Question

A patient scheduled for abdominal assessment complains of pain in the right iliac fossa. How would you carry out his abdominal assessment?   

  

Answer 1

ANSWER :

▪︎ABDOMINAL ASSESSMENT :

History of presenting complaint :

• Pain : Onset(sudden or gradual ) ,duration , type of pain ( pricking , stabbing, burning etc) , radiation and any aggravating or relieving factors of pain.
• H/o nausea or vomiting
• H/o loss of appetite or loss of weight
• H/o abnormal bowel movements
• H/o fever
• H/o burning or increased frequency of micturition

In female patient take gynic history :

• Her last menstrual period and menstrual history
• Abnormal vaginal bleeding or discharge

Examination :

General examination :

• Conscious and coherent or not
• Vital status : Temp, BP , RR , PR and Spo2

Abdominal examination :

• Inspection : shape ,distended or not , any scars ,see for hernial orifices free or not
• Palpation : watch for any mass and for guarding , rigidity and rebound tenderness (tenderness over Mcburney's point indicate appendicitis)
• Percussion : Tympanic note indicate bowel obstruction
• Auscultation : Auscultate for normal bowel sounds or any abnormal sounds

Depending upon the above assessment establish whether it is acute abdomen or not and intervene accordingly.