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Basic adult health Exam 4 Study Guide A+ Basic Adult Health Care (Keiser University)
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Basic adult health Exam 4 Study Guide A+Basic Adult Health Care (Keiser University)
,Basic Exam 4 Study Guide
GASTROINTESTINAL GI
Assessment of the GI System #1
❖ Health history:
o Information about abdominal pain, dyspepsia, gas, nausea and vomiting, diarrhea,
constipation, fecal incontinence, jaundice, and previous GI disease is obtained
❖ Pain:
o Character, duration, pattern, frequency, location, distribution of referred abdominal
pain, and time of the pain vary greatly depending on the underlying cause
❖ Dyspepsia (indigestion)
o Most common symptom of patients with GI dysfunction
❖ Intestinal gas
o Bloating, distention, or feeling “full of gas” with excessive flatulence as a symptom of
food intolerance or gallbladder disease
❖ Nausea and vomiting
o Nausea is a vague, uncomfortable sensation of sickness or “queasiness” that may or may
not be followed by vomiting
❖ Change in bowel habits and stool characteristics
o May signal colonic dysfunction or disease
o Constipation, diarrhea
❖ Past health, family and social history
o Oral care and dental visits
o Lesions in mouth
o Discomfort with certain foods
o Use of alcohol and tobacco
o Dentures
Physical Assessment of the GI System
❖ Oral cavity:
o Lips
o Gums
o Tongue
❖ Abdominal assessment; four quadrant method
o Inspection
o Auscultation
o Percussion
o Palpation
❖ Rectal Inspection
Assessing Bowel Elimination
❖ Factors Affecting Bowel Elimination
o Age
o Diet (fiber intake: 25-38g/day) o Positioning
o Fluid intake (2-3L/day) o Pain
o Physical activity o Pregnancy
o Psychosocial factors (anxiety = diarrhea) o Surgery/anesthesia
o medication
, o Personal habits
❖ Hemorrhoids
o Engorged, dilated blood vessels which occur due to difficult defecation, pregnancy, liver
disease and heart failure
o Can be itchy, painful and bloody
o Use moist wipes when wiping
o Can treat with a sitz bath, ice pack or topical medications (phenylephrine cream)
❖ Constipation
o Causes: laxative overuse, low fluid/fiber intake, immobilization, surgery/anesthesia,
pregnancy, medications
o Assess bowel movements, bowel sounds, diet history
o Treatment: increase fluid/fiber intake; increase activity; laxatives; enemas
o Paralytic ileus: intestinal obstruction – treated with IV hydration/may require NGT/may
require surgery
❖ Diarrhea
o Causes: viral/bacterial gastroenteritis; antibiotic therapy, inflammatory bowel disease,
irritable bowel syndrome, diet changes
o Treatment: assess and treat the cause; may use medications (loperamide); dietary changes
(increase fiber, may recommend yogurt)
o Assess for clostridium difficile infection (if positive – special contact precautions with soap
and water hand washing – do not give loperamide)
❖ Ostomies
o May be temporary or permanent
o Ileostomy/colostomy
o Stool may be liquid or soft
o Assess stoma (should be pink, shiny, and moist – notify if purple/black/pale in color) and skin
around stoma
******* test***Order of Abdominal assessment:
Inspection, auscultation, percussion, and palpation
Labs
❖ Liver function tests
o Asparate aminotransferase (AST) – elevated in liver dysfunction
o Alanine aminotransferase (ALT) – elevated in liver dysfunction
o Bilirubin [indirect (preliver)/direct (postliver)/total] – elevated in liver dysfunction,
hepatobiliary disorders, increased destruction of erythrocytes – urine or serum – ANY
bilirubin in urine indicates liver dysfunction (may be dipstick test or 24-hr collection)
o Albumin – decreased in liver dysfunction
o Ammonia – elevated in liver dysfunction
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