Week 4 Exam Review

Flashcards covering abdominal assessment, GI conditions, musculoskeletal assessment, age-related changes, and common disorders like osteoarthritis and rheumatoid arthritis.

Abdominal Assessment Sequence

Inspect, Auscultate, Percuss, Palpate.

Reason for Auscultation before Palpation

To avoid stimulating bowel sounds.

Abdominal Inspection Components

Contour, symmetry, skin, umbilicus, pulsations, visible peristalsis, demeanor.

Order to Auscultate Abdomen

Start in RLQ (ileocecal valve), then RUQ, LUQ, LLQ.

Active Bowel Sounds

5-30 sounds per minute.

Hypoactive Bowel Sounds

Less than 5 sounds per minute; may occur post-surgery or with peritonitis.

Hyperactive Bowel Sounds

More than 30 sounds per minute; may occur with diarrhea.

Absent Bowel Sounds

No sounds heard for 5 minutes; may indicate ileus.

Light Palpation (Abdomen)

Assesses ~1 cm deep for surface characteristics, tenderness, guarding, and superficial masses.

Deep Palpation (Abdomen)

Assesses ~5-8 cm deep for organs and deep masses.

Normal Organ Palpation Findings

Liver edge may be felt, kidneys usually not palpable, spleen not palpable.

Red Stool

Indicates lower GI bleed or hemorrhoid.

Grey Stool

Indicates biliary obstruction or 'clay' colored stool.

Black Stool

Indicates upper GI bleed or iron supplement use.

Organs in RUQ

Liver, gallbladder, duodenum, pancreas head, right kidney, hepatic flexure of colon, part of ascending and transverse colon.

Priority Intervention: Abdominal Pain

Assess, take vitals, NPO (nothing by mouth).

Priority Intervention: Suspected GI Bleed

Monitor vitals, provide hemodynamic support, notify provider.

Priority Intervention: Ascites

Daily weights, measure girth, monitor breathing, restrict Na+.

Age-related GI Changes in Older Adults

Slower peristalsis, constipation, decreased saliva, reduced liver size/function, more gallstones.

Functional Units of the Musculoskeletal System

Bones, muscles, ligaments, tendons, joints.

Flexion

Bending a body part, e.g., elbow bending.

Extension

Straightening a body part, e.g., elbow straightening.

Abduction

Movement of a limb away from the midline of the body.

Adduction

Movement of a limb toward the midline of the body.

Major ROM Movements of the Spine

Flexion, extension, lateral bending, rotation.

Muscle Strength Grading Scale 0

No muscle contraction.

Muscle Strength Grading Scale 5

Full range of motion against gravity and resistance.

Common Musculoskeletal Changes with Aging

Decreased height, kyphosis, decreased ROM, muscle atrophy, increased fall risk.

Osteoarthritis (OA)

Wear-and-tear arthritis, common in older adults, asymmetric, worse with use, associated with Heberden's/Bouchard's nodes.

Rheumatoid Arthritis (RA)

Autoimmune arthritis, can occur at any age, symmetrical, worse with rest, systemic, leads to deformities.

Classic RA Deformities

Ulnar drift, swan neck deformity, boutonnière deformity.

Crepitation

Audible or palpable grating sound/sensation produced when bones or joints rub together.

Phalen's Test

Special test for carpal tunnel syndrome, involving wrist flexion.

Tinel's Sign

Special test for carpal tunnel syndrome, involving tapping the median nerve.

why is it important to recognize normal vs abnormal findings

Detect early disease, prevent complications, prioritize interventions.

How might aging

changes affect ab- dominal and mus- culoskeletal assess-

ment

Slower GI transit, ROM, postural changes, fall risk “ altered baseline findings, ’

What safety considerations are most important during assessment?

Stop if severe pain, protect fall-risk patients, recognize acute changes (GI

bleed, sudden weakness).

What safety considerations are most important during assessment?

Stop if severe pain, protect fall-risk patients, recognize acute changes (GI

bleed, sudden weakness)

RLQ

solon, small intestines, right ureter, appendix, right ovary, right fallopian tube

RUQ

liver, gallbladder, duodenum, head of pancreas, right kidney and adrenal, hepatic flexure of colon, part of ascending and transverse colon

LUQ

stomach, spleen, pancreas

LLQ

colon, small intestine, ureter, major vein and artery of left leg

what makes an older patient at higher fall risk

assistive devises, confusion, immobility, medications, balance issues