Health Assessment Chap 25 Rectum Anus Postate

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1

Percussion

-splenic dullness
-fist or blunt: organ tenderness at the costovertable angle CVA

2

Guidelines for Palpation of the Abdomen

light: 1 cm
Deep: 5-8 cm

3

palpation for liver

place right hand below lower right costal margin and point finder towrds clin'es right shoulder
-push fingers deeply

4

palpation for spleen

- stnand at right side of supine client
-be gentle

5

Palpation technique for kidney

-right place right hand on anterior abdomen in MCL next to umbilicus
-left more difficult to feel

6

Additional abdominal tests:

Rebound tenderness test (Blumberg Sign)

-supin position
-90 degree angle to abdominal wall
-on area of no pain or discomfort ( press slowly in and rapidly remove)
-if pull back and there is pain some kind of peritoneal irritation

7

If you suspect ascites:

-Fluid wave test (don't worry about)
-Shifting dullness test (don't worry about
-Ultra sound studies are the definitive test

8

Nice to know

Inspiratory Arrest (Murps Sign)-gallbladder inflammation

one for appendecitis

9

Difference in Developmental

-Infants
-Children
-Pregnant clients (hemorriohds)
-Adults
-Older Adults

10

Surgeries

-Iliostomy
-Colostomy

11

Anus Rectum

-anatomy

12

Subjective Data

-bowel routine
-change in bowel habits
-rectal bleeding, blood in stool
-medications
-Rectal conditions: pruritus, hemorrhoids, fissure, fistula
-Family History
-Self-care behaviors: diet of high fiber foods, most recent eaminations

13

Objective Data:

-preparation: position (left lateral, lithotomy, standing)
-equipment: penlight, lub, glove (blank)

14

Inspect perianal area

-spread buttocks wide apart and inspect perianal region

15

Palpate anus and rectum

objective
-instruct person that palpation is not painful use lub

16

Abnormal findings

-pilonidal cysts
-anorectal fistula
-fissue
-hemorrhoids
-rectal prolapse
-pruritus ani

17

abnormal finding rectum

-abscess
-rectal polyp
-fecal impaction
-carcinoma