a nurse is assessing a client who has peritonitis
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this is cereth registered nurse Arion calm and in this video Im going to demonstrate how to complete an abdominal assessment and if you would like to watch a complete head-to-toe nursing assessment you can access this card up here in the corner or in the YouTube description below access to that video now before you do this skill youll want to provide privacy to the patient perform hand hygiene and tell the patient what you will be doing and some equipment that you will need for this is a stethoscope so lets get started now were going to assess the abdomen and remember were switching our sequence and how we assess were going to do inspection auscultation and then percussion or palpation so were going to auscultation second so whenever youre looking and assessing the abdomen have the patient lay on their back and what were gonna do is were going to inspect the abdomen and first we want to ask Ben are you having any stomach issues at all no okay and when was your last bowel movement yesterday morning and how are you urinating do you have any pain while youre peeing do have problems starting a stream any discharge anything like that okay and with your male patients you want to ask about that due to prostate enlargement was starting a stream and if he was female I would ask him when his last menstrual period was and also again ice to be more patient about urinating and things like that now if the patient had a Foley this is the time when you would want to look at the urine inspect the Foley and look at that just conglomerate your urinary system in your GI system together okay so were inspecting the abdomen were looking at the abdominal contour and this patients is scaphoid it goes in a little bit you can also have flat round it or protuberant and also were going to know if theres any pulsations a lot of times in this area right here on thin patients like with being I can see the aortic pulsation in this patients rod above the umbilicus and looking at the belly button and checking for any mass do we see any hernias or anything like that also if your patient had any wounds you wouldnt want to look at that and if they had a peg tube you wouldnt want to assess the site make sure its not red and ask them how it feels and with your ostomies with your ostomies you want to look at the stoma and make sure it is like a rosy pink color its not a dusky cyanotic color and its not prolapsed and look and see what type of stool its putting out and note that note the smell note when if the bag needs to be changed anything like that so now were ready to listen to the
bowel sounds and what were going to do is were going to listen with the diaphragm of our stethoscope and we are going to start in the right lower quadrant and work our way clockwise and were gonna listen all four quadrants and you should hear five to thirty sounds per minute and if you dont hear any bowel sounds you need to listen for five full minutes and you need to note are these normal are they hyperactive or hypo active so lets listen right lower quadrant were gonna move out to the right upper quadrant move over to the left upper quadrant and then down to the left lower quadrant ambassy ons are normal now were gonna listen for vascular sounds and youre gonna do this with the bell of your stethoscope and were gonna listen at the aortic were gonna listen at the renal arteries iliac arteries and you could listen at the femoral already arteries if you need it to so youre gonna listen at the aorta artery and its a little bit below the xiphoid process a little bit above the umbilicus so about right here and were listening for like a blowing swishing sound that which would represent a bruit okay and none is noted then were gonna listen at the right and left renal arteries which is a little bit down from the aorta location so heres right okay none note it and then over the left then were gonna listen at the iliac and its a little bit below the belly button right here and this is Illya Carter II and then listen on the other side and again like I pointed out you could listen at the femoral artery and the groin if you need it too now were going to do palpation first were going to do light palpation then deep and being as I do this please tell me if you feel any pain or tenderness so first were gonna do by palpation well just start in the right lower quadrant and work her way around and youre gonna go about two centimeters and youre just feeling for any rigidity any lumps masses anything like that hows that feel okay okay now were gonna do deep palpation and were gonna go about four to five centimeters so a lot more deep then again youre just feeling for any masses lumps and then tell me if you have any tenderness and sometimes you can do this with two hands if need be if youre not strong enough me telling anything feels nice and soft hurts um belly sounds thats why you do this after you listen because you stimulate it good so that wraps up how to perform an abdominal assessment and dont forget to check out that video on the complete head-to-toe nursing assessment thank you so much for watching and dont forget to subscribe to our channel for more videos
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