NR 304 Exam 1 Supplemental Assignment.docx

NR 304 Exam 1 Supplemental Assignment.docx - Exam 1...

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Exam 1 Supplemental Assignment ABDOMEN A female client, had abdominal surgery to repair an incarcerated hernia 2 days ago and remains an inpatient on the general surgery unit. The healthcare provider (HCP) has prescribed a progressive diet, but the client reports to the nurse "I am too miserable to eat. I feel bloated and nauseated. I can’t remember the last time I had a bowel movement." The client cannot even tolerate liquids. The nurse notes the client’s abdomen is firm and distended,. In what order should the nurse perform the physical exam of the abdomen? Inspect, ascultate, percuss, palpate Then RN auscultates the bowels and hears gurgling after 3 minutes. How should the nurse document these findings? Hypoactive (decreased mobility) constipation The RN finds indicate that the client has CONSTIPATION. The patient has not been taking in oral fluids well. How has this contributed to this? Dehydration = less movement What are some other risk factors for the above condition? Opiates, pregnancy, older adults What are some things the nurse should include in the postoperative plan of care for this concern? FLUIDS , FIBER , MOVEMENT vs. Stool softener What might the nurse expect to percuss in this patient? Dullness due to density of stool (In general) What are the differences between light and deep palpation? What are the purposes of each? Light palpation isn’t deep , one hand (MUSCULAR) Deep palpation deeper, two hands (MASSES, TUMORS, ORGAN ENLARGMENT A nurse is caring for a client admitted with history of liver cirrhosis. The nurse notes the presence of abdominal distention.
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Ascites What examination findings would the nurse expect? (Think I-A-P-P) Protruded abdomen, portal hypertension veins, stretch marks Normal bowel sounds Dullness percuss, fluid moves when patient moves, SHIFTING DULLNESS Fluid wave when hit the side What are the two tests the nurse should perform? Also how they are performed?
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  • Fall '17
  • Ascites

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