The abdomen is assessed using inspection, auscultation and palpation (White 2005). The abdomen is inspected for size and symmetry and is normally rounded, symmetric, protuberant, and soft because of weak abdominal musculature with a slightly greater diameter above the umbilicus than below. The subcutaneous blood vessels in the abdomen may appear distended and blue (Williams & Wilkins 2006). Assessing the Abdomen Essay
Abdominal assessment is complex, largely because of the many vital organs and blood vessels within the cavity of abdomen and its life-sustaining functions, such as digestion and elimination that are performed here (Weber & Kelley 2009). The abdomen houses the several body structures– reproductive (female), gastrointestinal, urinary and lymphatic. Known as the solid or hollow abdominal viscera, these structures include the pancreas, liver, adrenal glands, spleen, ovaries, kidneys, and uterus (solid viscera) and the gallbladder, stomach, small intestine, bladder (hollow viscera) and colon.
During the abdominal assessment, the abdomen is first inspected for rashes and scars. The abdomen is observed for symmetry and visible signs of peristalsis or pulsations. Auscultations are the second component of the abdominal assessment of a client’s bowel status. A “bubbly-gurgly” sound, caused by peristalsis and movement of the intestinal contents, can be heard by placing the stethoscope on each quadrant of abdomen and listening for approximately 1 minute. These sounds should be present in all four quadrants of the abdomen, beginning in the right lower quadrant, and moving clockwise around the four quadrants. When approximately 5 to 20 bowel sounds are heard per minute, the bowel sounds are considered active (Weber 2009). Assessing the Abdomen Essay
The absence of bowel sounds during 1 minute of auscultations in each quadrant is documented as absent bowel sounds. Percussion of abdomen is done in all four quadrants. The predominant abdominal percussion sound in tympany caused by precussing over the air-filled stomach and intensities. Light palpation of the abdomen is done to assess for muscle tone, masses, pulsations, or any signs of tenderness or discomfort. Assessing the Abdomen Essay
A good knowledge of the normal function of the bladder and lower urinary tract is important to gather understanding the effects of abnormal functions. The bladder and lower urinary tract have two main functions, storage of urine at low pressures and periodic elimination of urine.
The bladder is a hollow muscular organ which lies in the anterior part of the pelvic cavity, behind the symphysis pubis. Bladder function comprises cycles of filling and emptying. Urine production by the kidneys is continuous and during the bladder filling phase the rugae flatten and bladder volume increases with very little change in internal pressure (Bartley 2007). This is termed compliance and is possible because the lining layers of transitional epithelial cells can overlap and slip over each other as the volume increases and because of the intrinsic ability of the smooth muscle to maintain constant tension over a wide range of stretch. The voiding phase is initiated voluntarily and can normally be delayed until appropriate circumstances are recognized. When a voiding dysfunction is suspected, or when there is no clear diagnosis, a diagnosis which is often missed is a post-voiding residual volume. All patience attending a continence clinic should have a routine pre and post-voiding bladder scan as part of standard care practice. PVR is the amount of urine left in bladder within 10-15 minutes after voiding and urinary retention is the inability or failure to empty the bladder completely with voiding. Assessing the Abdomen Essay
Application to Surgical Ward
The assessment by nurses refers to the data collection, data analysis, and identification of the problem. Nurses are encouraged to obtain the clinical history of patient from the family members and patient which form the foundation of the assessment. The preliminary assessment is done using the interview technique followed by the physical check-up. The assessment is a process needs to be adopted both pre-operation and post-operation in the surgical ward. For the abdominal assessment pre-operation and post-operation is generalized and remains same, they will be discussed simultaneously. The abdominal assessment, both pre-operative and post-operative has their significance. A surgical pre-operative abdominal assessment is important to determine the presence of an abdominal aortic aneurysm (AAA), which is a potential contraindication of the use of an intra-aorta balloon pump. Abdominal palpitation to detect abnormal widening of an aortic pulsation is suggested to be the most effective method to determine presence of AAA (Elliot et al 2007). The width is compared with the intensity