Presentations text content in Abdominal Assessment
Slide1
Abdominal Assessment
Lisa Pezik, RN, BScNClinical Educator
Slide2Objectives
Review basic anatomy of the abdominal system.
Discuss assessment techniques.
Critically think through common problems.
Discuss treatment plans for these problems.
Slide3GI System
Gastrointestinal System
30 Feet Long
Muscles, vessels, organs
From mouth to anus
Turns food into energy, growth, cell repair
H
ormones of digestion
Gastrin
Secretin
Cholecystokinin
Gastric inhibitory peptide
Slide4Hormones
Slide5Digestion
Slide6Outside Muscles
Slide7Inside Muscles
MusclesSupport the abdominal cavityProtect organsWeakness leads to:HerniasDistentionPostural problemsBack painRisk of Falls
Slide8Vessels
Arteries carry oxygenated blood away from the heart.Veins carry de-oxygenated blood to the heart.
Slide9Organs
Upper GIEsophagusPancreasGallbladderStomachSpleenLiverDuodenumLower GISmall IntestineLarge IntestineAppendix
Slide10Functions of The Organs
Esophagus
Carries liquids and saliva to the stomach
Pancreas
Digestive enzymes to control insulin and glucagon
Stomach
Secretes enzymes to digest food
Muscles churn to process food
Pyloric sphincter pushes food to the small intestine
Slide11Functions of the Organs
SpleenStores and produces lymphocytes to aid immunityGallbladderAids in fat digestion and stores bileLiverBile productionImmune functionsBlood clottingStores sugarMetabolizes drugs
Slide12Functions of the Organs
Small intestineChemical digestion occursAbsorbs nutrients21 feet longLarge intestineAbsorbs water and lubricates contentsNeutralizes acids and bacteria5 feet longAppendix4 inches longJunction of small and large intestineStores good bacteria in the gut?
Slide13Assessment Basics
InspectionAuscultationPercussionPalpation
Slide14Inspection and Palpation
Look for distention or un-evenness of the umbilicusPalpate 1cm for any painful areasMeasure abdominal growth if applicable
Slide15Organs Per Quadrant
Slide16Auscultation
Where to begin
Start in RUQ and listen 2 minutes in each quadrant
Absent, hypo/hyper/
normoactive
Normal sounds in the small intestine
High pitched and gurgling
Normal sounds in the large intestine
Low pitched and rumbling
Normal Rate
5-35 sounds a minute
Slide17Percussion
Percuss all quadrants for dullness
Percuss for
tympany
Low drum like sound caused by gas
Percuss for hyper-
ressonance
Increased lower pitch due to distended bowel
Percuss bladder volume
Fullness causes pressure upwards
Slide18Interpretation of Results
Slide19Constipation
Mild ConcernInability to pass stool, hard stool, or self impactionComplaints of fullnessCan cause hemorrhoids
Slide20Constipation
Moderate ConcernLeaking, small stoolsCramping, bloatingStrainingBlood tinged stoolVomitingFecal impactionA large lump of dry stool Caused by chronic constipation
Slide21Stool
Slide22Constipation
Severe Concern
Bowel Obstruction
Complete blockage of the small and large intestines
Distended tympanic abdomen
Tachypnea, Tachycardia, Low BP
Cramping, Pain, Tenderness
Vomiting
Diarrhea
Bloody Stools
Absent or hyperactive bowel sounds
Slide23Small Bowel Obstruction
Slide24Large Bowel Obstruction
Slide25Ascites
Build up of fluid in the abdomenHigh pressure in the blood vessels of the liverLow levels of albuminCaused by:CancerLiver failurePancreatitisCHFPortal Vein Thrombosis
Slide26Peritonitis
Inflammation of the peritoneum causing severe pain
Slide27Points to Ponder
Pain = InflammationDullness with percussion = Fullness of normal OR abnormal structureCrepitus = Diverticulitis or organ perforationBruising = Hemorrhage or injury
Slide28Questions?
Abdominal Assessment
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