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79 Cards in this Set
- Front
- Back
What are the solid organs of the abdomen?
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Spleen
Liver Pancreas Kidneys |
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In what abdominal quadrants will you find the kidneys?
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left and right upper quadrants
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What are the hollow organs of the abdomen?
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Stomach
Gallbladder Duodenum Large intestine Small intestine Bladder |
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Where are most abdominal organs contained?
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Peritoneum
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What does the visceral peritoneum do?
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Covers organs
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What is the parietal peritoneum attached to?
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The abdominal wall
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What feature is found at the center junction of the four abdominal quadrants?
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Umbilicus
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What organs are found in the right lower quadrant?
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Colon
Small intestines Major artery and vein to right leg Ureter Appendix |
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What organs are found in the left lower quadrant?
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Colon
Small intestines Major artery and vein to the left leg Ureter |
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What organs are found in the right upper quadrant?
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Liver
Right kidney Colon Pancreas Gallbladder |
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What organs are found in the left upper quadrant?
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Liver
Spleen Left kidney Stomach Colon Pancreas |
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What organ is found in all four abdominal quadrants?
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Colon
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In what abdominal quadrants will you find the liver?
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Left and right upper quadrant
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In what abdominal quadrants will you find the small intestines?
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Left and right lower quadrant
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What do we describe using the abdominal quadrants?
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Pain
Tenderness Injury Abnormalities |
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What does a pulsating mass indicate?
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An aneurysm ready to rupture (Abdominal Aortic Aneurysm, or AAA)
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What are the four types of abdominal pain?
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Visceral pain
Parietal pain Tearing pain Referred pain |
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Define visceral pain
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Pain that originates from organs. No one specific area of pain. Could be intermittent, achy, crampy (often from hollow organs) or dull, persistent (often from solid organs)
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Define parietal pain
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Pain that originates from abdominal cavity lining. May be caused by irritation from internal bleeding or infection. Sharp, constant, and worse with movement.
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Define tearing pain.
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An uncommon type of pain usually associated with abdominal aortic aneurysm (AAA) -- this is VERY serious
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Define referred pain
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Pain felt in area different from where it originates due to shared nervous pathways.
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What might pain described as "indigestion" also be an indicator of?
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Cardiac involvement. Consider treating the patient for a heart attack.
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What can you do during scene size-up to help you get a grip on a call for an abdominal emergency?
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Note odors present
Be aware of vomiting Use scene clues for any indication of trauma |
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What can you do during initial assessment to help you get a grip on a call for an abdominal emergency?
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Determine level of consciousness
Ensure patent airway Assess for signs of shock (always treat for shock during state medical trauma assessments) Note patient's body positioning (doubling over, guarding, etc) Administer high-concentration oxygen |
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What questions must you ask specifically to female patients in case of an abdominal emergency call?
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Any possibility of being pregnant?
Where are you in your menstrual cycle? Are you late? Any vaginal bleeding? Any history of similar problems? |
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What should you be on the lookout for when visually inspecting the abdomen?
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Discoloration
Distension Bloating Protrusions Any other abnormalities Question past surgical scars |
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What guidelines should you keep in mind when palpating the abdomen?
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Palpate the area of pain last
Use fingertips to palpate Loosen clothing to palpate lower quadrants Only palpate each area once |
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What is guarding?
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A protective defense to prevent pain -- arms drawn across the abdomen or abdominal muscle clenching are common
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What are some common signs and symptoms of abdominal emergencies?
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Pain and tenderness
Anxiety and fear Guarded positioning Rapid, shallow breathing Rapid pulse, changes in BP Nausea, vomiting, diarrhea Rigid or distended abdomen |
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How often do you assess vital signs when you're transporting a patient with a suspected abdominal emergency?
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Every 5 minutes
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What are some common abdominal conditions?
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Appendicitis
Cholecystitis/gallstones Pancreatitis Ulcer/internal bleeding Abdominal aortic aneurysm (AAA) Hernia Renal colic |
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What is appendicitis?
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Inflammation of the appendix -- if left untreated can lead to swelling and rupture.
Pain originates in right lower quadrant. "Rebound pain" when palpating this quadrant is a good indicator of appendicitis. |
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What are some common signs and symptoms of appendicitis?
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Onset of pain followed by vomiting and fever. Pain localized in right iliac fossa. Extreme sensitivity to palpation. Rebound tenderness is common (pain upon release of palpation). Remember that sometimes palpation will elicit no pain because a distended cecum can prevent the palpations from reaching the appendix and causing pain.
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What are some common findings with cholecystitis?
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Sudden onset of pain to epigastric region and RUQ
More common at night and after eating fatty foods Tenderness to RUQ Low-grade fever Nausea, vomiting Most common to females between 30-50 years of age |
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What is pancreatitis?
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Inflammation of pancreas, may be triggered by ingestion of alcohol or large amount of food. Also can be caused by excessive triglyceride buildup in blood.
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What are some common findings with pancreatitis?
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Severe pain in middle of the upper quadrants
Nausea and vomiting Abdominal pain with radiation from umbilicus to the back and shoulders Severe cases may have fever, tachycardia, and hypoperfusion |
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What are ulcers/internal bleeding?
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Open wounds or sores to the digestive tract.
Common to stomach and small intestines Caused by gastric fluids deteriorating walls |
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What are some common findings to ulcers and internal bleeding?
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Sudden burning pain to epigastric and LUQ before meals or during stress
Nausea and vomiting (possible hematemesis) If bleeding severe, possible hypoperfusion Indications of possible peritonitis |
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What is an abdominal aortic aneurysm?
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Weakening of descending aortic wall
Most lethal cause of abdominal pain |
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What are common findings with AAA (abdominal aortic aneurysm)?
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Onset of lower lumbar and abdominal pain
Possible tearing sensation Nausea, vomiting Mottled or spotty abdominal skin Decreased or absent femoral or pedal pulses Rigidity or tenderness if the aneurysm bursts |
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Define hematemesis
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Vomiting of blood
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What's a hernia?
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Caused by a small hole forming in peritoneum -- the "strangulated" tissue may become necrotic.
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What are some common findings with a hernia?
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Sudden onset of abdominal pain (usually after heavy lifting or strain)
Fever Rapid pulse |
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What structures in the pancreas actually secrete insulin?
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Islets of Langerhans
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Which abdominal organ has a role in both filtering blood and assisting with immune response?
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The spleen
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Which abdominal organ removes toxins from the body?
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The liver
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What are the four quadrants of the abdomen?
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Left upper quadrant (LUQ)
Right upper quadrant (RUQ) Left lower quadrant (LLQ) Right lower quadrant (RLQ) |
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Define "peritoneum"
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The membrane that lines the abdominal cavity (parietal peritoneum) and covers the organs within it (visceral peritoneum)
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Within what structure are most organs of the abdomen enclosed?
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The peritoneum
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What is contained between the parietal peritoneum and the visceral peritoneum?
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Lubricant fluid
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What type of organ is the esophagus, and what does it do?
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Hollow digestive organ. Carries food from the mouth and pharynx into the stomach.
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What type of organ is the stomach, and what does it do?
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Hollow digestive organ. Begins breakdown of foods.
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What type of organ is the small intestine, and what does it do?
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Hollow digestive organ. Takes stomach contents, removes nutrients, and passes them on to the large intestine.
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What type of organ is the large intestine, and what does it do?
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Hollow digestive organ. Absorbs fluid from contents, creating fecal waste for excretion.
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What type of organ is the appendix, and what does it do?
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Hollow lymphatic organ. Rich in lymphatic tissue. Has a few suspected purposes, but in modern times is mostly just good for becoming infected and hurting and/or killing people.
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What type of organ is the liver, and what does it do?
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Solid digestive organ. Helps regulate carbohydrate levels, involved in bile secretion, detoxifies blood.
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What type of organ is the gallbladder, and what does it do?
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Hollow digestive organ. Stores bile before release into the intestine.
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What type of organ is the spleen, and what does it do?
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Solid lymphatic organ. Removes abnormal blood cells and helps in immune response.
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What type of organ is the pancreas, and what does it do?
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Solid digestive organ. Releases enzymes that assist in breaking down food, secretes hormones to regulate blood sugar.
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What type of organ is the kidney, and what does it do?
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Solid urinary organ. Filters and excretes waste. Regulates water, blood, and electrolyte levels. Helps liver w/ detoxification.
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What type of organ is the bladder, and what does it do?
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Hollow urinary organ. Collects urine from kidneys prior to excretion.
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Define "retroperitoneal."
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Outside of the peritoneum.
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What three abdominal organs are found in the retroperitoneal area?
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Kidneys
Pancreas Aorta |
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What abdominal organs are found only in females and can be a source of pain?
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Ovaries
Fallopian tubes Uterus |
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Should abdominal pain or discomfort always be considered an emergency if signs of shock are not present?
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Yes. Always treat abdominal pain or discomfort as an emergency.
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What are the six basic steps in assessing a patient with abdominal distress?
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1) Scene size-up
2) Initial assessment and interventions (provide oxygen) 3) Take a patient history 4) Expose the site 5) Palpate the abdominal quadrants 6) Transport the patient |
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What additional determination can you make during the "last oral intake" section of the SAMPLE history that might be especially pertinent to a patient in abdominal distress?
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Determine whether the patient's recent oral intake has been at all out of the norm.
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When interviewing a patient about events leading up to their abdominal emergency, what five events are of specific importance?
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Vomiting
Nausea Diarrhea Constipation Presence of bright red, dark red, or coffee-ground-like substances in feces. |
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What important questions can you ask a woman of childbearing age when interviewing her about an abdominal emergency?
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1) Where are you in your menstrual cycle?
2) Is your period late? 3) Do you have bleeding from the vagina that isn't menstrual bleeding? 4) If you are menstruating, is the flow normal? 5) Have you had this pain before? If so, what did it happen and what was it like? Is it possible you are pregnant? |
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If a woman reports abdominal pain, and any abnormalities in menstruation or possible pregnancy, what condition should you expect, and how should you react?
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Suspect ectopic pregnancy, transport immediately.
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What three factors make assessing a geriatric patient with abdominal pain unique?
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1) Older patients have decreased ability to sense pain
2) Elderly patients are more likely to have a life-threatening cause of abdominal pain than younger patients 3) Elderly patients are frequently on medications that affect their bodies |
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What two techniques do you use to physically assess the abdomen?
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Inspection and palpation
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What should you be looking for when inspecting the abdomen?
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Distension
Bloating Discoloration Protrusions |
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When do you palpate the abdominal quadrant in which pain is reported?
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Last.
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What may you do if the initial palpation doesn't cause pain in the patient?
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You may palpate a bit deeper.
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What do you do if you palpate a pulsating mass in the abdomen?
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Do not palpate again. Assign high priority for transport. Call medical control and let them know that you're transporting a patient with a suspected abdominal aortic aneurysm. Keep them informed.
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Under normal conditions, might you feel a faint pulsating sensation when deeply palpating a patient's abdomen?
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Yes. On very thin patients you may just be feeling the aorta pulsate. However, if you actually feel a pulsating MASS, this is an issue.
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How often do you reassess a patient with abdominal pain?
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Every five minutes.
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Can abdominal pain increase a patient's pulse?
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Yes, the pain alone can increase a patient's pulse.
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