assessing the abdomen

• Abdomen


  Bordered superiorly by the costal margins, inferiorly by the symphysis pubis and inguinal canals, and laterally by the flanks
• Abdominal Quadrants and Regions


  • Used to describe the location of abdominal structures and pathologies

  
• Abdominal Wall Muscles


  • Three muscle layers from back, around flanks, to front: external and internal abdominus oblique, transverse abdominus
  • Protect internal organs and allow normal compression of internal organs during functional activities
• Solid viscera


  • Liver
  • Pancreas
  • Spleen
  • Kidneys
• Liver


  Helps with metabolism, produces bile, produces clotting factors, detoxifies drugs and alcohol, converts glucose to glycogen, stores vitamins A, B, E, K
• Pancreas


  Produces insulin, glucagon, helps produce enzymes to help with digestion, endocrine gland
• Spleen


  Produces RBCs, activates B and T cell lymphocytes, stores RBCs and platelets, helps with immunity
• Kidneys


  Maintain homeostasis, makes erythropoietin (helps stimulate RBCs)
• Hollow viscera


  • Stomach
  • Gallbladder
  • Small intestine
  • Colon
  • Urinary Bladder
• Current Symptoms


  • Abdominal Pain
  • Indigestion
  • Nausea and vomiting
  • Loss of appetite (anorexia)
  • Bowel movement (constipation and diarrhea)
  • UTI
  • Hepatitis
• Past History


  • Abdominal surgery, trauma, injury, medications
  • Abdominal pain and treatment
  • Lab work or gastrointestinal studies
• Family History


  • Stomach, colon, liver cancer
  • Abdominal pain, appendicitis, colitis, bleeding, hemorrhoids
  • Nutritional habits in family
• Lifestyle and Health Problems

  • Alcohol
  • Smoking
  • Diet
  • Antacid (with Magnesium, Aluminum)
  • Medications
  • Fluid intake
  • Exercise
  • Stress
  • Past actions with abdominal pain or problems
• Preparing the Client


  • Empty the bladder
  • Remove clothes and put on a gown
  • Lie supine with the arms folded across the chest or resting by the sides
  • Drape the client
  • Breathe through the mouth; take slow, deep breaths
• Assessment of the Abdomen

  • Inspection
  • Auscultation
  • Percussion
  • Palpation
• Inspection


  Observe the coloration and vascularity of the skin, look for lesions and rashes, assess abdominal contour, symmetry, and movements
• Auscultation


  Use diaphragm to listen for bowel sounds, use bell to listen for vascular sounds
• Percussion


  Percuss abdomen for tone, determine liver and spleen size, check for dullness
• Palpation


  Perform light and deep palpation to check for tenderness, masses, and organ enlargement
• Special Abdominal Tests


  • Tests for ascites
  • Tests for appendicitis
  • Tests for cholecystitis
• Analysis of Data


  Formulate nursing diagnoses, collaborative problems, and make necessary referrals