3b Health Assessment

What are the main functions of the gastrointestinal (GI) and urinary (GU) systems?

GI = digests food, absorbs nutrients, and eliminates stool.

GU = filters blood, removes waste through urine, and helps regulate body fluids.

What are the functions of the major digestive organs?

Stomach =

liver =

gallbladder =

pancreas =

small intestine =

large intestine =

Stomach = mixes and digests food;

liver = produces bile and detoxifies blood;

gallbladder = releases bile to digest fats;

pancreas = produces digestive enzymes and insulin;

small intestine = absorbs nutrients;

large intestine = absorbs water and forms stool.

What are the functions of the urinary organs?

Kidneys =

ureters =

bladder =

urethra =

Kidneys = filter blood and produce urine;

ureters = carry urine to the bladder;

bladder = stores urine;

urethra = carries urine outside the body.

What are the four abdominal quadrants and their major organs?

• RUQ = liver, gallbladder.

• RLQ = appendix, cecum.

• LUQ = stomach, spleen, pancreas.

• LLQ = descending/sigmoid colon.

What important questions should the nurse ask during a GI assessment?

Ask about abdominal pain, nausea, vomiting, bowel movements, constipation, diarrhea, appetite, weight changes, swallowing problems, and blood in vomit or stool.

What are important questions during a GU assessment?

Ask about painful urination, frequency, urgency, difficulty starting urination, nighttime urination, blood in urine, incontinence, and flank pain.

What do these GI terms mean?

• Dysphagia =

• Odynophagia =

• Dyspepsia =

• Hematemesis =

• Jaundice =

• Dysphagia = difficulty swallowing.

• Odynophagia = painful swallowing.

• Dyspepsia = indigestion.

• Hematemesis = vomiting blood.

• Jaundice = yellowing of skin/eyes from bilirubin buildup.

What do these GU terms mean?

• Dysuria =

• Polyuria =

• Nocturia =

• Hematuria =

• Hesitancy =

• Incontinence =

• Dysuria = painful urination.

• Polyuria = excessive urine production.

• Nocturia = frequent urination at night.

• Hematuria = blood in urine.

• Hesitancy = difficulty starting urination.

• Incontinence = inability to control urination.

What are the three types of abdominal pain?

Visceral = poorly localized, cramping/burning pain from internal organs.

Parietal = sharp or steady, localized pain that worsens with movement.

Referred = pain felt away from its original source.

What is the difference between guarding, rigidity, and rebound tenderness?

Guarding = voluntary tightening of abdominal muscles;

rigidity = involuntary muscle tightening from irritation/inflammation;

rebound tenderness = pain when pressure is suddenly released.

What is GERD?

Gastroesophageal reflux disease = stomach acid flows backward into the esophagus, causing heartburn.

What is the difference between IBS and inflammatory bowel disease (IBD)?

IBS = bowel disorder causing abdominal pain, diarrhea, or constipation. IBD (Crohn's or ulcerative colitis) = inflammation of the digestive tract.

What is appendicitis, and what symptoms are expected?

Inflammation of the appendix; pain may begin around the belly button and move to the RLQ, with nausea, vomiting, and fever.

What is cholecystitis, and what is it associated with?

Inflammation of the gallbladder, associated with abdominal pain and a positive Murphy's sign.

What are ascites and hernia?

Ascites = fluid buildup in the abdomen.

Hernia = an organ or tissue pushing through a weakened muscle wall.

What are common kidney and urinary conditions?

UTI = urinary tract infection;

kidney stones = hard deposits that may cause flank pain;

chronic kidney disease = gradual loss of kidney function.

What is the correct sequence for an abdominal assessment?

Inspection → Auscultation → Percussion → Palpation. Listen before touching because palpation and percussion may change bowel sounds.

How should the patient be prepared for an abdominal assessment?

Patient supine and relaxed, bladder emptied, appropriate draping, warm hands/stethoscope, and examine painful areas last.

What does the nurse inspect during an abdominal assessment?

Skin color, scars/stretch marks, symmetry, abdominal shape, umbilicus, distention, masses, pulsations, and visible peristalsis.

What are normal bowel sounds, and where does auscultation begin?

High-pitched gurgling sounds, approximately 5–30 per minute. Listen with the diaphragm, starting in the RLQ and moving clockwise: RLQ → RUQ → LUQ → LLQ.

What are hypoactive, hyperactive, and absent bowel sounds?

Hypoactive = decreased sounds;

hyperactive = increased sounds;

absent = no sounds heard after prolonged listening. Lecture specifies listening for at least 2 minutes before identifying absent sounds.

What are abdominal bruits?

Abnormal swooshing sounds caused by turbulent blood flow through arteries. Listen with the bell of the stethoscope.

What are normal and abnormal abdominal percussion sounds?

Tympany = hollow, drumlike sound from air (common/expected);

dullness = solid organ, mass, or fluid.

What is costovertebral angle (CVA) tenderness, what can it indicate

Pain when the nurse gently percusses the back near the kidneys. May indicate kidney infection or inflammation.

What is the difference between light and deep abdominal palpation?

Light = approximately 1 cm, checks tenderness and superficial masses. Deep = approximately 5–8 cm, assesses deeper organs and masses.

Where is McBurney's point, and what does tenderness suggest?

Area in the RLQ near the appendix. Tenderness may indicate appendicitis.

What is Rovsing's sign, what does it suggest?

Pressing on the LLQ causes pain in the RLQ, suggesting appendicitis.

What is the psoas sign, whats it suggest?

Abdominal pain triggered by moving or extending the hip/leg, suggesting appendiceal irritation.

What is the obturator sign, whats it suggest?

Pain with internal rotation of the flexed right hip, suggesting appendicitis,

What is Blumberg's sign, what does it indicate?

: Rebound tenderness—pain when pressure is suddenly released from the abdomen. Can indicate peritoneal irritation.

What is Murphy's sign, what does it suggest?

Pain and interrupted inspiration when the nurse presses under the right rib cage while the patient inhales; suggests cholecystitis.

What GI and GU changes or risks are common in older adults?

Reduced pain sensitivity,

decreased appetite,

greater risk of dehydration and

electrolyte imbalances with diarrhea, and

increased susceptibility to UTIs.

How are hepatitis A, B, and C transmitted?

• Hepatitis A = fecal-oral route; vaccine available.

• Hepatitis B = infected blood and body fluids; vaccine available.

• Hepatitis C = mainly blood exposure; no vaccine.

What are common colorectal cancer risk factors?

Older age, family history, smoking, alcohol use, inactivity, excess weight, and high intake of red/processed meat.

What colorectal cancer screening is recommended in the lecture?

The slides describe stool blood testing, sigmoidoscopy, or colonoscopy for adults aged 50–75.