NR 304 Week Two Health Assessment II
Introduction
The diagram provided shows the corresponding organs labeled in each section as follows:
Section A contains the liver, right kidney, gallbladder, and large and small intestines. Section B includes the liver, stomach, spleen, duodenum, adrenal glands, and pancreas. Section C includes part of the liver, stomach, pancreas, left kidney, spleen, and both the large and small intestines. Section D displays the gallbladder, liver, and ascending colon. The organs present in Section E are the duodenum, small intestine, and transverse colon. In Section F, you will find the descending colon and the left kidney. Section G is labeled with the appendix, cecum, ascending colon, and small intestine. Section H contains the bladder, sigmoid colon, small intestine, and reproductive organs. Finally, in Section I, you can observe the sigmoid colon, descending colon, and small intestine.
Hepatomegaly refers to an enlarged liver. There are several possible causes for hepatomegaly, including liver disease (such as hepatitis or cirrhosis), congestive heart failure (CHF), liver cancer, excessive alcohol consumption, obesity, infections (such as hepatitis A, B, or C), autoimmune diseases (like autoimmune hepatitis), and more. These conditions can lead to liver enlargement and require further evaluation and treatment. Specific organs can usually be palpated in the abdomen during an examination. The liver, spleen, and kidneys are among the organs that can be felt through palpation. However, it is essential to note that the ability to palpate these organs can vary depending on factors such as body habitus and any abnormalities or pathologies.
NR 304 Week Two Health Assessment II
The abdominal contour can differ based on the individual’s age and condition; for a pregnant woman, an oval, round, and protuberant abdominal shape is expected due to the growing uterus and the presence of the developing fetus. In teenagers, a rounded abdomen is typical. In contrast, elderly patients often have an elongated and pear-shaped abdominal contour, which can be attributed to changes in body composition and musculature associated with aging. Hypoactive bowel sounds refer to decreased or absent bowel sounds, which can occur during and immediately after abdominal surgery or in conditions like paralytic ileus. On the other hand, hyperactive bowel sounds are characterized by increased high-pitched and frequent sounds. They may be heard in diseases such as gastroenteritis or when someone takes laxatives. These sound differences help healthcare professionals assess and monitor gastrointestinal motility and function.
It is possible to auscultate and hear no bowel sounds in certain situations. After abdominal surgery, it is normal for bowel sounds to be temporarily absent. When assessing for bowel sounds in such cases, listening for a few minutes is recommended to allow for the return of regular bowel activity. An X-ray is typically performed to verify the correct placement of a nasogastric tube (NGT). This imaging technique provides a definitive confirmation of the tube’s order within the gastrointestinal tract. Listening to lung sounds while the patient speaks can also give a clue regarding the tube’s placement. Further adjustment is required if the patient coughs or experiences choking, indicating that the line is in the lungs.
NR 304 Week Two Health Assessment II
Costovertebral tenderness typically indicates potential issues such as ureter pelvic junction obstruction, nephrolithiasis (kidney stones), or pyelonephritis (kidney infection). To determine costovertebral tenderness, the healthcare provider places one hand over the 12th rib and the costovertebral angle (CVA), then thumps on the hand using the ulnar edge of the other fist. If the patient experiences pain in the area, it suggests a potential kidney infection or other underlying conditions. Several conditions can alter percussion over the abdomen. Obesity, excessive gas in the gastrointestinal tract, ascites (accumulation of fluid in the abdominal cavity), and the presence of a large ovarian cyst are examples of conditions that can affect percussion sounds. Depending on the specific situation, percussion may result in a sound that is either tympanic (high-pitched and drum-like) or dull (low-pitched and thud-like).
The umbilical cord consists of two umbilical arteries and one umbilical vein. These blood vessels play a crucial role in fetal circulation, with the umbilical arteries carrying deoxygenated blood from the fetus to the placenta and the umbilical vein transporting oxygenated blood from the placenta to the fetus. Murphy’s sign is a physical examination maneuver used to assess for acute cholecystitis, which is inflammation of the gallbladder. During the plot, the healthcare provider palpates the right upper quadrant of the abdomen just below the liver border while the patient takes a deep breath. If the patient experiences sudden pain and inspiratory arrest upon palpation, it suggests a positive Murphy’s sign, indicating possible acute cholecystitis.
NR 304 Week Two Health Assessment II
When auscultating the abdominal quadrants, the order follows the path of the bowel. It begins in the right lower quadrant (RLQ), then moves to the right upper quadrant (RUQ), followed by the left upper quadrant (LUQ), and finally ends in the left lower quadrant (LLQ). During an abdominal exam, the patient should be prone, lying flat on their back with their arms by their sides. To ensure comfort, they may be provided with a pillow, or the head of the bed may be slightly elevated.
The Three patients in the order they should be treated are as follows:
- An asthmatic patient with an active attack. This patient should be treated first because airway, breathing, and circulation (ABC) concerns take top priority, and an active asthma attack can quickly escalate and compromise the patient’s breathing.
- A patient who fell and landed on their left upper quadrant (LUQ) is now experiencing pain and a drop in blood pressure. This patient should be treated next because a fall impacting the LUQ can potentially cause internal bleeding or organ damage, leading to a circulatory problem.
- A patient with a recent fall and a change in consciousness (LOC) level over the last two days. Although LOC changes are concerning, since they occurred two days ago, they are not as immediate of a priority as the previous two cases. A patient with a broken wrist and an oozing wound. This patient can be treated last as it is considered a lower priority than the other situations mentioned. Rigidity refers to the constant hardness of the abdominal muscles, which may be unilateral and painful when the patient sits up. On the other hand, guarding refers to bilateral muscle tension that relaxes during exhalation. Guarding is often associated with a cold or tense demeanor.
