A nurse is performing an abdominal assessment on a client. Identify the sequence of actions the nurse should take.
A.
Auscultation
B.
Inspection
C.
Palpation
D.
Percussion
The correct sequence for performing an abdominal assessment is:
- B. Inspection
- A. Auscultation
- D. Percussion
- C. Palpation
Explanation:
- Inspection: The nurse starts by visually inspecting the abdomen for any abnormalities, such as distention, asymmetry, or discoloration. This is the first step because palpation and percussion can alter bowel sounds and other findings.
- Auscultation: Next, the nurse listens to bowel sounds using a stethoscope. Auscultation should be done before palpation or percussion to avoid altering bowel sounds.
- Percussion: The nurse then performs percussion to assess the size and density of abdominal organs and to identify areas of fluid or gas.
- Palpation: Finally, the nurse palpates the abdomen to assess for tenderness, masses, or organ size. Palpation is done last to prevent discomfort or changes in bowel sounds that might occur if performed earlier in the assessment.
Correct sequence: B, A, D, C