NURS 550 Final Set Tested Questions With Revised Correct Answers <CLEAR IMAGES INCLUDED> >Guaranteed Pass!!>
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NURS 550 Final Set Tested
Questions With Revised Correct
Answers
<CLEAR IMAGES INCLUDED>
>Guaranteed Pass!!>
HIDA scan- to visualize the flow of bile
Murphy's sign-
abdominal pain
Emergent Causes of Abdominal Pain
• Abdominal Aortic Aneurysm (AAA) • Myocardial Infa...
NURS 550 Final Set Tested
Questions With Revised Correct
Answers
<CLEAR IMAGES INCLUDED>
>Guaranteed Pass!!>
What order to assess the abdomen
1.) Inspect
2.) Auscultate
3.) Percuss
4.) Palpate
• Where would the pain be in?
o Hepatitis:
RUQ discomfort
o Where would the pain be in?
Cholecysitis:
RUQ pain
Cholecystitis
,Definition: Acute cholecystitis is inflammation of the gallbladder
wall.
Ninety percent of the time acute cholecystitis is caused by
gallstone obstruction of cystic duct.
Common presentation: "female, fat, and forty."
Attacks are intermittent and may be related to consumption of
a large, fatty meal. Onset of pain is gradual and pain may be
epigastric, and/or radiate to right shoulder or interscapular
area. Pain is aggravated by jarring and/or deep breathing.
"Female, fat, and forty" is a mnemonic used to describe a
common presentation, although acalculous cholecystitis can
occur in younger and older people after surgery, burns, sepsis,
or critical illness. It is more likely in people with a positive family
history. A drastic weight loss diet, extremely low in fat and
calories, is a risk factor for cholecystitis.
Clinical Manifestations: Signs/Symptoms
Acute, colicky or steady, aching RUQ pain
Nausea/vomiting
Low grade fever
Anorexia
Positive Murphy's sign (peritoneal inflammation)
Slightly elevated neutrophil count
Acute cholecystitis usually improves in 2-3 days and resolves
,within a week. Recurrences are common. Jaundice is usually not
present unless the common bile duct is obstructed.
Assessment Skill/Techniques /Labwork /Procedure used to
diagnose clinical problem
Murphy's sign-
increase in RUQ tenderness with palpation,
or from ultrasound probe, and inspiration
CBC- increased neutrophils
liver function tests- increased AST/ALT, increased amylase with
CBD obstruction
Gallbladder ultrasound- non-visualization of the gallbladder and
wall thickening
HIDA scan- to visualize the flow of bile
Murphy's sign-
abdominal pain
Emergent Causes of Abdominal Pain
, • Abdominal Aortic Aneurysm (AAA) • Myocardial Infarction
(MI) • Ectopic Pregnancy • Obstruction
• Mesenteric Ischemia • Appendicitis • Perforated Peptic Ulcer
• Splenic Rupture • Cholecystitis • Peritonitis
Physical Examination
General appearance • Vital signs including temperature and
pain scale - 0-10 at onset and present • Abdominal Assessment
- Inspection • Cullen sign • Turner sign - Auscultation -
Percussion - Palpation
Classification of Abdominal Pain
- Visceral pain: when hollow organs (stomach, colon) forcefully
contract or become distended. Solid organs (liver, spleen) can
also generate this type of pain when they swell against their
capsules. Visceral pain is usually gnawing, cramping, or aching
and is often difficult to localize (hepatitis) - Parietal pain: when
there is inflammation from the hollow or solid organs that
affect the parietal peritoneum. Parietal pain is more severe and
is usually easily localized (appendicitis) - Referred pain:
originates at different sites but shares innervation from the
same spinal level (gallbladder pain in the shoulder)
Rebound tenderness • Palpate deeply in the periumbilical area
and both lower quadrants. Rebound tenderness occurs if pain
increases when the examiner decreases the pressure against
the abdomen
cullen sign
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