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Abdomen
Abdomen
The Abdomen
The nurse locates and describes abdominal findings using 2 common methods of subdividing the abdomen:
Quadrants Regions
Abdominal Landmarks
Practitioners often use certain landmarks to locate abdominal signs and symptoms
Assessment
Inspection of the abdomen
Skin integrity Contour and symmetry
Observe the abdominal contour (profile line from the rib margin to the pubic bone) while standing at the clients side when the client is supine Ask the client to take a deep breath and to hold it (makes an enlarged liver or spleen more obvious) If distention is present measure abdominal girth Place tape measure around the abdomen @ the level of the umbilicus
Ascites
Deviations:
Hypoactive bowel sounds
Extremely soft and infrequent (1/min) Indicate ed motility associated w/ manipulation of bowel during surgery, inflammation, paralytic ileus, or late bowel obstruction
Abdominal aneurysm
Auscultate splenic site stethoscope over LL rib cage, ant. axillary line
Ask to deep breathe = accentuate sound of friction rub
Liver site
over LR rib cage
Dyana M. M. Saplan, RN, MAN
Deviation:
Large dull areas = associated w/ presence of fluid or a tumor
Lifespan considerations
Infants
Internal organs proportionately larger than older children and adults = abdomen rounded and tend to protrude Liver palpable 1 2 cm below rt. intercostal margin Umbilical hernias may be present @ birth
Umbilical hernia
Children
Toddlers characteristic pot belly appearance until 3 4 years Late pre-school and school-age leaner and have flat abdomen Visible peristaltic waves than in adults May not be able to pinpoint areas of tenderness
Observe facial expressions to det. Areas of maximum tenderness
If ticklish, guarding, or fearful use task that requires concentration to distract, or have child place hands on examiners hands = helping do exam
Dyana M. M. Saplan, RN, MAN
Potbelly
Elders
Rounded abdomens = due to adipose tissue, muscle tone Abdominal wall slacker and thinner
Palpation easier and more accurate
Elders
Fecal incontinence in confused or neurologically impaired older adults Colon cancer higher incidence
Change in bowel fxn, rectal bleeding, weight loss
Video Presentation
Dyana M. M. Saplan, RN, MAN