The nurse is assessing the abdomen of the client with an undiagnosed disorder. In which sequence would the nurse conduct the abdominal assessment? (Use all options.)
Palpation.
Inspection.
Auscultation.
Percussion.
The Correct Answer is B
Inspection, followed by Auscultation, Percussion, and Palpation. Inspection assesses for abdominal contour, symmetry, any visible masses, scars or other abnormalities. Auscultation assesses bowel sounds, and Percussion assesses for any areas of tenderness, and to determine the presence of fluid, gas or masses. Palpation assesses for any masses, areas of tenderness, organ size or other abnormalities. This is the order that allows the nurse to assess the abdomen systematically and accurately.
A: Palpation comes last because it can stimulate bowel sounds, which can make the nurse miss some of the sounds while auscultating.
C: Auscultation must be done before percussion and palpation to prevent altering bowel sounds.
D: Percussion comes before palpation to avoid altering the underlying structures of the abdomen.
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Related Questions
Correct Answer is D
Explanation
Myocardial infarction. Gout is a form of arthritis that results from the deposition of uric acid crystals in joints and tissues. It occurs due to hyperuricemia, a condition characterized by an elevated level of uric acid in the blood. The most common cause of hyperuricemia is the overproduction or under-excretion of uric acid. Myocardial infarction is a condition that results from the blockage of blood flow to the heart, which can lead to tissue death. Gout is not caused by long-standing cardiopulmonary disease, fungal infection, or iron- deficiency anemia.
Choice A, Long-standing cardiopulmonary disease, is incorrect because it is not a cause of gout.
Choice B, Fungal infection, is incorrect because it is not a cause of gout. Choice C, Iron-deficiency anemia, is incorrect because it is not a cause of gout.
Correct Answer is A
Explanation
drug allergy. A skin rash is a common symptom of an allergic reaction to a medication, and a drug allergy can occur at any time during drug therapy. A drug allergy may be due to an immune response, causing the immune system to overreact to a medication that it identifies as harmful to the body. The symptoms of a drug allergy may include a rash, hives, itching, or difficulty breathing. It is important for the nurse to determine which medication the client is taking and if the client has a history of allergies.
Heat stroke (B) occurs when the body is exposed to high temperatures, leading to symptoms such as high body temperature, confusion, and loss of consciousness. Hormone changes (C) can cause various changes in the body but do not usually cause skin rashes. A suntan (D) is a reaction of the skin to ultraviolet light and is not a cause of a skin rash.
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