INSPECT FOR THE COLOR
First, I am going to
inspect the coloration of the
skin ( the size, shape,
symmetry, movements,
vascularity,protrusion and
surface characteristics) To
check if the abdominal skin
is paler than the general
skin tone and if there are
lesions or masses such as
Grey- Turner sign, jaundice,
ascites, redness, bruises as
well as to note for any
striae/stretchmark.
 Upon inspecting, the
client’s abdominal skin
is paler than the
general skin tone and
the skin is intact with
no lesions or masses.
NEXT IS TO INSPECT
VASCULARITY OF THE
ABDOMNAL SKIN. To check if
the scattered veins are
visible and to detect if there
are any caput medusa and
spider angioma present.
Next is to Inspect scars to
check if the scars are pale
and smooth and to check if
there are any non-healing
wounds, redness and
inflammation (USE
CENTIMETER RULER)
STATE THE SIZE
 Upon inspecting, it is
pale, smooth with
minimally raised old
scars
NEXT IS TO INSPECT
FOR LESIONS AND
RASHES TO SEE IF
THEIRS IS CHANGES
IN MOLES OR IF IT IS
FREE FROM LESION
AND RASHES
 the client’s
abdominal area is
free of lesions and
rashes.
Next, I am going to inspect the
umbilicus and note for its color
to see if there is Cullen sign or
grey-turner. I will also be
observing the umbilical location
and assess the contour of
umbilicus.
-Upon inspecting, the client’s
umbilical skin tone is similar to
surrounding abdominal skin
tones. The client’s umbilical is
midline at lateral line. As for
the contour of the umbilicus, it
is round and inverted no more
than 0.5 cm.
Next, I am going to inspect
the abdominal contour by
sitting at the client’s side
and look across the
abdomen to check if the
abdomen is flat or
distended and I will be
inspecting the area between
the lower ribs and pubic
bone as well as measure
the abdominal girth.
-The client’s abdomen is flat.
Next, I am going to assess
the abdominal symmetry by
looking at the abdomen as
the client lies in a relaxed
supine position. To check if
there is asymmetry, hernia
or diastasis recti
-upon assessing the
abdominal symmetry, the
client’s abdomen is symmetric
and does not bulge when the
client raise head.
And I will observe
abdominal movement when
the client breaths to see if
there is increased
peristaltic waves or
abnormal respiratory
movements.
-an abdominal respiratory
movement was seen.
We’re through with the
inspection, now I am going
to conduct an auscultation
on the abdominal area.
First, I am going to auscultate
the bowel sounds by using the
diaphragm of the stethoscope
to check if there are any soft
clicks and gurgles (yung 4
quadrants listen 1 min each)
-Upon auscultating the bowel
sounds, there is a series of
intermittent soft clicks and
gurgles heard at the rate of 5 to
30 per minute
And then next, using the
bell of the stethoscope, I am
going to listen for vascular
sounds to check if there are
any bruits heard over the
abdominal aorta or renal
and iliac femoral arteries
(ikot muna ang bell then
ipa warm mo sa kamay
mo auscultate the 5
areas)
- Upon auscultating the
vascular sounds, I didn’t hear
any bruit sound on the client’s
abdominal aorta, iliac and
femoral arteries.
Next, I will be percussing
for tone by gently tapping
on the skin to create
vibration to check if there
are any tympany, dullness
and abnormalities
-Upon percussing for tone, a
tympany sound predominated the
abdomen and dullness is heard
over the liver and the spleen.
Next, I will be percussing
the liver by percussing the
lower boarder in the
midclavicular line and
proceed to its upper
boarder at the upper right
chest line to check if there
is hepatomegaly and
atrophy present. And then, I
will repeat percussing the
liver at the midsternal line.
(mag mark ka ng 1 *saan
mo narinig ung dull
sound
Mark 2*ask patient hold
breath
Mark 3 galing la sa taas
pababa until may marinig
kang sound sa linya ng
nipple banda)
- Upon percussing the lower
level of the liver, the dullness
sound is located at the costal
margin to 1-2 cm below. For
the upper level of the liver, the
dullness sound is located
between the left 5th and 7th
intercostal spaces. In the
midsternal line, the client’s
liver span is 4-8 cm.
Next, I will be performing a
blunt percussion on the
liver To check if there are
any tenderness present and
by placing my left hand flat
against the lower right
anterior rib cage and
percuss the kidneys at the
costovertebral angles over
the 12th rib.
-There’s no pain elicited upon
performing blunt percussion
on the liver and the kidneys.
I will be performing a light
palpation by using my
fingertips and compress to
a depth of 1 cm in a dipping
motion and perform deep
palpation by using the
palmar surface of my
fingers and compress to a
maximum depth of 5 to 6
cm on all quadrants to
detect tenderness and
masses in all four
quadrants and to detect
swelling, bulges and
masses in the umbilicus,
- Upon performing light
palpation, the client’s
abdomen is nontender and
soft and there is no guarding.
However, there is a mild
tenderness over the xiphoid,
aorta, cecum, sigmoid colon
and ovaries when the deep
palpation is performed.
There’s no palpable masses
present and the umbilicus and
surrounding area are free of
swellings, bulges and
masses.
Now, I will be performing
the test for appendicitis. I’ll
begin with assessing for
rebound tenderness. To
execute this procedure, I’ll
perform deep palpation in
the abdomen where the
client has pain then
suddenly release pressure.
- There is no rebound
tenderness present.
Next, I will perform a test for
referred rebound
tenderness by deeply
palpating in the LLQ and
quickly release pressure.
- There is no rebound pain
elicited.
knee and ankle and flex the
client’s hip and knee and
rotate the leg internally and
externally.
-Upon assessing for
obturator sign, there is no
abdominal pain present.

I will be assessing for

psoas sign by raising the
client’s right leg from the
hip and then, I will be
placing my hand on the
lower thigh. I’ll ask the
client to try to keep the leg
elevated as I apply pressure
downward against the lower
thigh.
- there is abdominal pain
present.

Lastly, for the test for

appendicitis, I will be
assessing for obturator
sign to check if there are no
abdominal pain by
supporting the client’s right