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

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
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
Chron’s disease

5. 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

12. CVA – Costovertebral Angle
CVA tenderness – positive in pyelonephritis.

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.