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Physical Assessment
Abdomen
Information gathered
From the patient: subjective
When was your last BM What was it like: small/large, hard/soft Have you been passing gas (charted as flatus) Do you feel full or bloated
From the nurse’s observations: objective
Character of BMs % of meals taken emesis, especially after meals Physical assessment
Inspection
Landmarks: Craven p.
- right upper quadrant (RUQ)
- left upper quadrant (LUQ)
- right lower quadrant (RLQ)
- left lower quadrant (LLQ)
Epigastric region Umbilical region
Hypogastric or suprapubic region
Auscultation
Performed before palpation.
Utilizes diaphragm of stethoscope. Bowel
sounds are high pitched.
Begin RLQ - bowel sounds are normally
present here. Proceed to auscultate all four quadrants if necessary.
Bowel Sounds
Active (normal): irregular,
gurgling, tinkling. 5-
30x/min. It is not necessary
to count!!
Hyperactive: Loud, high
pitched, rushing. Increased
frequency.
Hypoactive: < 5x/min.
Short, quiet sounds.
Absent
Palpation
Light palpation: all four quadrants
Normal:
- soft, smooth, non-tender, pain free.
- guarding
Abnormal
- Rigid, tense, hard, firm
- tenderness, pain
- guarding
Documentation - examples
States, “I passed gas when I got up this morning.” Bowel sounds hypoactive. Abdomen firm, without tenderness on palpation. Ate 50% clear liquid breakfast without nausea/vomiting. M. Bright SN
States, “My stomach hurts all over. I haven’t had a BM in two days!” Bowel sounds active. Abdomen large, soft, non- tender on palpation. M. Bright SN
