第六週｜Assessment of Abdomen–2ˍ賴維淑老師

Introduction

This tutorial provides a step-by-step guide for assessing the abdomen, as presented in a video by Professor Lai Wei-Shu. Understanding abdominal assessment is crucial for healthcare professionals to diagnose and monitor various conditions. This guide will break down the assessment process into clear, actionable steps.

Step 1: Prepare the Patient

• Ensure the patient is comfortable and in a relaxed position, preferably lying down.
• Ask the patient to expose their abdomen adequately while maintaining their dignity.
• Explain the procedure to the patient to help reduce anxiety and ensure cooperation.

Step 2: Inspect the Abdomen

• Look for any visible abnormalities:
  • Scars, rashes, or lesions
  • Distension or asymmetry
  • Pulsations or movements
• Note the skin color and texture. Normal skin should be smooth and evenly colored.

Step 3: Auscultate the Abdomen

• Use a stethoscope to listen to bowel sounds:
  • Place the diaphragm of the stethoscope on the four quadrants of the abdomen (right upper, left upper, right lower, left lower).
  • Note the frequency and character of bowel sounds:
    • Normal sounds: gurgling every 5 to 15 seconds
    • Hyperactive sounds: frequent and loud
    • Hypoactive sounds: infrequent or absent
• Listen for any bruits over the aorta or renal arteries.

Step 4: Percuss the Abdomen

• Gently tap on the abdomen to assess organ size and fluid presence:
  • Use your fingers to create a percussion note.
  • Differentiate between dullness (indicates solid organs or fluid) and tympany (indicates gas).
• Percussion helps assess the size of the liver and spleen, as well as detect fluid in the abdomen.

Step 5: Palpate the Abdomen

• Use both light and deep palpation techniques:
  • Light Palpation: Use your fingers to gently press on the abdomen to identify tenderness or superficial masses.
  • Deep Palpation: Press deeper with your fingers to assess for larger masses and organ size.
• Be aware of the patient's response, and adjust pressure as needed. Note any areas of tenderness or rigidity.

Common Pitfalls to Avoid

• Avoid rushing through the assessment; take your time to ensure a thorough evaluation.
• Do not force palpation if the patient shows signs of significant pain.
• Ensure the stethoscope is placed correctly to avoid missing important sounds.

Conclusion

In this tutorial, we covered the essential steps for assessing the abdomen, including preparation, inspection, auscultation, percussion, and palpation. Mastery of these techniques is vital for accurate diagnosis and effective patient care. For further learning, consider practicing these skills in a clinical setting or watching additional resources to reinforce your understanding.