Abdominal Assessment and Related Procedures
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Questions and Answers

What is essential to check for prior to performing a CT scan?

  • Patient's dietary habits
  • Presence of metal implants
  • Level of hydration
  • Allergy to iodine (correct)

    • What is the correct position for a patient after undergoing a catheterization procedure?

  • Flat on the bed with lower extremities hyperextended (correct)
  • Standing with support
  • Sitting cross-legged on the bed
  • Seated position with feet elevated

    • What is the normal range for Central Venous Pressure (CVP) readings?

  • 15-25 mmHg
  • 2-12 mmHg (correct)
  • 0-5 mmHg
  • 10-20 mmHg

    • Which of the following should be avoided during CVP monitoring to ensure accurate readings?

    <p>Coughing and straining</p> Signup and view all the answers

    What is the primary purpose of a chest X-ray?

    <p>To detect organ abnormalities in the thoracic area</p> Signup and view all the answers

    Which nursing action is essential before performing a cystoscopy?

    <p>Check for informed consent</p> Signup and view all the answers

    What should be done if bleeding occurs at the arterial puncture site post-procedure?

    <p>Place a sandbag on the site and apply pressure</p> Signup and view all the answers

    What is required of the drainage bag during catheterization?

    <p>It must always be below the bladder</p> Signup and view all the answers

    What indicates that a patient should notify the doctor after a procedure?

    <p>Bright red urine</p> Signup and view all the answers

    What is the primary purpose of a Doppler ultrasound?

    <p>To evaluate the patency of lower extremity veins and arteries</p> Signup and view all the answers

    What is a nursing key point for an Electrocardiogram (ECG) procedure?

    <p>Patients should lie still and breathe normally.</p> Signup and view all the answers

    What should a patient do if electrode gel remains in their hair after an EEG?

    <p>Use acetone to remove the gel</p> Signup and view all the answers

    What blood sugar level confirms diabetes mellitus?

    <p>More than 140 mg/dl</p> Signup and view all the answers

    In a duodenal ulcer, what is the expected level of hydrochloric acid (HCl)?

    <p>Elevated HCl levels</p> Signup and view all the answers

    What is a key nursing action prior to an Intravenous Pyelography (IVP)?

    <p>Check for allergies to iodine or shellfish</p> Signup and view all the answers

    What is the primary purpose of a liver biopsy?

    <p>To diagnose liver disorders</p> Signup and view all the answers

    What is the normal range for pulmonary artery pressure (PAP) systolic and diastolic pressure in adults?

    <p>20 to 30 mm Hg</p> Signup and view all the answers

    What is the purpose of the 24-hour urine collection?

    <p>Assess kidney and adrenal excretion</p> Signup and view all the answers

    What position should a patient be in during a thoracentesis procedure?

    <p>Sitting with feet on a chair, leaning over a table</p> Signup and view all the answers

    What is the acceptable intraocular pressure range measured by tonometry?

    <p>12-21 mm Hg</p> Signup and view all the answers

    During suctioning, how long should a patient not be suctioned for?

    <p>More than 15 seconds</p> Signup and view all the answers

    Which condition is indicated by a specific gravity decrease in urinalysis?

    <p>Diabetes insipidus</p> Signup and view all the answers

    Which test is used to diagnose unilateral hearing loss?

    <p>Weber test</p> Signup and view all the answers

    When performing an X-ray, what should the patient be instructed to do?

    <p>Remove all jewelry and metallic objects</p> Signup and view all the answers

    What is the main purpose of obtaining blood tests before an aspiration procedure?

    <p>To assess potential for bleeding</p> Signup and view all the answers

    Which position should the patient assume during a lumbar puncture?

    <p>C-position (fetal position)</p> Signup and view all the answers

    How long should a patient lie flat after a lumbar puncture to prevent spinal headache?

    <p>6-12 hours</p> Signup and view all the answers

    What should be avoided on the day of a mammogram to prevent false-positive results?

    <p>Using deodorant or lotion</p> Signup and view all the answers

    What does a positive Mantoux test indicate in a child under 4 years old?

    <p>An induration of 10 mm or more</p> Signup and view all the answers

    What is the primary purpose of an MRI scan?

    <p>To provide detailed cross-sectional images of brain tissues</p> Signup and view all the answers

    After a liver biopsy, the patient should be positioned on the right side to:

    <p>Prevent bleeding</p> Signup and view all the answers

    What is the recommended timing for self-breast examinations relative to menstruation?

    <p>7 days after menstruation</p> Signup and view all the answers

    What is the primary purpose of conducting an abdominal assessment?

    <p>To determine the presence of mass, abnormal bowel sounds, lesions, and other abnormalities in the abdominal region</p> Signup and view all the answers

    Which position should a patient be in for an abdominal assessment?

    <p>Dorsal Recumbent</p> Signup and view all the answers

    What should be avoided prior to obtaining a specimen for arterial blood gas analysis?

    <p>Suctioning</p> Signup and view all the answers

    What is a key nursing intervention following a barium swallow procedure?

    <p>Administer a laxative to counteract the constipating effects of barium</p> Signup and view all the answers

    What is a necessary pre-procedure instruction for a barium enema?

    <p>Provide a liquid diet before the procedure</p> Signup and view all the answers

    Which condition primarily requires monitoring for metabolic alkalosis?

    <p>Vomiting</p> Signup and view all the answers

    What is a contraindication for palpation during an abdominal assessment?

    <p>Patients with Wilm's tumor and abdominal aortic aneurysm</p> Signup and view all the answers

    In cardiac catheterization, what is primarily measured?

    <p>Oxygen concentration, saturation, tension, and pressure in various chambers of the heart</p> Signup and view all the answers

    Study Notes

    Abdominal Assessment

    • Determines the presence of mass, abnormal bowel sounds, lesions, and other abdominal abnormalities.
    • Performed in the dorsal recumbent position.
    • Sequence of assessment: inspection, auscultation, percussion, palpation; start palpating from RLQ to RUQ to LUQ, to LLQ.
    • Palpation is done last because it can alter bowel rhythms, leading to abnormal sounds.
    • Palpation is contraindicated for patients with Wilm's tumor and abdominal aortic aneurysm.

    Arterial Blood Gas Analysis

    • Monitors patient response to oxygen therapy and detects acid-base imbalance.
    • Avoid suctioning prior to obtaining blood specimen.
    • Assess for bleeding and hematoma at the puncture site.
    • Apply 5-10 minutes of firm pressure at the puncture site.
    • Place the specimen in an iced container.
    • Patients with vomiting may experience metabolic alkalosis, while patients with diarrhea may exhibit metabolic acidosis.

    Barium Enema

    • Assesses the large intestines.
    • Provides a liquid diet before the procedure.
    • Administer a laxative before the procedure to enhance visualization and after to prevent constipation.
    • Report to the doctor if there is no bowel movement within 2 days.
    • Instruct the patient to increase fluid intake and consume fiber-rich foods.

    Barium Swallow

    • Assesses the esophagus, stomach, and portions of the small intestines.
    • Maintain NPO for 6-8 hours pre-procedure.
    • Withhold anticholinergic and narcotic medications for 24 hours before the test.
    • Administer a laxative after the procedure to counteract barium's constipating effects.
    • Encourage increased fluid intake and consumption of fiber-rich foods.

    Cardiac Catheterization

    • Measures oxygen concentration, saturation, tension, and pressure within various heart chambers.
    • Determines the need for cardiac surgery.
    • Verify informed consent.
    • Assess iodine allergy.
    • Maintain NPO for 6-8 hours before the procedure.
    • Check for distal pulses after the procedure.
    • Assess for bleeding at the arterial puncture site and apply pressure.
    • Maintain a 20 lbs. sandbag at the bedside for potential bleeding management.
    • Keep the patient flat with lower extremities hyperextended for 4-6 hours.
    • Perform neurovascular assessment distal to the catheter insertion site and report any abnormal findings.

    Catheterization, Urinary

    • Determines residual urine and obtains sterile specimen.
    • The procedure is sterile.
    • Maintain a closed system.
    • The drainage bag must remain below the bladder to prevent backflow.
    • The catheter bag should not touch the floor.
    • Avoid contacting the drainage spout with the collection receptacle or toilet bowl during drainage.
    • Provide urine acidification.

    Chest X-Ray

    • Detects abnormalities in the thoracic area.
    • Remove any metallic objects before the procedure.
    • Use a lead shield for women of childbearing age.

    CT Scan

    • Provides photographic representations of tissue densities using radiation.
    • If contrast medium is used, assess for iodine allergies and instruct the patient to be NPO for 4 hours pre-procedure.
    • Assess for fear of close spaces (claustrophobia).
    • The procedure is contraindicated for pregnant and obese patients (>300 lbs.).
    • Encourage the patient to remain still throughout the procedure.

    CVP (Central Venous Pressure) Monitoring

    • Measures the pressure of the Right Atrium.
    • Place the zero level of the manometer at the level of the right atrium (4th intercostal space) for accurate readings.
    • Instruct the client to avoid coughing and straining, which can influence readings.
    • Normal CVP reading is 2-12 mmHg when the tube is at the superior vena cava.

    Cystoscopy

    • Assesses the bladder and urethra.
    • Verify informed consent.
    • Maintain NPO for general anesthesia or liquid diet for local anesthesia.
    • Monitor intake and output.
    • Post-procedure, encourage fluid intake as prescribed.
    • Apply a sitz bath for abdominal pain.
    • Pink-tinged or tea-colored urine is expected within 24-48 hours.
    • Notify the doctor if bright red urine or clots are observed.

    Doppler Ultrasound

    • Evaluates the patency of veins and arteries in the lower extremities.
    • Inform the patient that the procedure is painless.

    ECG (Electrocardiogram)

    • Records the heart's electrical waves.
    • Encourage the patient to lie still and breathe normally during the procedure.
    • Instruct the patient to refrain from talking during the test.
    • ST segment elevation or T wave inversion indicates myocardial infarction (MI).

    EEG (Electroencephalogram)

    • Records the electrical activity of the brain.
    • Detects intracranial hemorrhage and tumors.
    • Advise the client to shampoo their hair before and after the procedure.
    • Acetone can be used to remove electrode gel if shampooing is ineffective.
    • Withhold stimulants, antidepressants, tranquilizers, and anticonvulsants for 24-48 hours before the test.

    Fasting Blood Sugar Level

    • Detects diabetes mellitus.
    • Normal blood sugar level is 80-120 mg./dl.
    • A blood sugar level exceeding 140 mg/dl confirms diabetes.

    Gastric Analysis

    • Detects ulcers and rules out pernicious anemia.
    • Analyzes the acidity, appearance, and volume of gastric secretions.
    • In gastric ulcers, HCl levels are normal.
    • In duodenal ulcers, HCl levels are elevated.
    • Refrigerate gastric samples if not tested within 4 hours.

    IVP (Intravenous Pyelography)

    • Visualizes the urinary tract.
    • Verify informed consent.
    • Maintain NPO for 8-10 hours before the procedure.
    • Administer a laxative to clear the bowels pre-procedure.
    • Assess for iodine, seafood, or shellfish allergies due to iodine-based dye use.
    • Keep epinephrine at the bedside for potential allergic reactions.
    • IVP utilizes a contrast medium, while KUB does not.
    • Inform the patient about a possible salty taste during the test.
    • Increase fluid intake post-procedure to facilitate dye excretion.

    Liver Biopsy

    • Determines liver disorders.
    • Verify informed consent.
    • Obtain blood test results prior to aspiration due to potential bleeding.
    • Position the patient on their left side or supine during biopsy.
    • Instruct the patient to inhale, exhale, and hold their breath during needle insertion to stabilize the liver and prevent accidental diaphragm puncture.
    • Position the patient on the right side with pillows after the biopsy to prevent bleeding.
    • Maintain bed rest for 24 hours post-procedure.

    Lumbar Puncture

    • Withdraws cerebrospinal fluid (CSF) to determine abnormalities.
    • Verify informed consent.
    • Empty the bladder and bowel before the procedure.
    • Position the patient in the C-position (fetal position).
    • Insert the needle between L3-L4 or L4-L5 to prevent accidental spinal cord puncture as the spinal cord ends at L2.
    • Position the patient flat for 6-12 hours post-procedure to prevent spinal headaches.
    • Increase fluid intake.

    Mammograph

    • Detects the presence of breast tumors.
    • Instruct the patient to avoid using deodorant, talcum powder, lotion, perfume, or ointment on the day of the exam, as these substances can produce false-positive results.
    • Inform the patient that their breasts will be compressed between two x-ray plates.
    • Provide instruction on self-breast examination:
      • Performed 7 days after menstruation.
      • Position: Lying down with a pillow under the shoulder of the breast being examined or sitting in front of a mirror while raising the arm on the side of the breast being examined.

    Mantoux Test

    • Determines exposure to tuberculosis (TB).
    • A positive test yields an induration of 10 mm or more for foreign-born children under 4 years old.
    • An induration of 5 mm or more is considered positive in patients with HIV, treated TB, or direct TB exposure.
    • BCG may cause false-positive reactions.
    • Assess for a previous history of PTB and report immediately to the doctor.
    • Results are read after 48-72 hours.

    MRI (Magnetic Resonance Imaging)

    • Provides cross-sectional images of brain tissue, more detailed than a CT scan.

    PAP (Pulmonary Artery Pressure)

    • Measures blood pressure in the pulmonary artery.
    • If there is a fifth lumen, it is used to measure oxygen saturation of the blood.
    • Normal adult PAP systolic and diastolic pressure is 20 to 30 mm Hg.

    PCWP (Pulmonary Capillary Wedge Pressure)

    • Measures pulmonary capillary wedge pressure by inflating a balloon at the distal tip of a catheter inserted into a pulmonary artery.
    • Normal PCWP is 8-13 mm Hg.
    • The balloon should only be inflated when obtaining PCWP readings.

    Suctioning

    • Obtains sputum samples and clears the airway.
    • Hyperoxygenate the patient before and after the procedure.
    • Apply intermittent suction when withdrawing the catheter.
    • Do not suction for more than 15 seconds.

    Thoracentesis

    • Aspiration of fluid and/or air from the pleural space.
    • Verify informed consent.
    • Position the patient sitting on the side of the bed with feet on a chair, leaning over a bedside table.
    • If the patient cannot sit, position them lying on the affected side with hands of that side resting on the opposite shoulder.
    • Instruct the patient not to cough, breathe deeply, or move during the procedure.
    • Post-procedure, position the patient on the unaffected side with the puncture site up.
    • Check for bleeding at the puncture site and monitor respiratory function.
    • Notify the physician if pneumothorax, air embolism, or pulmonary edema occur.

    Tonometry

    • Measures intraocular pressure.
    • Normal reading is 12-21 mm Hg.
    • A reading of 25 mm Hg indicates glaucoma.

    Urinalysis

    • Assesses urine characteristics.
    • First voided morning sample is preferred (15 ml).
    • Use a clean container.
    • Decreased specific gravity indicates diabetes insipidus.
    • Increased specific gravity indicates diabetes mellitus, dehydration, or SIADH.
    • (+) Protein: PIH, nephrotic syndrome.
    • (+) Glucose: Diabetes mellitus, infection.

    Urine Collection, 24 Hour

    • Determines the excretion of substances from the kidneys, adrenal glands, and stomach.
    • Required for ACTH test and Schilling's test.
    • Discard the first voided urine.

    Weber Test

    • Detects unilateral hearing loss.
    • Set the tuning fork into vibration and place it on the patient's forehead or teeth.
    • Placing the tuning fork on the teeth is generally more reliable, even with dentures.

    X-Ray

    • Provides radiological data for assessing certain organs and bones.
    • Assess the patient's exposure to radiation.
    • Instruct the patient to remove all jewelry and metallic objects before the procedure.

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    Description

    This quiz covers essential techniques for abdominal assessment, including methods for detecting abnormalities and the importance of proper sequence in the examination process. It also discusses arterial blood gas analysis and specific conditions that may impact patient assessments, such as metabolic alkalosis and acidosis. Lastly, it touches on the barium enema procedure for large intestine assessment.

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