Abdominal assessment

Question 1

preparation

Answer 1

wash hands

introduce self

identify patient

explain procedure

provide privacy

don gloves

Ask patient if they need to empty bladder

Question 2

Subjective data

Answer 2

• appetite
• changes in weight
• food intolerances
• abdominal pain
• nausea and vomiting
• bowel movements (last)
• past med hx of abdominal issues
• usual diet

Question 3

Inspection

Answer 3

• contour (flat, protuberant)
• symmetry between left and right sides
• umbilicus: centrally located, inverted or everted
• skin color: even, warm, dry, lesions
• pulsations- none
• masses
• scars
• dilated veins

Question 4

Auscultation

Answer 4

• listen for bowel sounds in all 4 quadrants
• Identify abnormal bowel sounds if any: hypo/hyperactive, positive bowel sounds in all 4 quadrants
• Use bell to auscultate arteries
• aorta
• auscultates full length of abdominal aorta (listen for brews from the typhoid process to below belly button)
• renal arteries bilaterally( diagonal above umbilicus)
• iliac arteries bilaterally(diagonal below umbilicus)
• verbalizes need to auscultate over femoral arteries

Question 5

Percussion

Answer 5

• Percusses abdomen fully clockwise beginning RLQ
• Notes tympany
• Percusses for liver span accurately
• Estimates liver span (use ruler)
• Percusses for splenic dullness accurately (left side to very last intervertebral space, pt must take deep breath while percussing)

Question 6

Palpation

Answer 6

• Have pt raise knees
• Performs light palpation clockwise, begin with RLQ
• Performs deep palpation clockwise begin with RLQ
• Palpates for liver edge using hooking tech.
• Notes presence or absence of Murphys sign (to check for gallbladder or liver tenderness, watch puts expression during hooking technique)
• Palpates for spleen (start in the RLQ and work your way up diagonally)
• Accurately locates and palpates the aorta -Accurately estimates width of aorta

Question 7

Maneuvers

Answer 7

Perform psoas muscle test

Performs rebound tenderness

Question 8

Kidneys

Answer 8

Checks for Costovertebral Angel tenderness bilaterally

Question 9

Closing

Answer 9

Make patient safe and comfortable

lower bed to the lowest position

side rails

offer to answer any questions

wash hands

Question 10

Murphys sign

Answer 10

• To check for liver or gallbladder inflammation
• Watch puts expression during hooking technique
• Is it negative or positive for Murphys sign

Question 11

Psoas sign

Answer 11

• Test for apendicitis
• Put pressure on right knee and have pt keep leg straight and push against resistance

Question 12

order of abdominal exam

Answer 12

Preparation Subjective data Inspection Auscultation Percussion Palpation Maneuvers Kidneys Closing