Abdominal Assessment Overview

Pre-Assessment Considerations

• Provide privacy to the patient.
• Perform hand hygiene before starting.
• Explain the procedure to the patient.
• Necessary Equipment: Stethoscope.

Assessment Sequence

• Inspection
• Auscultation
• Percussion or Palpation

Inspection

• Have the patient lay on their back.
• Questions to Ask:
  • Any stomach issues?
  • Last bowel movement?
  • Any pain during urination?
  • For males: Issues starting a urine stream?
  • For females: Last menstrual period?
• Inspect for:
  • Abdominal contour (Scaphoid, Flat, Rounded, Protuberant).
  • Pulsations (e.g., aortic pulsation above the umbilicus).
  • Masses, hernias, wounds, PEG tube site.
  • Ostomies: Check stoma color and output.

Auscultation

• Use the diaphragm of the stethoscope.
• Listen to bowel sounds in all four quadrants starting from the right lower quadrant and moving clockwise.
  • Expect 5-30 sounds per minute.
  • If no sounds heard, listen for 5 full minutes.
  • Categorize sounds as normal, hyperactive, or hypoactive.
• Listen for vascular sounds using the bell of the stethoscope:
  • Aortic artery (below xiphoid process, above umbilicus).
  • Right and left renal arteries.
  • Iliac arteries.
  • Optional: Femoral artery in the groin.

Palpation

• Light Palpation:
  • Start in the right lower quadrant.
  • Palpate about 2 cm deep.
  • Check for rigidity, lumps, masses.
• Deep Palpation:
  • Go about 4-5 cm deep.
  • Feel for masses, lumps, tenderness.
  • Use two hands if necessary for deeper palpation.

Conclusion

• Performing an abdominal assessment includes inspection, auscultation, and palpation.
• Be thorough in checking both the GI and urinary systems.
• Always ensure patient comfort and privacy.

• Reminder: For a full head-to-toe assessment, see the associated video link.
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