Abdominal Assessment Procedure

Preliminary Steps

• Ensure Patient Privacy: Provide privacy for the patient before beginning the procedure.
• Hand Hygiene: Perform hand hygiene to maintain cleanliness.
• Inform the Patient: Explain to the patient what the assessment will involve.
• Required Equipment: A stethoscope is needed for the assessment.

Assessment Sequence

• The sequence for abdominal assessment differs from other assessments:
  1. Inspection
  2. Auscultation
  3. Percussion/Palpation

Inspection

• Patient Position: Have the patient lie on their back.
• Questions to Ask:
  • Any stomach issues?
  • Date of last bowel movement?
  • Any pain during urination, difficulty starting a stream, or discharge?
  • For male patients, inquire about prostate-related urination issues.
  • For female patients, ask about the date of the last menstrual period.
• Observations:
  • Inspect abdominal contour (scaphoid, flat, rounded, or protuberant).
  • Check for pulsations, especially in thin patients (look for aortic pulsation above the umbilicus).
  • Examine the belly button for masses or hernias.
  • Inspect any wounds, PEG tube sites, or ostomies (stoma color, output type, smell, and bag condition).

Auscultation

• Use the diaphragm of the stethoscope.
• Sequence:
  1. Right Lower Quadrant
  2. Right Upper Quadrant
  3. Left Upper Quadrant
  4. Left Lower Quadrant
• Normal Bowel Sounds: 5-30 sounds per minute.
  • If no sounds are heard, listen for 5 minutes.
  • Note sound quality: normal, hyperactive, or hypoactive.
• Vascular Sounds:
  • Use the bell of the stethoscope.
  • Listen for bruits (blowing/swishing sounds).
  • Check the following arteries:
    • Aortic (below the xiphoid process, above the umbilicus)
    • Right and Left Renal Arteries
    • Iliac Arteries (below the belly button)
    • Femoral Arteries (in the groin, if necessary)

Palpation

• Light Palpation:
  • Start in the right lower quadrant and work clockwise.
  • Depth: about 2 cm.
  • Check for rigidity, lumps, or masses.
  • Ask the patient to report any pain or tenderness.
• Deep Palpation:
  • Depth: about 4-5 cm.
  • Feel for masses or lumps.
  • Use two hands if necessary.
  • Ensure the patient informs if there is any tenderness.

Conclusion

• This completes the abdominal assessment procedure.
• Encourage the audience to check out additional resources, such as a complete head-to-toe nursing assessment video.