Abdomen

Page 1: Bowel Sounds and Abdominal Assessment

Bowel Sounds

  • Produced when air and fluid move through the stomach and intestines via peristalsis.

  • Auscultation is essential for assessing bowel motility.

  • Vascular sounds should not be expected during assessment.

  • Order of Assessment:

    • Begin with auscultation before percussion and palpation to avoid altering findings.

    • Palpation can stimulate peristalsis, changing bowel sounds, and affect the client's pain sensation.

Inspection

  • Position the client supine on the exam table with head on a pillow and knees slightly bent for relaxation.

  • Visually inspect the abdomen, ensuring visibility while maintaining privacy.

  • Focus on the shape and contour of the abdomen.

Auscultation

  • Use the diaphragm side of the stethoscope lightly on the abdomen.

  • Begin auscultation in the right lower quadrant (RLQ), where bowel sounds are expected due to the ileocecal valve's location.

Page 2: Assessing Bowel Sounds and Palpation

Auscultation Procedure

  • If no bowel sounds are heard in the RLQ, continue clockwise: right upper, left upper, and left lower quadrants.

  • Note the location and frequency of the bowel sounds during auscultation.

Palpation Techniques

  • Light Palpation:

    • Use finger pads of all four fingers to depress the abdominal surface about 1 cm (0.4 in).

    • Move in a clockwise motion to palpate all quadrants, remembering to assess painful areas last.

  • Deep Palpation:

    • Performed only by advanced providers to assess the size and shape of organs and masses.

Health Promotion

  • Hydration: Encourage adults to drink 8 to 10 glasses of water daily.

  • Dietary Fiber: Helps absorb water and create larger, softer stools for easier passage.

  • Exercise: Promote 30 minutes of moderate exercise daily to increase peristalsis and reduce constipation.

  • Balanced Diet: High in whole grains, vegetables, and fruit to maintain GI health and efficient peristalsis.

Page 3: Screening for Colorectal Cancer

Importance of Screening

  • Individuals at high risk due to family history may need to start screenings in their early 20s.

  • Everyone over 45 should undergo regular colorectal cancer screenings.

Screening Tests

  • Stool Tests:

    • Checking for occult blood and stool DNA tests for altered DNA.

  • Flexible Sigmoidoscopy:

    • Examines the rectum and descending colon.

  • Colonoscopy:

    • Examines the rectum and entire large intestines.

  • Double Contrast Barium Enema:

    • Uses x-rays and dye to examine the large intestines.