of renal glomeruli caused by autoimmune process; symptoms: fever, chills, nausea, malaise, arthralgia, CVA tenderness |
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Term
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Definition
formation of stones in kidney pelvis Associated with obstruction and UTIs Alkaline urine- calcium phosphate stones Acid urine- cystine stones Men more than women
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Term
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Definition
Sudden, severe impairment Pre-renal, intra-renal, post-renal Urine output may be normal, decreased, or absent May require emergency dialysis |
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Term
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Definition
Slow, insidious, irreversible renal damage Uremia develops gradually Oliguria/anuria; signs of fluid volume overload Requires dialysis |
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Term
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Definition
the presence of excessive amounts of urea and other nitrogenous waste products in the blood
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Term
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Definition
diminished capacity to form and pass urine, less than 500ml every 24 hours
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Term
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Definition
absence of urine production or less than 100ml in 24 hours
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Term
Pre-renal: reduced cardiac output Intra-renal: acute pyelonephritis/glomerulonephritis, nephrotoxic agents,etc. Postrenal: urinary tract obstruction |
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Definition
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Term
Example Nursing Diagnosis: |
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Definition
Perceived constipation Risk for constipation Diarrhea Excess fluid volume Deficient fluid volume Risk for imbalanced fluid volume Imbalance nutrition Acute pain Nausea Impaired urinary elimination |
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Term
A 50-year-old client asks how he can reduce his risk of colon cancer. The nurse teaches the client that
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Definition
Regular exercise to reduce body fat helps prevent colon cancer |
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Term
A client reports a gnawing, burning in the midepigastric area that is aggravated by bending over or lying down. The nurse asks further questions of the client to detect possible:
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Definition
gastroesophogeal reflux disease (GERD) |
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Term
Albumin can be low when pt is |
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Definition
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Term
African Americans are 2.5 times as likely to develop what cancer than whites? |
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Definition
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Term
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Definition
|
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Term
the peritoneum has two layers: |
|
Definition
the parietal and visceral |
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Term
parietal peritoneum lines the |
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Definition
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|
Term
visceral peritoneum lines |
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Definition
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|
Term
the space b/w the two layers of the peritoneum is the |
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Definition
|
|
Term
the external oblique oponeurosis |
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Definition
is a stong membrane that covers the entire ventral surface of the abdomen and lies superficial to the rectus abdominis |
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Term
fibers from both side of the aponeurosis interlace in the midline to form the |
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Definition
|
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Term
|
Definition
a tendinous band that protects the midline of the abdomen b/w the rectus abdominis muscles |
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Term
the alimentary tract begins with the |
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Definition
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Term
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Definition
|
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Term
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Definition
hollow, flask-shaped, musclular |
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Term
the large intestine consists of the |
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Definition
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Term
in the small intestine, ingested food is... |
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Definition
mixed, digested, and absorbed. |
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Term
what makes red blood cells |
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Definition
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Term
what activiate B and T lymphocytes (WBC's)? |
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Definition
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Term
esophogeal cancer risk increases with age at a peak between what years? |
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Definition
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Term
men are __ times more at risk for esophogeal cancer than women |
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Definition
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Term
What veins empty into the inferior vena cava? |
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Definition
hepatic portal system (which drain the intestines, pancreas, stomach, and gallbladder); renal veins (which drain the kidneys and the ureters). |
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Term
About what percent of pancreatic cancer is believed to be directly related to cigarette smoking? |
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Definition
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Term
What meds cause GI side effects and should be noted during assessment? |
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Definition
aspirin, NSAID's (nonsteroidal antiinflammatory drugs), |
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|
Term
how much tylenol/day increases risk of liver disease? |
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Definition
|
|
Term
|
Definition
most common type of incontinence, characterized by involuntary loss of small amts of urine cause by physical exertion such as coughing, sneezing, jogging, and lifting |
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Term
|
Definition
associated with a sudden strong urge to void |
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Term
pancreatitis pain is relieve in what position? |
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Definition
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|
Term
visceral pain arises from the |
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Definition
GI tract; can be b/c of tumor growth or obstruction |
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Term
pain from gallbladder disease by be felt in the |
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Definition
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|
Term
back pain is associated with |
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Definition
aneurysms or duodenal ulcers |
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Term
sudden, acute pain that awakens the pt. may be associate with |
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Definition
acute preforation, inflammation, or torsion of and abdominal organ |
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Term
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Definition
pain associated with menstruation; may cause lower abdom pain and vomiting b/c of increase in prostaglandin |
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Term
pain from appendicitis is relived by |
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Definition
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|
Term
colicky pain from a gallbladder or kidney stone is relieved by |
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Definition
|
|
Term
individuals with greatest risk for colorectal cancer are those with a history of |
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Definition
polyposis, ulcerative colitis, or previous history of the cancer itself |
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Term
loss of appetite is associate with |
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Definition
|
|
Term
shortness of breath is associated with |
|
Definition
heart failure, and ascites associated with chronic liver disease |
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Term
nausea w/o vomiting is common during |
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Definition
pregnancy or metastatic disease |
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Term
one of the seven signs of cancer is a change in |
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Definition
|
|
Term
screening for colorectal cancer should begin at age |
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Definition
|
|
Term
fecal occult blood test should be done in adult 50 or over how often |
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Definition
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Term
flexible sigmoidoscopy should be done how often in those 50 years of age and over |
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Definition
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Term
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Definition
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Term
when inspecting the abdomen pt should be in what position |
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Definition
|
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Term
|
Definition
trauma or low platelet count |
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Term
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Definition
|
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Term
|
Definition
|
|
Term
when auscultating bowel sounds you should begin in the |
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Definition
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Term
when auscultating the abdomen for bowel sounds use what part of the stethoscope |
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Definition
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Term
always listen how many minutes in each quadrant? |
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Definition
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Term
bulges during couging indicate |
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Definition
abdominal hernia; vental, umbilical, inguinal, or femoral |
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Term
is peristalsis normally visible |
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Definition
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Term
marked concavity is usually indicative of |
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Definition
general wasting signs or anteroposterior rib expansion |
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Term
pt. with ileostomy have what kind of stool |
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Definition
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Term
If pt has transverse (upper colon) level colostomy, the stool is |
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Definition
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Term
if pt has colostomy in the descending or sigmoid colon, the stool should be |
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Definition
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Term
the duration of a normal bowel sound may last |
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Definition
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Term
bowel sounds should be noted every |
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Definition
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Term
Bowel sounds are normally |
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Definition
high pitched gurgles or clicks, although it varies greatly |
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Term
report any absence of bowel sounds after listening for |
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Definition
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Term
you should hear bowel sounds how many times in one minute? |
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Definition
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Term
auscultate abdomen for arterial and venous sounds using what part of stethoscope? |
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Definition
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Term
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Definition
1.epigastric 2.umbilical 3.hypogastric 4.right hypochondriac 5.left hypochondriac 6.right lumbar 7.left lumbar 8.right inguinal 9. left inguinal
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Term
when percussing liver begin below the |
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Definition
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Term
when palpating the abdomen deeply, ask pt. to |
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Definition
breathe slowly through the mouth to facilitate muscle relaxation |
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Term
a nontender, enlarged gallbaldder signifies |
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Definition
common bile duct obstruction |
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Term
when palpating the spleen place your ____ hand over the ____ |
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Definition
left; left costovertebral angle |
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Term
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Definition
for costovertebral angle (CVA) tenderness; tenderness there can indicate problems such as kidney stones |
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Term
Movement of dullness as pt shifts position reflects |
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Definition
the shift of fluid in the peritoneal cavity |
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Term
degeneration of gastric mucosa and decreased secretion of gastric acids and digestive enzymes along with decreases motility occurs in |
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Definition
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Term
palpation of organs may be easier in older adults due to |
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Definition
loss of abdominal muscle tone |
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