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Assessment of Abdomen

Assessment of Abdomen. Examination. 9. Inspection Auscultation Percussion Palpation. Abdominal Structure and Function. 9. Abdominal quadrants Upper right quadrant Upper left quadrant Lower right quadrant Lower left quadrant. 9. Abdominal Structure and Function. Abdominal quadrants.

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Assessment of Abdomen

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  1. Assessment of Abdomen

  2. Examination 9 • Inspection • Auscultation • Percussion • Palpation

  3. Abdominal Structure and Function 9 Abdominalquadrants • Upper right quadrant • Upper left quadrant • Lower right quadrant • Lower left quadrant

  4. 9 Abdominal Structure and Function Abdominal quadrants

  5. Equipment needed 9 The only equipment needed are: • Stethoscope • cloth or plastic ruler • Pencil • Examination table • Light • Small pillow • Drapes to cover the patient

  6. Subjective History 9 • Abdominal pain • Onset • Location • Duration • Characteristics • Associated findings • Relieving factors • Tx attempted • Appetite • Dysphagia • Food intolerance • Nausea /Vomiting • Bowel habits • Past abdominal history • Medications • Nutritional assessment

  7. The Examination 9 • Client • Empty bladder, disrobe & gown, supine, head on pillow, knees bent, arms at side or across chest, have pt ID any area of pain • Nurse • Warm hands & stethoscope, warm environment, good lighting, approach slowly, monitor pt’s face during exam, tender areas last • Inspect, Auscultate, Percuss, Palpate- light & deep

  8. Inspection 9 Contour - flat, rounded. Symmetry- Umbilicus Skin - texture, color, lesions, veins, turgor Surface motion - pulsations or peristalsis Respiratory movement Hair distribution Demeanor

  9. Abdomen - Hernia 9

  10. Auscultation 9 • Use diaphragm high pitched • hold lightly against skin • Begin RLQ (ileocecal valve area) • Bowel sounds • character & frequency • originate from air & fluid movement thru small intestines • hi pitched, gurgling, cascading, irregular, • 5-30 times/min, depends on last time pt ate

  11. Auscultation cont. 9 • Findings • Normal • hypoactive - absent, slow ie) surgery, inflammation • hyperactive - loud, rushing, tinkling – hyper peristalsis, ”stomach growling” • Listen for 5 minutes before deciding absent

  12. Auscultation cont. 9 • Vascular sounds • Bruits- pulsatile blowing sound with artery occlusion (use firmer pressure) • aorta • renal • iliac • femoral • Venous hum- periumbilical region • Peritoneal friction rub

  13. Palpation--Specific Organs 9 • Liver • Spleen • Kidney • Aorta

  14. Special Procedures 9 • Blumberg sign (Appendix test) • Rebound tenderness • Murphy’s sign (Gallbladder test) • Hernias

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