Abdominal Assessment (GI System) Gastrointestinal (GI) system assessment should include nutritional status, such as dehydration, malnutrition, and obesity, and conditions of the mouth and nose, especially when the patient is on tube feedings. Gag reflex, swallowing ability, dentures, and gums also need to be assessed. When you assess the patient’s abdomen, use natural light to observe skin color changes, such as those from jaundice. Artificial light can be misleading in skin assessment. Stand on the right side and flex the patient’s knees using a pillow if the patient is unable to do so during assessment. You can inspect the patient’s abdomen while auscultating it; first, use the diaphragm, without applying pressure, for bowel sounds, and then use the bell to auscultate for low-pitched sounds such as abdominal bruits. Bowel sounds may be diminished or difficult to hear in critically ill patients. Start your auscultation from the right lower quadrant (RLQ) because bowel sounds are easily transmitted from this area. Normal bowel sounds may be about 5 to 30 in a minute. If they are absent or diminished, listen for 5 minutes before you document bowel sounds as absent. Auscultate for abdominal bruit in four areas: aortic, renal, iliac, and femoral. Figure 3-3 demonstrates the sites to auscultate for vascular bruit. Inspect the …show more content…
If the patient has a urinary catheter, and most ICU patients do, he or she may not have any reportable symptoms. Therefore, good assessment of urinary elimination, done in relation to a patient’s signs, symptoms, urine amount, intake and output, and lab values, is important. The lab values are discussed in Chapter 5. Acute and chronic renal failure can cause numerous systemic symptoms and altered homeostasis ( Collins, 2011). See Table 3-10 for abnormal urinary elimination. Skin Assessment
Objective data are observable and measurable. This information is usually obtained through the senses as sight, smell, hearing and touch, during the physical examination of the patient. During Mary was assessed, this is the objective data: symmetrical abdomen, bowel sounds in all quadrants, tender to palpation in the lower quadrants, guarding, skin is warm and moist and her lips and mucous membranes are dry.
Gastrointestinal tract (GIT) is the portal through which nutritive substances; vitamins, minerals and fluids enter the body. The digestive tract is more than 10 metres long from one end to the other. It is continuous starting from the mouth, passing through the pharynx and the oesophagus, to the stomach, the small and large intestines, ending in the rectum, and finally into the anus. The GI tract is divided into two main sections: the upper GI tract and the lower GI tract. Upper GIT includes the mouth, pharynx, oesophagus and stomach. The lower GI tract includes the small and large intestines and anus. The accessory organs of digestions are the gallbladder, liver and pancreas. Diseases that may occur in upper and lower GIT can be divided as oesophageal diseases, gastric diseases and intestinal diseases.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
When tissue or an organ tears through a portion of abdominal wall, it is known as a Hernia. When this condition occurs, the tissue usually protrudes through the weakest point of the abdominal wall or abdominal muscles. An Inguinal Hernia is a type of Hernia that occurs in the groin area, specifically protruding through the Inguinal Canal, which can be very painful, and in some cases, life threatening.
The second procedure I was fortunate to observe was an esophagogastroduodenoscopy (EGD). The operation was performed with local anesthesia to the throat or sedation. The same type of scope was utilized, but instead of inserting through the rectum, the scope was inserted through the mouth. This procedure allowed the doctor to inspect the lining of the esophagus, stomach, and duodenum. Like the scope above, the doctor extracted biopsies, inflated the gastrointestinal tract, and cleansed the walls utilizing the scope. (Lewis, Dirksen, Heitkemper, & Bucher, 2014, p.
The Foley Catheter has allowed for people to excrete their urine. Not being able to excrete your urine can cause higher chances of urinary retention, not being able to empty your bladder completely, Urinary tract infections, your bladder will fill up until it bursts open inside your body, and you won’t get rid of the waste and excess water
(3)Bellomo,R.,Cass,A.,Cole,L.,Finer,S.,Gallagher,M.,Lo,S.,McAthur,C.,McGuinness,S.,Myburgham J.,Norton,R.,Scheinkestel,C.,& Su,S. for renal study investigators(2009).Intensity of continuous renal-replacement therapy in critically ill patients. The New England Journal of Medicine, 361(17), 1627-1638.
Ridley, E. J., Dietet, B. N., & Davies, A. R. (2011). Practicalities of nutrition support in the intensive care unit: the usefulness of gastric residual volume and prokinetic agents with enteral nutrition. Nutrition, 27(5), 509-512. doi:10.1016/j.nut.2010.10.010
The dream that I most desire in life is to become a Diagnostic Medical Sonographer. I’ve always had an interest in the inner workings of the human body, but I also value life, and care for others, and my happiness is the happiness of others. Although this career has its bumps on the road just to see mothers face light up when they see the image of their unborn baby is such a breath taking experience. This all originated from going to one of my sisters’ ultrasound appointment that I ended up going to all my sisters’ ultrasound appointments. I believe becoming a diagnostic medical sonographer is something I can do because I have what it takes. Diagnostic medical sonographer is imaging modality that can work in conjunction with other imaging modalities
Due to the fact that I have not read any of the Harry Potter books, or even watched any of the movies, I chose to go a different route. I decided to use the familiar character, Winston Smith, the protagonist from George Orwell‘s 1984. Winston is considered of having bad health, he smokes, drinks and has a hard time getting up in the morning. One of the most notable deformities that Winston is his varicose ulcer above his right ankle . This is Winston’s Mark that sets him apart as the protagonist for the story, Because it symbolizes his hatred and dislike for the party. In the second time the ulcer is brought up in the book, it itches due to the fact that Winston can’t remember why he started his diary. Subconsciously he is holding back his
A cesarean section, also called a c-section, is the surgery to deliver a baby at birth. (www.webmd.com) The baby is taken out through the mother's stomach. in certain circumstances, a c-section is scheduled in advance, but in other cases it's done in response to an unforeseen complication. for a c-section there can be some sort of pain depending on the person and how their health may be. (www.babycenter.com) There can be little to no pain at all and the healing may take longer than a viginal birth.
Hernia is the protrusion of an organ or part of an organ or other structure through the wall of the cavity that normally contains it. Hernias are qualified by the name of the part that protrudes or the area through which protrusion occurs. The most common types of hernias are inguinal, incisional,femoral, umbilical and hiatal. An inguinal hernia, the most common form, is one that passes through the abdominal wall in the groin area. A hiatal hernia is one in which part of the stomach or a loop of the intestine herniates upward through an opening in the diaphragm into the chest cavity. An umbilical hernia is one in which the bowel or the membranous apron overlying it, known as the omentum, protrudes through the abdominal wall under the skin
The Northeast region consisted of 101 units (67 hospitals) from 4 states, the Midwest region consisted of 356 units (246 hospitals) from 9 states, the South region consisted of 433 units (271 hospitals) from 12 states, and the West region consisted of 211 units (124 hospitals) from 9 states. Across the participating units, catheter utilization was 31%. Utilization in the ICU at 61% was greater than the non-ICU at 20%. The West has the highest utilization in the non-ICU setting at 24% while the South had the highest utilization in the ICU at 63%. Compared with non-ICUs in the West, catheter utilization was significantly lower in non-ICUs in the Northeast (P=.001) and South (P=.007). Compared with ICUs in the West, catheter utilization was significantly higher in ICUs in all other areas: Northeast P =.02, Midwest P =.002, and South P <.001. Overall utilization did not vary by region after the hospitals characteristics were adjusted. Furthermore, several finding came from this nation study. It was found that catheter utilization remains common across the United States, with 20% in non-ICU settings and 61% in the ICU. Catheter appropriateness in the ICU was high across all regions, however; the study found that 30%-40% of catheters in the non-ICU setting may be placed without an appropriate indication. CAUTI rates were 2.5 per 1,000 catheter-days and did not differ by unit type.
Chronic abdominal pain in children is most often caused by a functional disorder. There are a variety of treatments that can be helpful, but no single treatment is best. Thus, most experts recommend trying several treatments. This may require several visits with the doctor, especially if pain has been a problem for a long time. Although functional abdominal pain can be triggered or reinforced by a desire for attention, it is rare for a child to "fake" pain. Therefore this child's pain needs to be acknowledged and believe that her pain is real and offer sympathy, support, and reassurance. Since the CT scan and lab work were negative. Other treatment options can be considered. The first goal of treatment is to help this child return to normal activities. Secondly, is to help her pain improve.
Liu Kathleen D, Chertow Glenn M (2008). Acute renal failure. In AS Fauci et al., eds., Harrison's Principles of Internal Medicine, 17th ed., vol. 2, pp. 1752-1761. New York: McGraw-Hill. 2008. 04 Dec. 2013