Question

Hello, pls help with these questions. Thank you

1.     What order will you complete the 4 steps of the abdominal assessment

2.     This is a sample nursing documentation:

6/10/15 0945 c/o “gassy” pain lower right quadrant. No bowel movement x 48 hrs. Ate 75% regular diet yesterday. Abdomen flat. Active bowel sounds all 4 quadrants. Tympany above umbilicus, dull below. No masses felt on palpation. 30 mL Milk of Magnesia given.

What does the tympany and dullness tell you?

3.     All the following patients are at risk for alteration in nutrition except? (choose the appropriate answer and cite the rationale for the chosen answer)    a. Patient I., whose weight is 10% above his ideal body weight

b. Patient J., who is 86-years-old, lives alone and has poorly fitting dentures

c. Patient M., a 17-year-old girl who weighs 90 pounds and frequently complains about her baby fat

d. Patient K., who has been allowed nothing by mouth (NPO) for 7 days after bowel surgery and is receiving 3000 mL of 10% dextrose per day.

4.     List at least 3 laboratory assessments that will help you determine a patient’s nutritional status?

5.     Identify at least 4 possible complications of enteral tube feedings and the possible cause.

6. Explain in your own words how the concepts of Fluid & Electrolyte and Nutrition are interrelated?

Answer 1

1) Abdominal assessment

• Inspection, Auscultate, Percussion, Palpation
• This order is followed because the physical handling of peritoneal contents may alter frequency of bowel sounds.
• Inspection : examine all quadrants. Look for symmetry, shape, any enlargement, any pigmentation, scars, peristalsis.
• Ausculatation : Auscultate stomach for normal gut sounds.
• Percussion : percy's all four quadrants, categorize sound heard as tympanic ,dull or resonant.
• Palpation : begin light Palpation by depressing abdominal wall, check for tenderness.

2)Tympanic sound on Percussion indicates gas accumulation in abdomen.

Dull sound on Percussion indicates dense areas may be due to solid viscera or stool predominate.