Abdominal Assessment by RegisteredNurseRN.com

Pre-assessment Steps

• Preparation:
  • Provide privacy to the patient.
  • Conduct hand hygiene.
  • Explain the procedure to the patient.
• Required Equipment:
  • Stethoscope

Assessment Sequence

1. Inspection
2. Auscultation
3. Percussion or Palpation

Inspection

• Patient Position:
  • Patient should lie on their back.
• Questions to Ask:
  • Any stomach issues?
  • Last bowel movement?
  • Any pain or difficulty urinating?
  • For males, ask about prostate issues; for females, ask about the last menstrual period.
• Observe for:
  • Abdominal contour: scaphoid, flat, rounded, protuberant.
  • Pulsations: Check for aortic pulsation above the umbilicus.
  • Masses, hernias, wounds, PEG tube sites.
  • Ostomies: Check stoma color (should be rosy pink, not dusky or cyanotic), stool type, smell, and if the bag needs changing.

Auscultation

• Bowel Sounds:
  • Use stethoscope diaphragm.
  • Start in the right lower quadrant and move clockwise through all four quadrants.
  • Normal: 5 to 30 sounds per minute.
  • If no sounds, listen for 5 minutes.
  • Categorize sounds as normal, hyperactive, or hypoactive.
• Vascular Sounds:
  • Use stethoscope bell to listen for bruits.
  • Check aortic, renal, iliac, and femoral arteries.
  • Listen for blowing swishing sounds indicating bruits.

Palpation

• Light Palpation:
  • Start in the right lower quadrant.
  • Feel about 2 cm deep for rigidity, lumps, or masses.
  • Inquire about pain or tenderness.
• Deep Palpation:
  • Press 4 to 5 cm deep.
  • Use two hands if necessary.
  • Continue to check for masses and ask about tenderness.

Conclusion

• Everything should feel normal (soft, no tenderness).
• Complete the assessment process.

Additional Resources

• Watch the complete head-to-toe nursing assessment video for more information.

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