ASSESSMENT OF THE ABDOMEN

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• ASSESSMENT OF THE ABDOMEN

Rachel S. Natividad, RN,MSN
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ANATOMY

• RUQ liver, gallbladder, duodenum, head of the
  pancreas, hepatic flexure of colon, ascending
  /transverse colon, right kidney
• LUQ stomach, spleen, body of pancreas, left
  kidney, splenic flexure of colon,
  transverse/descending colon
• RLQ cecum, appendix, right ovary, tube, ureter,
  and spermatic cord
• Midline aorta, uterus, bladder
• Epigastric, umbilical, suprapubic

Abdominal Quadrants
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Abdominal Regions
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Obtaining a Health History

• History of GI problems and/or GI symptoms
• Heartburn
• Nausea/vomiting
• Altered bowel habits
• Investigate
• PQRST

• Abdominal surgery or trauma
• Current meds
• Family hx
• Ulcerative colitis
• Colon CA
• Stomach ulcers
• Alcoholism
• Chrons disease

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Different Sequence of Assessment

• Inspect
• Auscultate
• Percuss
• Palpate

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ASSESSMENT Inspection

• Contour
• flat
• round
• Scaphoid
• Protuberant
• distended 

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Inspection Distended Abdomen
Ascites
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Inspection

• Skin lesions, color, texture, scars, venous
  pattern, striae

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Auscultation of Bowel Sounds

• Absent
• no BS for 5 min
• Hypoactive
• less than 5/min
• Active
• 5-30 per min
• Hyperactive
• gt 30 /min

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Auscultation vascular sounds
Aneurysm
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Percussion

•     To assess density of abdominal contents,
  locate organs, and screen for abnormal fluid or
  masses
•     Tympany predominantly over the abdomen
  gas-filled
•      Dull over organs in the abdominal cavity
  (liver, spleen)
• CVA tenderness

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CVA Costovertebral Angle
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Palpate all quadrants
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Palpation

• Light PalpationTenderness, Masses,
• Rigidity

• Deep Palpation
• Tenderness, Masses,
• Enlarged organs

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Normally Palpable Structures
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Assessment Guide Elimination

• Abdomen
• Inspection flat, round, obese, concave,
  distended
• Auscultation BS active on all quadrants, no
  vascular sounds
• Palpation soft, nontender firm and tender on
  RLQ

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• Urine describe clear yellow dark amber with
  sediments
• Bowel Sounds skip
• Flatus present, none
• Stool large amount, brown formed stool
• Date LBM 3/3
• Med List Dulcolax, Lomotil, MOM, etc.