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NURS 261 Final Exam Study Guide Spring 2019.
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Virginia Commonwealth UniversitySchool of Nursing
NURS261 Health Assessment for Nursing Practice
Study Guide for Final Exam 2019
ABDOMEN
1. Identify the anatomy of the abdominal cavity.
a. The abdominal cavity is the largest cavity in the body and contains the stomach,
small and large intestines, liver, gallbladder, pancreas, spleen, kidneys, ureters,
bladder, adrenal glands and major vessels.
b. Esophagus lies outside abdominal cavity but is vital part of gastrointestinal (GI)
system.
c.
2. Describe the anatomical landmarks used in the assessment of the abdomen.
,3. Describe the expected findings from inspection of the abdomen.
a. Surface characteristics should be smooth. Silver white striae; scars; and a very
faint vascular network may be present. The umbilicus should be centrally located
b. Skin color may be paler than other parts of the body because of lack of exposure
c. Contours may be round, flat or scaphoid. A flat contour is found in muscular or
athletic adults. A round contour is found in adults with poor muscle tone or
subcutaneous fat. A scaphoid contour is found in thin adults
d. The abdomen should move smoothly and evenly with respirations
i. Females exhibit thoracic movements
ii. Males exhibit abdominal movements
e. Peristalsis is not visible
4. Describe the process for auscultating the
abdomen for bowel sounds, and the expected
findings.
a. Bowel sounds are produced by the
movement of air and fluid through
stomach, small and large intestines. Because
of this listening in all four quadrants is not
necessary. A bowel sound heard in one
quadrant can be hear in another
quadrant.
b. Process: use diaphragm of stethoscope lightly and listen in a systematic
progression. RLQ, RUQ, LUQ, LLQ.
i. Cannot say BS absent unless you listen for 4-5 minutes without hearing
anything
c. Findings: sounds that are high pitched gurgles or clicks.
i. Hypoactive (5 sounds or lower)
ii. Normoactive (5-35 sounds)
iii. Hyperactive (over 35 sounds)
5. Explain the order of assessment techniques of the abdomen, including the rationale for
the order.
, a. Auscultate the abdomen- this is before palpation so that the presence of absence
of bowel sounds or pain is not altered
b. Auscultate for arterial and venous vascular sounds-listen for bruit
c. Percuss the abdomen(Special circumstance)- should hear tympany except for
the area around liver then you would hear dullness
d. Palpate the abdomen light for tenderness and muscle tone-palpate over the area
of pain last
e. Palpate the abdomen deeply for pain, masses and aortic pulsation
6. Identify at least two uses of auscultation in the abdominal exam.
a. To notice the presence of bowel sounds
i. Decreased or absence of bowel sounds occur with mechanical obstruction
or bowel obstruction
b. To listen for bruit sounds
i. A bruit indicates a turbulent blood flow by narrowing of blood vessels
ii. Bruits over the aorta suggest an aneurysm
iii. Normal vascular sounds are not heard
7. Be able to select health history questions related to the abdomen and GI system.
a. Past health history questions
i. Have you had problems with your abdomen or digestive system in the past?
Esophagus? Stomach? Intestines? Liver? Gallbladder? Spleen? If yes,
describe
ii. Have you had surgery of your abdomen or urinary tract? If yes, describe.
Has the surgery required that you change any of your former routines such
as the food you can eat or bowel or urinary elimination? How have you
adjusted to the effects of these surgeries?
iii. Have you had problems with your urinary tract in the past?
iv. Do you ever experience leaking of urine? When does this occur? Do you
ever use pads, tissue or cloth in your underwear to absorb urine?
8. List the commonly reported problems of the abdomen and GI system.
a. GERD
i. GERD:
ii. Flow of gastric secretions up into esophagus.
iii. Clinical findings:
1. Heartburn
2. Regurgitation
3. Dysphagia (difficulty swallowing)
b. Peptic ulcer disease
i. Peptic ulcer disease is ulcer occurring in lower end of esophagus, stomach,
or duodenum.
ii. Patients complain of burning after eating.
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