This article will explain how to assess the abdomen as a nurse. This assessment is part of the nursing head-to-toe assessment you have to perform in nursing school and on the job.
During the abdominal assessment you will be:
- Inspecting
- Auscultating
- Palpating/Percussing
Video Demonstration on a Nursing Abdominal Assessment
Abdomen:
Switches to Inspection, Auscultation, Percussion, and Palpation
- Have patient lay supine
- Ask patient about their last about bowel movement and if they have any problems with urination. If a female patient, ask when their last menstrual period was.
- If an ostomy is present note the type of ostomy, stoma color (should be pink and shiny), consistency and color of stool?
Inspect:
- Stomach contour scaphoid, flat, rounded, protuberant?
- Noted pulsations at the aorta (noted in thin patients): The aortic pulsation can be noted above the umbilicus.
- Characteristics of the navel (invert or everted)
- Masses (check for hernia after auscultation), PEG tube?
Auscultate with the diaphragm for bowel sounds:
- start in the RIGHT LOWER QUADRANT and go clockwise in all the 4 quadrants
- should hear 5 to 30 sounds per minute…if no, bowel sounds are noted listen for 5 full minutes
- Documents as: normal, hyperactive, or hypoactive
Auscultate for bruits (vascular sounds) at the following locations using the BELL of the stethoscope:
- Aorta: slightly below the xiphoid process midline with the umbilicus
- Renal Arteries: go slightly down to the right and left at the aortic site
- Iliac arteries: go few a inches down from the belly button at the right and left sides to listen
- Femoral arteries: found in the right and left groin.
Check for hernia: have patient raise up a bit and look for hernia (at stomach area or navel area)
Palpation of the abdomen:
- Light palpation (2 cm): should feel soft with no pain or rigidity
- Deep palpation (4-5 cm): feel for any masses, lumps, tenderness
Complete nursing head-to-toe assessment