第六週｜Assessment of Abdomen–5ˍ賴維淑老師

Introduction

This tutorial provides a comprehensive guide to assessing the abdomen, as demonstrated by Professor Lai Wei-Shu. Understanding abdominal assessment is crucial in clinical practice, as it helps in diagnosing various conditions. This guide will walk you through the essential steps involved in conducting an abdominal assessment effectively.

Step 1: Preparation for Assessment

• Gather Necessary Equipment

  • Stethoscope
  • Measuring tape
  • Penlight
  • Gloves (if needed)

• Create a Comfortable Environment

  • Ensure the room is warm and private.
  • Provide a comfortable examination table.

• Explain the Procedure

  • Inform the patient about the steps involved in the assessment to ease anxiety.

Step 2: Inspection of the Abdomen

• Position the Patient

  • Have the patient lie supine (on their back) with arms at the sides.

• Visual Examination

  • Observe the contour of the abdomen.
  • Look for any visible pulsations, scars, or skin lesions.
  • Note any asymmetry or distension.

Step 3: Auscultation

• Use the Stethoscope

  • Place the diaphragm of the stethoscope on all four quadrants of the abdomen.

• Listen for Bowel Sounds

  • Normal bowel sounds occur every 5 to 15 seconds.
  • Note the frequency and character of the sounds (e.g., hyperactive, hypoactive).

Step 4: Percussion

• Technique

  • Use your fingers to tap the abdomen gently, assessing the sounds produced.

• Identify Different Sounds

  • Tympany indicates air-filled areas (e.g., stomach).
  • Dullness may suggest fluid or solid masses.

Step 5: Palpation

• Start Lightly

  • Use your fingertips to gently palpate all four quadrants.

• Assess for Tenderness and Masses

  • Identify any areas of tenderness, rigidity, or masses.
  • Use deeper palpation if necessary to assess organ size and tenderness.

Practical Tips

• Always maintain patient dignity and comfort.
• Be gentle during palpation to avoid causing discomfort.
• Document your findings accurately for further assessment.

Conclusion

In this guide, we've covered the essential steps for an abdominal assessment, including preparation, inspection, auscultation, percussion, and palpation. Mastering these skills is vital for effective clinical evaluation. For continued learning, practice these techniques regularly and consider seeking feedback from experienced practitioners.