Week 7: Abdominal Assessment Flashcards
Definition: Bowel sounds
Noises made by the movement of food and gas through your intestines.
Definition: Bruits
Abnormal sounds in the body caused by turbulent blood flow in an artery (aortic, renal, iliac, femoral)
Definition: Deep palpation
A technique used to feel internal organs and masses; ~5cm deep.
NOT USED due to possible harm it can do
Definition: Edema
Swelling caused by fluid building up in body tissues.
Definition: Dehydration
Occurs when you use or lose more fluid than you take in and your body doesn’t have enough water and other fluids to carry out its normal functions.
Definition: Friction rub
An abnormal sound in the chest that can be heard with a stethoscope.
It can be a sign of inflammation in the pleura or pericardium, also used on spleen and liver.
Definition: Light palpation
Used to feel for abnormalities that are on the surface by pressing only 1cm.
Definition: Linea alba
The Linea alba is a band of connective tissue that runs down the middle of the abdomen.
It separates the rectus abdominis muscles, also known as the “six-pack” muscles.
Definition: Rectus abdominus
A pair of muscles that run vertically down the front of the abdomen, from the pubic bone to the ribs. They are the top layer of abdominal muscles and are often called the “six pack”.
Definition: Skin turgor
The skin’s elasticity, or its ability to change shape and return to normal.
What are the 4 quadrants for of the abdomen?
RLQ
RUQ
LUQ
LLQ
What organs can be found in the RLQ?
Appendix
Small intestines
Cecum
Ascending colon
What organs can be found in the RUQ?
Liver
Gallbladder
Transverse colon
What organs can be found in the LUQ?
Stomach
Pancreas
Spleen
What organs can be found in the LLQ?
Small intestine
Descending colon
What sort of questions would you ask for a focused health history for an abdominal assessment?
Bowel habits (colour, regularity)
Past abdominal history/Family history
Medications
Alcohol and tobacco use
Nutritional assessment
What sort of questions would you ask for an infant or child for a focused abdominal history?
Infant feeding
Table foods
Eating patterns
Constipation
Abdominal pain
Overweight children
What sort of questions would you ask for adolescents for a focused abdominal history?
Schedule and content
Exercise
Underweight
What sort of questions would you ask for an older adult for a focused abdominal history?
Food access
Emotional characteristics
Recall
Bowel movements
How do you prepare a patient for an abdominal examination?
- Empty bladder
- Good lighting
- Relaxed patient in supine position
- Pillows positioned under head and under knees
- Hands at side/on chest
- Full exposure to the abdomen
- Clean and warm hands & stethoscope
What are the 4 steps of an Abdominal examination?
Inspection
Auscultation
Palpation
Percussion
What do you look for during inspection?
- Skin integrity (colour, blemishes)
- Umbilicus (flat or concave)
- Contour (flat, round, concave, distended)
- Movements or pulses
What do you step to the foot of the bed to check?
Umbilicus
Bulges
Masses
Why do we Auscultate first before Percussion and Palpation?
Percussion and palpation can increase peristalsis and change the way you notice bowel
sounds
What should you do if a bruit is heard?
DO NOT palpate over the aorta, and should report it right away
in case of possible aortic aneurysm
What quadrant do you begin any step of examination on?
Lower Right Quadrant
What way do you continue after the RLQ on an abdominal assessment?
Clockwise - RUQ, LUQ, LLQ
How frequent are normal bowel sounds?
Every 5-30 minutes
What does it mean if there are more than 30 bowel sounds in a minute?
The bowels are hyperactive
What does it mean if there are less than 30 bowel sounds in a minute?
The bowels are hypoactive
What do you do if bowel sounds are absent?
Listen for a full 5 minutes before confirming
What is Borborygmi?
The normal rumbles and gurgles of the stomach and intestine (digestion, passing of air, foods, fluids)
What is Borborygmus?
Stomach growling (type of
hyperactive bowel sound)
Why do we check the aortic, renal, iliac, and femoral arteries during an examination?
To check for bruits/vascular sounds which could mean there is something wrong such as a blockage with an artery
How would you describe normal bowel sounds?
High-pitched, gurgling, and cascading
What do we listen for during Percussion of the abdomen?
Tympani and dullness
When might you hear tympani?
When the patient is lying down, air rises to the surface of the intestines, so tympany is the normal finding
When might you hear dullness?
Dullness is the finding over a full bladder, solid organ, adipose tissue, fluid or a mass
Where would you percuss to locate the spleen?
From the 9th-11th intercostal spaces just behind the left midaxillary line
Where would you percuss for the liver?
In RUQ approximately 5th ICS
Where would you percuss for the stomach?
In the LUQ
How would you palpate a very ticklish patient?
Place patients’ hand under both of yours and curl your fingers around the patient’s hand
Why do we use palpation in an abdominal examination?
To assess for any tenderness, muscle guarding, masses, or other abnormalities
What are common signs of appendicitis during palpation?
Rebound tenderness and acute
pain from umbilicus to RLQ often indicative of appendicitis
When the patient reports that a certain abdominal spot is tender, it is best to:
A. palpate that spot last, to prevent pain from interfering with the rest of the examination.
B. palpate that spot first, to avoid prolonging the
patient’s anticipation.
C. avoid that spot entirely, as other clinicians are going to palpate it after you.
D. palpate in the same order as you always would, to avoid missing something because you broke your routine.
A. palpate that spot last, to prevent pain from interfering with the rest of the examination.
Which of the following is not part of the list of common causes for abdominal
distension?
A. Flatus
B. Fetus
C. Fluid
D. Follicles
D. Follicles
To palpate for tenderness of an adult client’s appendix, the nurse should begin the
abdominal assessment at the client’s:
a. Left upper quadrant
b. Left lower quadrant
c. Right upper quadrant
d. Right lower quadrant
d. Right lower quadran
The nurse is preparing to assess the abdomen of a hospitalized client 2 days after abdominal surgery. The nurse should first:
a. Palpate the incision site
b. Auscultate for bowel sounds
c. Percuss for tympany
d. Inspect the abdominal area
d. Inspect the abdominal area
The nurse is planning to assess the abdomen of an adult male client. Before the nurse
begins the assessment, the nurse should:
a. Ask the client to empty his bladder
b. Place the client in a side lying position
c. Ask the client to hold his breath for a few seconds
d. Tell the client to raise his arms above his head
a. Ask the client to empty his bladder
During a physical examination of an adult client, the nurse is preparing to auscultate the
client’s abdomen. The nurse should:
a. Palpate the abdomen before auscultation
b. Listen in each quadrant for 15 seconds
c. Use the diaphragm of the stethoscope
d. Begin auscultation in the left upper quadrant
c. Use the diaphragm of the stethoscope
What are the 3 regions of the abdomen? (top to bottom)
Epigastric
Umbilical
Hypogastric
