Khadim Jehad Dr Ali Faris MSc Hassanain Mohammed Kadhim Lecture 8 Objectives At the end the students will be able to ID: 1007286
Download Presentation The PPT/PDF document "Abdominal Assessment Prof Dr. Salma" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Abdominal AssessmentProf Dr. Salma Khadim Jehad Dr. Ali Faris M.Sc Hassanain Mohammed KadhimLecture -8-
2. Objectives:At the end the students will be able to:1 .Demonstrate the ability to safely & accurately complete abdominal assessment.2.Demonstrate the ability to accurately document abdominal assessment data in organized manner.Equipment NeededI. Stethoscope.2.Measuring tip centimeter.3.Skin-marking pen.4.Alcohol swab (to clean end piece).
3. Preparation1 .Expose the abdomen so that it is visible.2.Drape the genitalia & female breast.3. Ask the client to empty the bladder.4.Keep the room warm.5.Position the client supine, with the head on a pillow, the knees bent or on pillow, & the arm atthe sides or cross the chest.6.Warm the stethoscope end piece.7.Warm your hand.8.1nsure about any painful area, examine such area last to avoid any muscle guarding.Note:Assessment of abdomen different from other assessments in that inspection & auscultation precede percussion & palpation.
4. Subjective data:1. Dysphagia 2. Nausea and vomiting3. Food intolerance 4. Bowel habits5. Past abdominal history6. Medications7. Nutritional assessment
5. Subjective data:Appetite Abdominal pain Dysphagia Nausea vomiting Food intolerance Bowel habitsPast abdominal history Medications Nutritional assessment
6. Abdominal Assessment 4 technique 1-Inspection 2-Auscultation3-Percussion 4-Palpation M.Sc Hassanain Mohammed Kadhim6
7. Abdomen LandmarksM.Sc Hassanain Mohammed Kadhim7
8. -7- F CAUSE Abdominal Distension 1- Fat (obese) 2- Fluid ( peritonitis)Gases)) 3- Flatus Pregnancy)) 4- Fetus 5- Feces 6- Fatal Growth ( malignancy )7- Fibroid Tumor M.Sc Hassanain Mohammed Kadhim8
9. Inspection: 1- Color2- Contour ( shape): flat or slightly roundedAb: scaphoid & distension3- Symmetry : symmetrical ( when client supine position raise his head)Ab: Asymmetrical caused by organ enlargement , mass , hernia 4- Respiratory movement : can seen clearly in male5-Aortic pulsation : no pulsation seen or slight pulsation in the epigastric region in thin people
10. 6- Peristaltic waves: no waves will be visible may be seen in thin person Ab: ripple form waves may seen in the intestinal obstruction 7- Inspect for lesion and rash: free on lesion and rash Ab: change in mole , petechiae Striae : free of striae , silver to white color striae may seen in obese or multigraveda 8- Vascularity : fine veins may seen located above or blow the umbilical area Ab: dilated vein seen in liver cirrhosis , obstruction of inferior vena cava , portal hypertension or ascites , spider angioma : dilated artery or capilliary in portal hypertension and liver disease
11. 9- Scar : free of scarAb: assess scar according to location , size and color ( young scar is pink while old scar is white)
12. 10- Umbilicus inspect for the following : a- Color : pink skin around it should be evenly as abdomen colorAb: bluish around umbilicus ( cullen’s sign) intra - abdominal bleeding b- shape inverted or protruded not more than 0.5 cmAb: everted in abdominal distension or hernia C- Location : midline at lateral line Ab: deviated umbilicus caused by mass , scar , hernia
13. Auscultation of abdomen for the following:Bowel soundsUse the diaphragm of a warm stethoscopeApply light pressure to auscultation bowel sounds for up to 5 minutes in each quadrant. Begin in the right lower quadrant(RLQ) at the ileocecal valve area Assess for frequency and pitch
14. Normal bowel sound: soft clicks and gargling heard in 5-30 per minute . Loud prolong gurgle of stomach growling – hyperactive sound called ( borborygmi )Ab: Hypoactive bowel sound in diminished motility in surgery , late bowel obstructionHyperactive bowel sound occur by diarrhea gastroenteritis or early bowel obstructionAbsent bowel sound associated with peritonitis or paralytic ileus
15. Vascular sound use the bell to auscultate for vascularSounds normally: No bruits, no venous hums, no friction rubs. Assessed in the following area:Right renal arteryLeft renal arteryRight iliac artery Left iliac arteryRight femoral arteryLeft femoral arteryAortic humUmbilical hum
16. Percussion of the abdomen for the following:1- General percussion 2- Liver span - percuss starting below umbilicus atclient's right midclavicular line(MCL). - Percuss upward until you heardullness; mark this point. - Percuss downward from the lungresonance in the right MCL todullness & mark.- Repeat in midsternal line.3- scratch test to assess liver
17. 4- Blunt percussion to assess kidneys
18. 5- Assess spleen
19. Special test ( Ascites )1- Shifting dullness2- Fluid wave test