Assessing the Abdomen Flashcards
What is the correct order for abdominal assessment?
A. Inspection, palpation, auscultation, percussion
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Palpation, inspection, auscultation, percussion
Inspection, auscultation, percussion, palpation
Rationale: The correct order for abdominal assessment is inspection, auscultation, percussion, palpation. Palpation is the last step in abdominal assessment. Auscultation follows assessment because percussion and palpation can alter the frequency and intensity of bowel sounds.
How often should normal bowel sounds be heard in each quadrant of the abdomen?
A. 5-35 times per minute
B. Less than 5 times per minute
C. 15-20 times per minute
D. 20-40 times per minute
5-35 times per minute
Rationale: Normal bowel sounds should be heard 5-35 times per minute. Bowel sounds reflect peristalsis and should be heard irregularly.
to assess abdomen, what position to keep patient
supine
Which of the following is an important part of performing an abdominal assessment?
A. Completing the assessment as quickly as possible
B. Stopping the assessment if the patient has any tenderness
C. Explaining each step of the assessment to the patient
D. Having the patient breathe normally at all times
Explaining each step of the assessment to the patient
Rationale: Explaining each step of the assessment demonstrates respect for the patient and allows the patient to be informed of the assessment process. Abdominal assessment should be performed in a thorough manner, not as quickly as possible. Complaints of tenderness from the patient should be noted, and the complete abdominal assessment should be continued. For most parts of the assessment, the patient will breathe normally. There are instances when the patient will need to take a deep breath, such as when assessing the spleen and gastric air bubble.
What should you do if a patient is ticklish when you are palpating the abdomen?
A. Distract the patient by talking to him or her.
B. Do not palpate the abdomen in the upper quadrants.
C. Do only deep palpation of all four quadrants.
D. Place your hand over the patient’s hand during palpation.
Place your hand over the patient’s hand during palpation.
Rationale: Place your hand over the patient’s hand during palpation, leaving your fingers free to palpate. Palpate with a firm hand or place your hand over the patient’s during palpation. All quadrants are palpated for a thorough abdominal assessment. The abdominal assessment begins with light palpation.
Moderate and deep palpation of the abdomen:
A. May cause tenderness
B. Should not detect masses
C. May locate the margins of the liver
D. All of the above
May cause tenderness
Should not detect masses
May locate the margins of the liver
Rationale: The patient may report tenderness with deep palpation that was not there during light palpation. Deep palpation may cause tenderness over the cecum, sigmoid colon, aorta, and xiphoid process. In a healthy patient, deep palpation should not detect masses. Palpate with the side of your hand over the liver and spleen; these organs should bump into your hand with inspiration.
visceral pain
Hollow organs forcefully contract or become distended
* Example: stomach, pancreas, intestine, colon
* Solid organs (liver, spleen)—if swell against their capsules
* Gnawing, burning, cramping, or aching
* Often difficult to localize
* Examples:
* Hepatitis
* Cholecystitis—gallbladder
* Irritable bowel syndrome (IBS)
parietal pain
Inflammation on the peritoneum or organs
attached to the parietal peritoneum
* Steady, aching pain
* More severe
* More easily localized over the involved structure
* Example:
* Appendicitis
* Peritonitis
referred pain
Originates at different sites but shares innervation
from the same spinal level
* Example: gallbladder pain (cholecystitis) may be
referred to the right scapula or shoulder
what are the 4 quadrants
- RUQ
- RLQ
- LUQ
- LLQ
3 central areas of abdomen
- Epigastric
- Umbilical
- Suprapubic (hpyogastric)
what are the structures
- Stomach
- Pancreas
- Spleen
- Small and large intestines
- Liver
- Gallbladder
- Kidney—lower poles
- Muscles
- Costal margins
- Arteries: Aorta, renal, iliac, femoral
what do you need to examine abdomen
- Need good light Relaxed patient with empty
bladder * Full exposure of abdomen &
warm room - Patient with arms at side or
across chest - Flex knees if abdomen tense or *Position—supine ticklish
what do you inspect on the abdomen
Condition of skin:
* Color
* Lesions
* Veins
* Hair distribution
* Hernias
what movements do you inspect
Respirations
* Pulsations—which arteries?
* Peristalsis
