Lab 10: Abdominal Assessment

Question 1

What factors impact normal bowel functioning patterns?

Answer 1

• Circumstances of development, diet (eg. fibre), fluid intake and output (intake 1.5-3L/day), activity, factors,psychological habits, medications, diagnostic procedures, anesthesia and surgery, pathological conditions (eg. illness), and pain affect defecation
• Development (weakening of sphincter muscles in older age, mobility issues, infants can’t control sphincter, colon isn’t mature
• Hormones

Question 2

Mrs. Brown is a 78 yr old woman who has come to your clinic for her annual physical examination. You will conduct an abdominal assessment. What will you inquire about?

Answer 2

• history of abdominal pain —Location, onset, sequence, and chronology
• –It’s quality (description)
• –It’s frequency
• –Associated symptoms (nausea, vomiting, diarrhea)
• –Bowel habits
• –Incidence of constipation or diarrhea
• –Change in client appetite, food intolerances, foods ingested in last 24hrs
• –Specific signs and symptoms (eg. heartburn, flatulence or belching, difficulty swallowing, hematemesis (vomiting blood), blood or mucus in stools, and aggravating and alleviating factors)
• –Previous problems and treatment (stomach ulcer, history of jaundice)
• –Flatulence
• –Incidence of abdominal pain (location, onset, quality, frequency, and associated symptoms)

Question 3

What are the characteristics of normal feces?

Answer 3

a. up to 75% water and 25% solid materials
b. Soft, formed, semisolid, moist
c. brown because of stercobilin and urobilin
d. Shape:cylindrical (contour of rectum), about 2.5cm diameter in adults
e. Amount: varies with diet (approx. 100 - 400 g/day)
f. Constituents: small amounts of undigested roughage, sloughed dead bacteria and epithelial cells, fat, protein, dried constituents of digestive juices, inorganic matter
g. Abnormal: blood (could be black (been digested) or red (on lower GI tract) depending on where it’s coming from in the body) (tary, blood stool = melina)

Question 4

What might you ask Mrs. Brown (78) about her bowel functioning and how she maintains her normal pattern?

Answer 4

a. Client’s diet (fibre = 25-30 g/day), activity, medications, and characteristics and ease of passage of feces and the frequency of bowel movements
b. Bowels work best right after a meal (especially after breakfast)

Question 5

At what level of the abdomen would you measure Mrs. Brown’s abdominal girth?

Answer 5

The level of the umbilicus

Question 6

When assessing Mrs. Brown’s abdomen, why is abdominal assessment not carried out “IPPA” as with other assessments?

Answer 6

• Performs inspection first, followed by auscultation, percussion, and palpation
• Auscultation is done before palpation and percussion because these techniques cause movement or stimulation of the bowel, which can increase bowel motility and heighten bowel sounds (creating false results)

Question 7

When examining Mrs. Brown, in which abdominal quadrant would you expect the following organs to be inspected / auscultated / percussed / palpated?

Answer 7

a. Stomach: left upper quadrant
b. Liver: right upper quadrant
c. Bladder: left and right lower quadrants
d. Descending colon: left upper and lower quadrants
e. Spleen: left upper quadrant

Question 8

What type of palpation is used when assessing the abdomen? Why?

Answer 8

Light palpation (1 - 2 cm deep) because deep palpation can be risky to damage organs