Question

Thorax, Heart, and Abdomen: Steps to Take When Performing an Abdominal Assessment (RM Fund 10.0 Chp 29 Thorax, Heart, and Abdomen,Active Learning Template: Nursing Skill Description of skill- Indications- nursing interventions(pre,intra,post)- outcomes/evaluation- client education- potential complications- nursing interventions please put correct answer

Answer 1

Steps to Take When Performing an Abdominal Assessment

The examination consists of a visual examination of the abdomen, noting the shape of the abdomen, skin abnormalities, abdominal masses, and abdominal wall movement with breathing. The abnormalities detected during the examination provide evidence of intra-abdominal pathology; It is studied in more detail by auscultation and palpation.

Abdominal auscultation is performed to detect altered bowel sounds, friction or vascular sounds. Normal peristalsis creates sounds in the intestine that may change or be absent due to disease. Irritation of serous surfaces can produce a sound (rubbing) as the organ moves against the serous surface. Atherosclerosis can interfere with arterial blood flow and make noise.

Palpation is the examination of the abdomen for cracks in the abdominal wall, for any pain in the abdomen, or for lumps in the abdomen. The liver and kidneys may be palpable in normal people, but any other mass is abnormal.

TECHNIC

INSPECTION
The abdomen is examined by placing the patient lying on an examination table or bed. The head and knees should be supported with small pillows or folded sheets for comfort and to relax the abdominal wall muscles. The entire abdominal wall should be examined and drapes placed accordingly. The patient's arms should be on the sides and not folded behind the head, as this strains the abdominal wall. Good lighting is essential, and it helps to have occasional lighting available, as this can create subtle shadows for the abdominal wall masses.

AUSCULTATION
The patient is placed comfortably in the supine position as indicated in the examination. A stethoscope is used to listen to several areas in the abdomen for several minutes due to the presence of bowel sounds. The diaphragm of a stethoscope should be placed against the abdominal wall with firm but gentle pressure. It is often helpful to warm the diaphragm in the hands of the examiner prior to application, especially in patients who have had a tickle. When bowel sounds are not present, one must listen for a full 3 minutes before determining that bowel sounds are actually absent.

PALPATION AND PERCUSSION
The patient is lying down with the head and knees supported, as is the case for examination and auscultation. Take the history, inspect and listen before palpation, as this tends to make the patient feel comfortable and increases cooperation. In addition, palpation can stimulate intestinal activity and thus increase intestinal sounds erratically if performed prior to auscultation. Ask patients with abdominal pain to indicate the area of ​​greatest pain. Then reassure them that you will try to reduce their discomfort and take this point last.

On palpation of the abdomen, you must first gently examine the abdominal wall with the tips of your fingers. This will show a crunchy and cracked sensation in the abdominal wall, which is a sign of gas or fluid in the tissues under the skin. Additionally, it will highlight any irregularities in the abdominal wall (such as lipomas or hernias) and give an idea of ​​areas of pain.