Overview
This video demonstrates the step-by-step process for conducting a focused abdominal assessment on a patient, highlighting preparation, inspection, auscultation, and palpation techniques for nursing practice.
Preparation for Abdominal Assessment
- Provide patient privacy and perform hand hygiene before the examination.
- Explain the procedure to the patient and gather necessary equipment, including a stethoscope.
Patient History and Preliminary Questions
- Ask the patient about current abdominal issues, bowel movements, urination habits, and for women, last menstrual period.
- If the patient has a Foley catheter, inspect urine and related system status.
Abdominal Inspection
- Observe abdominal contour (scaphoid, flat, rounded, or protuberant) and look for pulsations, masses, or hernias.
- Inspect the umbilicus and any present surgical wounds, peg tube sites, or ostomies for color, complications, and output.
Bowel Sound Auscultation
- Use the diaphragm of the stethoscope to listen to all four abdominal quadrants, starting from the right lower quadrant and moving clockwise.
- Identify bowel sound frequency (normal: 5–30/min); if absent, listen for five full minutes and note character (normal, hypoactive, hyperactive).
Vascular Sound Auscultation
- Use the bell of the stethoscope to listen for bruits at the aorta, renal arteries, and iliac arteries; femoral arteries if needed.
- Note any unusual blowing or swishing sounds.
Palpation Techniques
- Perform light palpation (≈2 cm depth) in all quadrants for rigidity, masses, or tenderness.
- Proceed to deep palpation (≈4–5 cm depth) to assess for deeper masses or pain, using two hands if needed.
- Ask the patient to report any tenderness or discomfort during palpation.
Recommendations / Advice
- Always auscultate before palpating to avoid altering bowel sounds.
- Assess and document patient responses and findings accurately.