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Questions and Answers
What would make you suspect that a 25-year-old male patient has a kidney stone?
What would make you suspect that a 25-year-old male patient has a kidney stone?
- Burning sensation from the center of the chest into the back
- Flank or back pain that is colicky and severe (correct)
- Crushing pain in the back
- A sharp pain in the back of the chest on inspiration
What is the medical term for the condition when a patient has blood in his urine?
What is the medical term for the condition when a patient has blood in his urine?
- Hematuria (correct)
- Renal calculi
- Anemia
- Hematochezia
What are two common problems that are seen in patients who miss dialysis treatments?
What are two common problems that are seen in patients who miss dialysis treatments?
- Gastrointestinal bleeding and electrolyte shifts
- Weakness and pulmonary edema (correct)
- Altered mental status and strokes
- Fluid depletion and congestive heart failure
During transport, how should a dialysis patient who has missed treatments be positioned on the cot?
During transport, how should a dialysis patient who has missed treatments be positioned on the cot?
What is the name of the urinary catheter that is inserted directly into the bladder via the urethra?
What is the name of the urinary catheter that is inserted directly into the bladder via the urethra?
What findings may be contributing to an elderly patient's suprapubic pain related to a Foley catheter?
What findings may be contributing to an elderly patient's suprapubic pain related to a Foley catheter?
How would the knowledge of a dialysis shunt affect your assessment of a patient's vitals?
How would the knowledge of a dialysis shunt affect your assessment of a patient's vitals?
When should you administer oxygen to a patient with a genitourinary complaint and no pulmonary complaints?
When should you administer oxygen to a patient with a genitourinary complaint and no pulmonary complaints?
The gallbladder is located in which abdominal quadrant?
The gallbladder is located in which abdominal quadrant?
The pancreas is located in which abdominal quadrant?
The pancreas is located in which abdominal quadrant?
What quadrant of the abdomen contains most of the stomach, the pancreas, part of the large intestine, and the spleen?
What quadrant of the abdomen contains most of the stomach, the pancreas, part of the large intestine, and the spleen?
What quadrant of the abdomen contains the appendix, part of the large intestine, and part of the female reproductive organs?
What quadrant of the abdomen contains the appendix, part of the large intestine, and part of the female reproductive organs?
What surrounds some solid organs such as the liver and spleen, but does not surround hollow and vascular structures?
What surrounds some solid organs such as the liver and spleen, but does not surround hollow and vascular structures?
Which statement is the BEST explanation as to why the patient may die if the descending abdominal aorta becomes perforated?
Which statement is the BEST explanation as to why the patient may die if the descending abdominal aorta becomes perforated?
What type of pain is characterized as a dull or aching discomfort that is poorly localized by the patient?
What type of pain is characterized as a dull or aching discomfort that is poorly localized by the patient?
Your patient is complaining of severe abdominal pain that is sharp in character and can be easily localized by pointing to it with one hand. That type of pain is known as:
Your patient is complaining of severe abdominal pain that is sharp in character and can be easily localized by pointing to it with one hand. That type of pain is known as:
A sudden onset of abdominal pain located from the middle of the upper quadrants to the right upper quadrant area, presenting at night, and associated with a low-grade fever and greenish emesis is MOST likely caused by:
A sudden onset of abdominal pain located from the middle of the upper quadrants to the right upper quadrant area, presenting at night, and associated with a low-grade fever and greenish emesis is MOST likely caused by:
Your patient has a history of alcohol abuse, is vomiting large amounts of bright red blood, and has a rapid pulse but no pain or tenderness in the abdomen. You suspect:
Your patient has a history of alcohol abuse, is vomiting large amounts of bright red blood, and has a rapid pulse but no pain or tenderness in the abdomen. You suspect:
Which disease is an inherited disorder that causes abnormally slow blood clotting?
Which disease is an inherited disorder that causes abnormally slow blood clotting?
Sickle cell anemia primarily affects which population?
Sickle cell anemia primarily affects which population?
Your patient with an acute abdomen is found in a guarded position. This position is:
Your patient with an acute abdomen is found in a guarded position. This position is:
When you conduct a focused history and physical examination of your patient with abdominal pain, remember to:
When you conduct a focused history and physical examination of your patient with abdominal pain, remember to:
The female reproductive structure that houses the fetus during development is the:
The female reproductive structure that houses the fetus during development is the:
Within what female reproductive structure does fertilization of the egg with sperm typically occur?
Within what female reproductive structure does fertilization of the egg with sperm typically occur?
All of the following are signs and symptoms that may accompany a gynecological emergency EXCEPT:
All of the following are signs and symptoms that may accompany a gynecological emergency EXCEPT:
Until it has been proven otherwise, you should assume that a missed or late menstrual period is due to:
Until it has been proven otherwise, you should assume that a missed or late menstrual period is due to:
You are caring for a patient with a gynecological emergency. The patient presents with a diminished orientation, tachypnea and tachycardia, and pale skin. The pulse oximeter reads 90 percent on room air. Which intervention should you perform to increase the pulse ox reading?
You are caring for a patient with a gynecological emergency. The patient presents with a diminished orientation, tachypnea and tachycardia, and pale skin. The pulse oximeter reads 90 percent on room air. Which intervention should you perform to increase the pulse ox reading?
What is the BEST indicator of your patient's status when you are initially assessing a gynecological emergency?
What is the BEST indicator of your patient's status when you are initially assessing a gynecological emergency?
The structure through which urine passes to be eliminated from the body is the:
The structure through which urine passes to be eliminated from the body is the:
How many kidneys does the body have?
How many kidneys does the body have?
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Study Notes
Abdominal Quadrants
- The gallbladder is located in the right upper quadrant (RUQ).
- The pancreas is found in the left upper quadrant (LUQ), along with most of the stomach and spleen.
- The left upper quadrant contains the spleen, pancreas, and part of the large intestine.
- The right lower quadrant (RLQ) houses the appendix and part of the reproductive organs.
- The left lower quadrant (LLQ) contains parts of the large intestine and reproductive organs.
Solid Organ Protection
- Solid organs like the liver and spleen are surrounded by a thick fibrous capsule for protection.
- This capsule aids in tamponade during bleeding events but does not surround hollow or vascular structures.
Aortic Perforation Risks
- Rupturing the descending abdominal aorta can lead to rapid blood loss due to its large vascular structure, potentially resulting in death.
Types of Abdominal Pain
- Visceral pain: Dull, aching, poorly localized, often associated with an organ.
- Parietal pain: Sharp, localized, intense pain usually relating to the peritoneum.
- Referred pain occurs in areas not directly related to the source of pain, while radicular pain travels along a nerve dermatomal pathway.
Cholecystitis
- Inflammation of the gallbladder (cholecystitis) often involves gallstones and presents with sudden RUQ pain, especially after fatty meals, and greenish emesis.
Esophageal Varices
- These are swollen blood vessels in the lower esophagus, commonly due to liver cirrhosis or alcohol abuse, causing significant vomiting of blood but generally not associated with abdominal pain.
Hemophilia
- A hereditary disorder that impairs normal blood clotting, leading to prolonged bleeding from minor injuries.
Sickle Cell Anemia
- Primarily affects individuals of African descent and causes crescent-shaped, fragile red blood cells that block capillary blood flow, leading to ischemia.
Patient Positioning
- A patient with acute abdomen tends to assume a guarded position with knees drawn up to alleviate pressure.
Patient Assessment Guidelines
- Assess the color of stool to identify potential gastrointestinal bleeding, since it provides critical clues about internal bleeding.
Female Reproductive Anatomy
- The uterus is the organ where fetal development occurs; fertilization typically takes place in the fallopian tubes.
Gynecological Emergency Indicators
- Abdominopelvic pain and vaginal bleeding are common signs; hypertension is not linked to gynecological emergencies.
Missed Menstrual Period
- A missed or late period should initially be attributed to pregnancy until proven otherwise.
Oxygen Administration
- In cases of cardiopulmonary distress, placing a patient on oxygen is essential for improving oxygen saturation levels.
Kidney Function and Disorders
- The body has two kidneys that filter blood and produce urine, playing a key role in acid-base balance.
- Kidney stones present as flank pain, often described as colicky and severe, with symptoms like hematuria (blood in urine).
Common Dialysis Complications
- Missing dialysis can lead to weakness and pulmonary edema as accumulated toxins and fluid overload occur.### Patient Positioning in Dialysis
- Patients who have missed dialysis and present with dyspnea and fluid in the lungs should be placed in a sitting or semi-Fowler's position to ease breathing.
- Lying supine can worsen dyspnea in these patients.
Foley Catheter Information
- A Foley catheter is inserted directly into the bladder through the urethra, featuring a balloon to retain it in place.
- Urine drains from the bladder into a bag via the catheter.
- Suprapubic catheters are inserted directly through the abdominal wall into the bladder, different from Foley catheters.
- G-tubes and J-tubes are unrelated, as they pertain to the gastrointestinal system.
Complications with Foley Catheters
- Kinks in the tubing can cause urinary retention and suprapubic pain due to trapped urine in the bladder.
- A collection bag that is one-third full or contains pale yellow urine is generally not a concern.
- The bag must be positioned lower than the urethra for proper drainage.
Assessment Considerations for Dialysis Patients
- Do not use the arm with a dialysis shunt to take blood pressure, as it may risk damage to the shunt.
- It is acceptable to assess skin condition and sensory findings in the arm with the shunt.
- Breath sounds can be evaluated without issues, as they relate to the thoracic cavity.
Oxygen Administration Guidelines
- Administer oxygen only if the SpO2 reading falls below 94%.
- No need for supplemental oxygen if SpO2 is above 94% and no respiratory distress or other hypoxia signs are present.
- In severe hypoxia cases, use a nonrebreather mask at 15 liters per minute to maintain adequate oxygen levels.
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