Abdominal Assessment Lecture Notes

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Topic: Demonstration of completing an abdominal assessment
• Additional Resource: Access a complete head-to-toe nursing assessment video via a card in the video or YouTube description.

Pre-Assessment Preparation

• Patient Privacy: Ensure privacy for the patient.
• Hand Hygiene: Perform hand hygiene before commencing.
• Patient Communication: Inform the patient of the procedure.
• Required Equipment: Stethoscope

Abdominal Assessment Steps

Sequence of Assessment

1. Inspection
2. Auscultation
3. Percussion or palpation

Inspection

• Patient Position: Patient should lay on their back.
• Questions for Patient:
  • Any stomach issues?
  • Last bowel movement?
  • Urination issues (pain, stream problems, discharge)?
  • Last menstrual period (for female patients)?
• Considerations:
  • Inspect Foley catheter and urine if applicable.
• Observations:
  • Abdominal contour (scaphoid, flat, rounded, protuberant).
  • Pulsations, especially aortic pulsation above the umbilicus.
  • Check for hernias, masses, wounds, PEG tube site, and ostomy stoma.

Auscultation

• Procedure:
  • Use diaphragm of stethoscope.
  • Start at Right Lower Quadrant (RLQ) and move clockwise through all four quadrants.
  • Normal bowel sounds: 5-30 sounds per minute.
  • Listen for five minutes if no sounds are heard.
  • Categorize sounds as normal, hyperactive, or hypoactive.
• Vascular Sounds:
  • Use bell of stethoscope.
  • Listen to aortic, renal, iliac, and femoral arteries.
  • Check for blowing/swishing sounds (bruits).

Palpation

• Sequence: Light palpation followed by deep palpation.
• Light Palpation:
  • Cover 2 cm depth.
  • Check for rigidity, lumps, or masses.
• Deep Palpation:
  • Cover 4-5 cm depth.
  • Feel for masses or tenderness using one or two hands as needed.
• Patient Feedback:
  • Ask for feedback on pain or tenderness during palpation.

Conclusion

• This session covers the complete process of an abdominal assessment.
• Reminder to watch the video on complete head-to-toe assessment.
• Encourage subscription to the channel for more educational videos.