第六週｜Assessment of Abdomen–1ˍ賴維淑老師

Introduction

This tutorial provides a step-by-step guide to assessing the abdomen, based on the instructional video by Professor Lai Wei-Shu. Understanding abdominal assessment is crucial for healthcare professionals as it helps in diagnosing various conditions. This guide will outline the key steps and techniques involved in performing an effective abdominal assessment.

Step 1: Prepare for the Assessment

• Ensure a private and comfortable environment for the patient.
• Gather necessary tools:
  • Stethoscope
  • Measuring tape
  • Penlight
  • Gloves (if needed)
• Explain the procedure to the patient to ease any anxiety.
• Position the patient comfortably, typically lying supine with arms at their sides.

Step 2: Inspect the Abdomen

• Observe the abdomen for any abnormalities:
  • Check skin color, scars, lesions, or distension.
  • Note the shape of the abdomen (flat, rounded, or distended).
• Assess for any visible pulsations or peristalsis.

Step 3: Auscultate the Abdomen

• Use the stethoscope to listen to bowel sounds:
  • Place the diaphragm of the stethoscope in all four quadrants.
  • Listen for at least 30 seconds in each quadrant.
  • Note the frequency and quality of bowel sounds (normal, hyperactive, or hypoactive).
• Check for any vascular sounds such as bruits over the renal and aortic arteries.

Step 4: Palpate the Abdomen

• Perform gentle palpation in all four quadrants:
  • Start with light palpation to assess for tenderness, muscle resistance, or guarding.
  • Follow with deep palpation to identify any masses or organomegaly.
• Pay attention to the patient's reaction and any signs of discomfort.

Step 5: Percuss the Abdomen

• Use percussion to assess the size of organs and detect fluid or masses:
  • Percuss in all four quadrants, noting the sound produced (tympany vs. dullness).
  • Check for liver size by percussing from the lower abdomen upwards.

Conclusion

In summary, the assessment of the abdomen involves careful preparation, inspection, auscultation, palpation, and percussion. Each step is essential for gathering important clinical information. Practicing these techniques will enhance your assessment skills and improve patient care. For further development, consider studying various abdominal conditions and their associated signs.