This is Sarah with RegisteredNurseRN.com and in this video I'm going to demonstrate how to complete an abdominal assessment. And if you would like to watch a complete head to toe nursing assessment, you can access this card up here in the corner or in the YouTube description below access to that video. Now before you do this skill, you'll want to provide privacy to the patient, perform hand hygiene and tell the patient what you will be doing.
And some equipment that you will need for this is a stethoscope. So let's get started. Now we're going to assess the abdomen and remember we're switching our sequence and how we assess.
We're going to do inspection, auscultation and then percussion or palpation. So we're going to do auscultation second. So whenever you're looking and assessing the abdomen have the patient lay on their back and what we're going to do is we're going to inspect the abdomen and first I want to ask Ben are you having any stomach issues at all?
No. Okay, and when was your last bowel movement? Yesterday.
Yesterday morning. And how are you urinating? Do you have any pain while you're peeing? Do you have problems starting a stream?
Any discharge? Anything like that? No, it's normal.
Okay, and with your male patients, you want to ask about that due to prostate enlargement was starting a stream. And if he was female, I would ask him when his last menstrual period was. And also, again, ask the female patient about urinating and things like that. Now, if the patient had a Foley, this is the time when you would want to look at the urine, inspect the Foley, and look at that.
Just conglomerate your urinary system and your GI system together. Okay, so we're inspecting the abdomen. We're looking at the abdominal contour, and this patient's is scaphoid. It goes in a little bit.
You can also have flat, rounded, or protuberant. And also, we're going to note if there's any pulsations. A lot of times in this area right here on thin patients like with Ben, I can see the aortic pulsation in this patient. It's right above the umbilicus and looking at the belly button and checking for any masses.
Do we see any hernias or anything like that? Also, if your patient had any wounds, you would want to look at that. And if they had a PEG tube, you would want to assess the site, make sure it's not red and ask them how it feels. and with your ostomies.
With your ostomies, you want to look at the stoma and make sure it is like a rosy pink color. It's not a dusky cyanotic color and it's not prolapsed. And look and see what type of stool it's putting out. And note that.
Note the smell. Note if the bag needs to be changed. Anything like that. So now we're ready to listen to the bowel sounds.
And what we're going to do is we're going to listen. with the diaphragm of our stethoscope and we are going to start in the right lower quadrant and work our way clockwise and we're going to listen to all four quadrants and you should hear 5 to 30 sounds per minute and if you don't hear any bowel sounds you need to listen for five full minutes and you need to note are these normal are they hyperactive or hypoactive so let's listen This is our right lower quadrant. We're going to move up to the right upper quadrant, move over to the left upper quadrant, and then down to the left lower quadrant. and bowel sounds are normal.
Now we're going to listen for vascular sounds and you're going to do this with the bell of your stethoscope and we're going to listen at the aortic, we're going to listen at the renal arteries, iliac arteries, and you could listen at the femoral arteries if you needed to. So you're going to listen at the aorta artery and it's a little bit below the xiphoid process and a little bit above the umbilicus. So about right here and we're listening for like a blowing swishing sound but which would represent a brewie.
Okay, and none is noted. Then we're going to listen at the right and left renal arteries, which is a little bit down from the aorta location. So here's the right. Okay, none noted, and then over the left.
Then we're going to listen at the iliac, and it's a little bit below the belly button right here. And this is the iliac artery. And then listen on the other side. Again, like I pointed out you could listen at the femoral artery in the groin if you needed to now we're going to do Palpation first we're going to do light palpation then deep and being as I do this Please tell me if you feel any pain or tenderness.
So first we're going to do light palp We'll just start in the right lateral quadrant and work our way around. You're going to go about 2 centimeters. You're just feeling for any rigidity, any lumps, masses, anything like that. How's that feel? It feels fine.
Okay. Okay, now we're going to do deep palpation. And we're going to go about 4 to 5 centimeters, so a lot more deep.
And again, you're just feeling for any masses, lumps. And Ben, tell me if you have any tenderness. And sometimes you can do this with two hands if need be, if you're not strong enough like me.
Feeling anything? Feels nice and soft. Heard some belly sounds.
That's why you do this after you listen, because you stimulate it. Okay, everything felt good. So that wraps up how to perform an abdominal assessment and don't forget to check out that video on the complete head-to-toe nursing assessment.
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