Abdominal Assessment Demonstration

Pre-Assessment Preparations

• Provide Privacy: Ensure patient privacy before starting.
• Perform Hand Hygiene: Clean hands thoroughly.
• Explain Procedure: Inform the patient about the assessment steps.
• Equipment Needed: Stethoscope.

Order of Abdominal Assessment

1. Inspection
2. Auscultation
3. Percussion/Palpation

Inspection

• Position Patient: Patient should lie on their back.
• Interview Patient:
  • Ask about any stomach issues.
  • Inquire about last bowel movement and urination issues.
  • For males, ask about urination, possible prostate issues.
  • For females, ask about last menstrual period and urination.
• If Foley Catheter is Present:
  • Inspect urine and catheter.
• Observe Abdominal Contour:
  • Check if scaphoid, flat, rounded, or protuberant.
• Check for Pulsations: Note aortic pulsation above umbilicus.
• Examine for Masses: Look for hernias or masses.
• Assess Wounds or PEG Tubes:
  • Ensure no redness, check patient comfort.
• Inspect Ostomies:
  • Stoma should be rosy pink.
  • Check for prolapse or abnormal color.
  • Note output type, smell, and bag change needs.

Auscultation

• Bowel Sounds:
  • Use diaphragm of the stethoscope.
  • Start in the right lower quadrant, move clockwise.
  • Listen to all four quadrants: Right Lower, Right Upper, Left Upper, Left Lower.
  • Normal sounds: 5 to 30 per minute.
  • If none heard, listen for 5 minutes.
  • Classify sounds as normal, hyperactive, or hypoactive.
• Vascular Sounds:
  • Use bell of the stethoscope.
  • Listen for blowing or swishing sounds (bruit).
  • Locations: Aorta, Right & Left Renal Arteries, Iliac Arteries.

Palpation

• Light Palpation:
  • Begin in Right Lower Quadrant.
  • Press about 2 cm deep.
  • Check for rigidity, lumps, or masses.
• Deep Palpation:
  • Press about 4-5 cm deep.
  • Check for masses, tenderness.
  • Can use two hands for more pressure.
• Patient Feedback: Ask the patient to report any pain or tenderness.

Conclusion

• Ensure to perform the steps in the correct order.
• Listen for belly sounds after auscultation to avoid stimulation.
• Promote additional resources, such as head-to-toe assessment video.

Closing Remarks

• Encourage viewers to subscribe for more educational videos.