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10 Cards in this Set
- Front
- Back
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What do you assess before physical assessment? |
ask if pt voided place pt in supine position |
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Bowel landmarking and auscultation |
4 quadrants (two times per quadrant( using the diaphragm, start at LRQ and go clockwise State: 5-30 sounds/min |
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Vascular auscultation landmarking |
Abdominal aorta midline, 4 fingers above umbilicus L+R renal arteries MCL, 2 fingers above umbilicus L+R iliac arteries MCL, 2 fingers below umbilicus L+R femoral arteries (over SP shorts) |
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Vascular auscultation |
Use bell to auscultate aorta, renal, iliac, and femoral arteries State presence/absence of bruits State no unexpected sounds heard |
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Abdo percussion (state each location when percussing) |
State tympany is predominantly heard in all quadrants Stomach: hyper resonance over gastric bubble Bladder: tympany, but dullness if bladder is full Spleen: left MAL, between 9th & 11th rib, dullness |
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Palpation (light, then deep) |
Light/deep palpate all 4 quadrants (two locations per quadrant) Validate presence/absence of pain Light technique: one hand, 1 cm deep State presence/absence of masses If pain, leave quadrant for last Deep technique: two hands, 5 cm deep Do not palpate painful quadrant |
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Liver + aorta palpation |
Liver: one/two hands, ask pt to breathe in Palpate right costal margin Aorta: thumb+index of one hand Midline 4 fingers above umbilicus State expected measurement 2.5 to 4 cm wide |
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Rebound tenderness: Blumberg and Rovsing signs |
Blumberg sign Push down with a perpendicular hand anywhere but RLQ, hold for 1 sec, then let go quickly Rovsing sign Semi-deep palpation in the LLQ, press down, and quickly release |
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Iliopsoas test |
Pt lifts their extended right leg Nurse pushes down on leg |
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Murphy’s Sign |
Done at same time as liver palpation Hold fingers at right costal margin Ask pt to take a deep breath |
