Please enable JavaScript.
Coggle requires JavaScript to display documents.
The enhanced abdominal assessment - Coggle Diagram
The enhanced abdominal assessment
Mouth, oesophagus and stomach
Red Flags Mouth
Mouth ulcers – Crohn’s disease / Cancer/coeliac disease
Red Flags Oesophagus
Swallowing difficulties – oesophageal cancer
Vomiting blood – esophageal varices
Red Flags
Ongoing indigestion/ reflux – hiatus hernia, stomach ulcer, cancer.
Nausea and vomiting – Bowel disease/obstruction/ileus/cancer/liver disease
Vomiting blood/melena – stomach ulcers/gastritis / esophageal varices / cancer
Liver and gallbladder
Red Flags
Jaundice – gallstones, alcoholic liver disease, pancreatitis, hepatitis/cancer
Pain – gallstones, pancreatitis, hepatitis, tumour,
Ascites - heart failure, cirrhosis of the liver, cancer
Pale faeces / dark urine
Intestines
Red Flags
Pain - Ulcerative Colitis
Boating - Crohn’s
Nausea & Vomiting - Cancer
Diarrhoea / Constipation - Obstruction
Melena/blood in stool - Perforation/peritonitis
Anorexia (loss of appetite) - ileus
Not passing wind
Kidneys and bladders
Red Flags
Unable to pass urine – cancer / neurological problems / enlarged prostate/bladder stones
No urine output or large urine output of dilute urine – acute or chronic renal failure
Blood in the urine – cancer/infection
Frequency - infection
Unable to empty bladder fully – tumour/bladder stones/ neurological problem
Pain on passing urine – infection, tumours
Incontinence – neurological problems, pregnancy, obesity, constipation, infections, tumours
Acute kidney infection
An acute decline in kidney function
3 causes
Prerenal – insufficient blood flow to kidneys – leading to ischemic in renal tissues
Haemorrhage
Severe dehydration
Reduced cardiac output (low blood pressure)
Sepsis
Shock
Intra renal - damage to the kidney itself
Glomerulonephritis
Hypertension
Chemicals/ drugs
Post renal – Obstruction in ureters, bladder or urethra
Stones
Prostatic hyperplasia
Urethral stricture
signs and symptoms for acute kidney injury
Signs and symptoms
Reduced urine output (min 0.5mL/KG/Hour)
Raised urea and creatinine
Changes of electrolytes
Fatigue
SOB
Confusion
Nausea
Fluid retention
Treatment for acute kidney injury
Close monitoring of
fluid balance
Vital signs
Treat possible causes
Haemodialysis
abdominal inspection
Skin colour: pallor and jaundice - liver failure.
General Demeanor: Restless, renal colic, obstruction, lying very still, peritonitis, pain
Shape of abdomen: distended, bloated, IBS, constipation, infection, obstruction and tumours
Nutritional status: fitting of clothing, muscle wasting and obesity
Abdomincal inspection
Face: Conjunctiva Pallor, Possible anaemia, Yellowing of sclera, Liver problems
Mouth and Tongue: Hydration - Dry/cracked lips and tongue can indicate dehydration, Smooth tongue (glossitis) - alcoholism (can be seen in older people). Ulceration - Crohn’s disease /coeliac disease, Poor nutrition, Dental enamel, Bulimia – acid from vomiting and damaged enamel.
Hands and Arms: clubbing, cirrhosis, IBD, coeliac disease, spider naevi, more than 6 liver diseases.
Palpation: Full set of obs, skin - sweaty clammy, temp. Cap refill
People with abdominal conditions can become very ill
For abdomical concerns
Additional tests:
Stool sample
Bladder scan
Urinalysis