Physical assessment - Abdomen: Nursing

An assessment of the abdomen should be completed as part of a comprehensive assessment, like during a routine physical exam, during an admission to the hospital, or as part of a focused exam if a client is experiencing abdominal issues like pain, nausea, or changes to bowel patterns. Let’s review the process of completing an abdominal assessment.

Supplies needed for the abdominal assessment include drapes, a stethoscope with a diaphragm and bell, gloves, a measuring tape, a washable skin marker, and a good source of light.

Before beginning, ask your client to empty their bladder. Then prepare for the abdominal assessment by properly draping your client. Remember to keep your client covered and only expose areas of their body as needed to perform your assessment.

Also, ensure privacy by closing any curtains or closing the door. Ensure your client is comfortable in the supine position, meaning they are lying flat on their back. You may also place a pillow under their knees to help relax their abdominal muscles. Also warm your hands and stethoscope and ensure your client is comfortable with the temperature of the room, since cold temperatures can cause rigidity of the abdominal muscles, making it more difficult to perform some assessment techniques.

Before getting started, explain the procedure to your client and be sure to answer any questions they might have before obtaining verbal consent. Then, perform hand hygiene and collect your supplies.

Locating the anatomical landmarks of the abdomen will help guide the appropriate placement of your equipment and hands throughout your assessment. Commonly used landmarks include the xiphoid process, costal margin, umbilicus, iliac crest, and the pubic crest. The abdomen can also be separated into four quadrants, to help you locate the abdominal organs.

First is the right upper quadrant, called the RUQ for short, which contains the liver, gallbladder, and right colic flexure.
Next, the left upper quadrant, also called the LUQ, which includes the stomach, pancreas, and left colic flexure. Then there’s the right lower quadrant, or RLQ, which contains part of the ascending colon, the cecum, and the appendix. Finally, there’s the left lower quadrant, which is called the LLQ, that contains the descending and sigmoid colon. If your client is experiencing any abdominal symptoms, like pain, it can be helpful to identify which quadrant or quadrants are involved to determine which internal structure might be responsible.