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abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
abdominal assessment
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abdominal assessment
abdominal assessment
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abdominal assessment
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abdominal assessment
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abdominal assessment
abdominal assessment
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abdominal assessment

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how to assess the abdomen of a client using the IAPP.

how to assess the abdomen of a client using the IAPP.

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  • 1. ABDOMINAL ASSESSMENTMaria Carmela L. Domocmat, RN,MSNInstructor, Nursing Health AssessmentSchool of NursingNorthern Luzon Adventist College
  • 2. Rectus abdominis muscle Xiphoid process Costal margin UmbilicusInguinal ligament Pubic tubercle Maria Carmela L. Domocmat, RN, MSN
  • 3. Maria Carmela L. Domocmat, RN, MSN
  • 4. Maria Carmela L. Domocmat, RN, MSN
  • 5. Maria Carmela L. Domocmat, RN, MSN
  • 6. Maria Carmela L. Domocmat, RN, MSN
  • 7. Maria Carmela L. Domocmat, RN, MSN
  • 8. Maria Carmela L. Domocmat, RN, MSN
  • 9. Maria Carmela L. Domocmat, RN, MSN
  • 10. Maria Carmela L. Domocmat, RN, MSN
  • 11. Maria Carmela L. Domocmat, RN, MSN
  • 12. Maria Carmela L. Domocmat, RN, MSN
  • 13. Maria Carmela L. Domocmat, RN, MSN
  • 14. Maria Carmela L. Domocmat, RN, MSN
  • 15. PHYSICAL ASSESSMENT Maria Carmela L. Domocmat, RN, MSN
  • 16. INSPECTION Maria Carmela L. Domocmat, RN, MSN
  • 17. VeinsMaria Carmela L. Domocmat, RN, MSN
  • 18. Caput Medusae• Dilated veins around a porto- systemic anastmosis in the umbilical veins• Dilated abdominal veins can be distinguished with Harveys test: - determines direction of flow – SVC obstruction: direction of flow above umbilicus downwards – IVC obstruction: direction of flow below umbilicus upwards – Caput medusae: direction of flow away from umbilicus Maria Carmela L. Domocmat, RN, MSN
  • 19. Maria Carmela L. Domocmat, RN, MSN
  • 20. Maria Carmela L. Domocmat, RN, MSN
  • 21. Maria Carmela L. Domocmat, RN, MSN
  • 22. Maria Carmela L. Domocmat, RN, MSN
  • 23. Maria Carmela L. Domocmat, RN, MSN
  • 24. Maria Carmela L. Domocmat, RN, MSN
  • 25. Maria Carmela L. Domocmat, RN, MSN
  • 26. Maria Carmela L. Domocmat, RN, MSN
  • 27. Maria Carmela L. Domocmat, RN, MSN
  • 28. Maria Carmela L. Domocmat, RN, MSN
  • 29. Maria Carmela L. Domocmat, RN, MSN
  • 30. Maria Carmela L. Domocmat, RN, MSN
  • 31. Maria Carmela L. Domocmat, RN, MSN
  • 32. Maria Carmela L. Domocmat, RN, MSN
  • 33. Maria Carmela L. Domocmat, RN, MSN
  • 34. Maria Carmela L. Domocmat, RN, MSN
  • 35. Maria Carmela L. Domocmat, RN, MSN
  • 36. Maria Carmela L. Domocmat, RN, MSN
  • 37. Maria Carmela L. Domocmat, RN, MSN
  • 38. Maria Carmela L. Domocmat, RN, MSN
  • 39. Maria Carmela L. Domocmat, RN, MSN
  • 40. Maria Carmela L. Domocmat, RN, MSN
  • 41. Maria Carmela L. Domocmat, RN, MSN
  • 42. Maria Carmela L. Domocmat, RN, MSN
  • 43. Maria Carmela L. Domocmat, RN, MSN
  • 44. Maria Carmela L. Domocmat, RN, MSN
  • 45. Maria Carmela L. Domocmat, RN, MSN
  • 46. Maria Carmela L. Domocmat, RN, MSN
  • 47. Maria Carmela L. Domocmat, RN, MSN
  • 48. Maria Carmela L. Domocmat, RN, MSN
  • 49. Maria Carmela L. Domocmat, RN, MSN
  • 50. Maria Carmela L. Domocmat, RN, MSN
  • 51. Maria Carmela L. Domocmat, RN, MSN
  • 52. Maria Carmela L. Domocmat, RN, MSN
  • 53. Maria Carmela L. Domocmat, RN, MSN
  • 54. Maria Carmela L. Domocmat, RN, MSN
  • 55. Maria Carmela L. Domocmat, RN, MSN
  • 56. Maria Carmela L. Domocmat, RN, MSN
  • 57. Maria Carmela L. Domocmat, RN, MSN
  • 58. Maria Carmela L. Domocmat, RN, MSN
  • 59. Maria Carmela L. Domocmat, RN, MSN
  • 60. Maria Carmela L. Domocmat, RN, MSN
  • 61. Maria Carmela L. Domocmat, RN, MSN
  • 62. Maria Carmela L. Domocmat, RN, MSN
  • 63. Maria Carmela L. Domocmat, RN, MSN
  • 64. Maria Carmela L. Domocmat, RN, MSN
  • 65. Maria Carmela L. Domocmat, RN, MSN
  • 66. Maria Carmela L. Domocmat, RN, MSN
  • 67. Maria Carmela L. Domocmat, RN, MSN
  • 68. Maria Carmela L. Domocmat, RN, MSN
  • 69. Maria Carmela L. Domocmat, RN, MSN
  • 70. Maria Carmela L. Domocmat, RN, MSN
  • 71. Maria Carmela L. Domocmat, RN, MSN
  • 72. Maria Carmela L. Domocmat, RN, MSN
  • 73. Maria Carmela L. Domocmat, RN, MSN
  • 74. Maria Carmela L. Domocmat, RN, MSN
  • 75. Maria Carmela L. Domocmat, RN, MSN
  • 76. Maria Carmela L. Domocmat, RN, MSN
  • 77. SPECIAL MANEUVERS Maria Carmela L. Domocmat, RN, MSN
  • 78. ASCITES Maria Carmela L. Domocmat, RN, MSN
  • 79. Shifting Dullnesshttp://depts.washington.edu/physdx/liver/tech.html Maria Carmela L. Domocmat, RN, MSN
  • 80. Maria Carmela L. Domocmat, RN, MSN
  • 81. http://www.wrongdiagnosis.com/bookimage Maria Carmela L. Domocmat, RN, MSNs/16/5352.1.png
  • 82. Fluid wave test Maria Carmela L. Domocmat, RN, MSN
  • 83. APPENDICITIS Maria Carmela L. Domocmat, RN, MSN
  • 84. McBurney’s Point (Appendicitis)• Pain in the right lower quadrant one third the distance from the anterior iliac crest to the umbilicus.• Caused by the inflamed appendix or bowel coming into contact with the peritoneum. Maria Carmela L. Domocmat, RN, MSN
  • 85. Blumbergs sign• pain on abrupt release of steady pressure (rebound tenderness) over the site of a suspected abdominal lesion, indicative of peritonitis. Maria Carmela L. Domocmat, RN, MSN
  • 86. Maria Carmela L. Domocmat, RN, MSN
  • 87. Rovsing’s sign (Appendicitis) • Pain described in the right lower quadrant (RLQ) when the left lower quadrant (LLQ) is palpated.http://www.impactednurse.com/?p=1835 Maria Carmela L. Domocmat, RN, MSN
  • 88. Psoas sign (Appendicitis)• Pain on passive extension of the right thigh. Patient lies on left side. Examiner extends patients right thigh while applying counter resistance to the right hip (asterisk). Maria Carmela L. Domocmat, RN, MSN
  • 89. • Anatomic basis for the psoas sign: inflamed appendix is in a retroperitoneal location in contact with the psoas muscle, which is stretched by this maneuver. Maria Carmela L. Domocmat, RN, MSN
  • 90. Psoas sign (Appendicitis)Psoas Psoasmajor minor Maria Carmela L. Domocmat, RN, MSN
  • 91. Obturator sign• Pain on passive internal rotation of the flexed thigh.• Examiner moves lower leg laterally while applying resistance to the lateral side of the knee (asterisk) resulting in internal rotation of the femur. http://www.aafp.org/afp/991101ap/2027.html Maria Carmela L. Domocmat, RN, MSN
  • 92. Anatomic basis for the obturator sign:• inflamed appendix in the pelvis is in contact with the obturator internus muscle, which is stretched by this maneuver. Maria Carmela L. Domocmat, RN, MSN
  • 93. Hypersensitivity test or Pinch-an-Inch Test (Appendicitis)http://www.ispub.com/ispub/ijs/volume_12_number_2/the_pinch_an_inch_test_is_more_comfortable_than_rebound_tenderness/pinch-fig1.jpg Maria Carmela L. Domocmat, RN, MSN
  • 94. CHOLECYSTITIS Maria Carmela L. Domocmat, RN, MSN
  • 95. Murphy’s sign (Cholecystitis):• Pain on inspiration during gentle palpation below the right subcostal arch.• As the patient breathes in, the liver moves down exposing the gallbladder to pressure from the examiners hand.• Murpy’s sign may also be present with hepatitis. Maria Carmela L. Domocmat, RN, MSN
  • 96. Maria Carmela L. Domocmat, RN, MSN
  • 97. Balance’s Sign (Splenic Injury):• Dullness on percussion of the left upper quadrant of the abdomen due to collection of blood in the subcapsular or extracapsular layers of a ruptured spleen. Maria Carmela L. Domocmat, RN, MSN
  • 98. Kehr’s Sign (Splenic injury / ruptured ectopic)• Severe left shoulder (tip) pain following injury to the spleen. May also arise following other forms of intra- abdominal bleeding such as ruptured ectopic pregnancy. The pain is due to irritation of the left diaphragm and phrenic nerve by intraperitoneal blood, or air when the patient is in the supine position. Maria Carmela L. Domocmat, RN, MSN
  • 99. Grey-Turners Sign ( Pancreatitis)• A bluish discoloration that occurs on the lower back and abdominal flanks. May also occur following bleeding originating from the kidney or with pelvic fractures following traumatic injury. Usually occurs 6-24 hours after onset of any retroperitoneal bleeding. Maria Carmela L. Domocmat, RN, MSN
  • 100. Cullen’s Sign ( Pancreatitis)• Is a bluish or blue-black discoloration around the umbilicus. Over time this discoloration can fade to green-brown or yellow. Often appears 1 to 2 days after the onset of symptoms of pancreatitis. Cullen’s sign may also arise in association with haemoperitoneum due to a ruptured ectopic pregnancy. Maria Carmela L. Domocmat, RN, MSN

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