1. ASSESSMENT OF THE ABDOMEN
Rachel S. Natividad, RN,MSN, NP

2. 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

3. Abdominal Regions

4. Obtaining a Health History
ROS - History of GI problems and/or GI symptoms
Heartburn
Nausea/vomiting
Altered bowel habits
Positive symptom =Investigate…
PQRST

5. A Different Sequence of Assessment
Inspect
Auscultate
Percuss
Palpate

6. ASSESSMENT Inspection:
·Contour
flat
round
Scaphoid
Protuberant
distended 

7. Inspection: Distended Abdomen
Ascites

8. Inspection:
Skin – lesions, color, texture, scars, venous pattern, striae

9. Auscultation of Bowel Sounds
Absent
no BS for 5 min
Hypoactive
less than 5/min
Active
5-30 per min
Hyperactive
> 30 /min

10. Auscultation: vascular sounds
Aneurysm

11. 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- kidney infection

12. CVA – Costovertebral Angle

13. Palpate all quadrants
Start with rlq or palpate tender areas last – if tender in rlq, then do not begin there.

14. Palpation Light Palpation Tenderness, Masses, Deep Palpation
Rigidity
Deep Palpation
Tenderness, Masses,
Enlarged organs

15. Normally Palpable Structures

16. 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

17. 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.