NSE 13A/B Lecture Notes - Lecture 23: Epigastrium, Abdominal Pain, Food Intolerance
Document Summary
1: privacy/confidentiality/permission to touch, wash hands, be organized and systematic/aseptic, make contract/conclusion, general survey 4 things. Timing should always be 2 questions: subjective questions (3) Nutrition assessment (24 hour recall): health promotion (2) Contour: stand at patients right side of bed & bed down to eye level, flat, round, scaphoid, protuberant. Umbilicus (belly-button) (normally midline and inverted: midline, inverted/everted, discoloration, color, skin condition, herniation, inflammation. Skin: contour, texture, moisture, lesions, herniation, stretch marks. Presence of pulsations: absent, look in the epigastric region, should be slow even respiration- when breathing. Demeanor (patient relaxed, slow even respirations: calm facial expression, movement general abdomen, see if there is chest movement or hives while at rest, auscultation (use diaphragm) Vascular sounds- shouldn"t be hearing begin rlq region (aka red dot: bell hold firmer against skin, aorta renal iliac femoral (for both sides, note: presence/absence of bruit. Hyperextend finger, palm off abdomen, 2 taps. 12 locations 3/quadrant clockwise general tympany.
