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Meta © 2022 Skip to content Open Resources for Nursing (Open RN) The nurse is performing a daily assessment on a patient who had hip surgery a few days ago. The patient reports she has not had a bowel movement since prior to admission three days ago. The nurse forms a hypothesis that the patient is constipated. 1. What subjective data should the nurse plan to obtain during the assessment to investigate “cues” regarding the potential hypothesis of constipation?
2. What objective data should the nurse plan to obtain during the assessment to investigate “cues” regarding the potential hypothesis of constipation?
3. The nurse discovers the following findings during the assessment. Which should be reported to the provider?
4. The nurse calls the provider and reports the assessment findings supporting the hypothesis of constipation. A new order for Milk of Magnesia 30 mL PO is obtained and the medication is administered. A few hours later, the patient has a large bowel movement. Write a focused DAR or SOAP note documenting the patient’s constipation status.
Learn how to prepare your patient for an abdominal exam with a simple acronym. Click here to read more! It’s important to prepare your patient for an abdominal exam so that they are aware of what the exam entails and are comfortable with the process. When you prepare the patient, focus on the four main components from the acronym CAPE:
Figure 1. When preparing a patient for an abdominal exam, focus on the four components of the acronym CAPE, 1, comfort, 2, attire, 3, position, and 4, exposure. ComfortFirst, make sure that the environment is welcoming, comfortable, and private. The space needs to be quiet enough for you and your patient to converse. Always wash your hands, introduce yourself, and confirm that you have the correct patient by addressing them by their name. Ask the patient for verbal consent to perform the exam. Make sure that the area where the patient is changing feels secure. Ensure that others will not walk in during the exam since their abdomen will be exposed. AttireComfortable attire is very helpful for both the patient and the clinician. Ideally, you should provide the patient with a hospital gown and ask them to change into it while you step out of the room. Ask them to have it loosely tied so that the robe is easy to lift up and adjust. Be clear with the patient which articles of clothing need to be removed and provide them with a sheet to cover their lower half for comfort. Make sure the bed is lowered to facilitate the patient getting into it, and help avoid accidents. PositionThe patient’s position is important during the exam. To start, have the head of the bed raised (up to 45°) while keeping the rest of the bed flat. Have the patient sit down on the side of the bed and then lay supine (e.g., lying down on their back) to examine the abdomen. If needed, assist the patient in laying down. Some patients with mobility issues may need two people to help them onto the bed. Placing a pillow behind the head or under the knees can help relieve some patients with limited mobility issues, and often makes for a more comfortable position. Make sure that the patient’s arms are at their side and not folded across the abdomen. ExposeNext, you’ll need to help the patient expose their abdomen while they’re laying down. Let the patient know that you’ll need to lift up the gown for the exam. To properly perform the exam, the entire abdomen needs to be exposed. This includes all four quadrants from the xiphoid to the suprapubic region. Keep the patient comfortable and remember to cover their pelvis and legs with a towel or sheet—especially if they are wearing a skirt or dress. Become a great clinician with our video courses and workshopsRecommended reading
About the author Olutayo A. Sogunro, DO, FACS, FACOS Breast Surgical Oncologist at Johns Hopkins Howard County General Hospital and Assistant Professor of Surgery at Johns Hopkins University Hospital, Maryland, USA Author Profile Which action would the nurse perform first when assessing a patient abdomen?The physical examination of the patient begins with inspection. Unique to the sequence of the abdomen, the abdomen is then auscultated, percussed and finally, palpated.
What is the prepared order for examination of the abdomen?The examination is conducted in a predetermined sequence starting from observation and then sequentially performing auscultation, palpation, and percussion (see images below) followed by ancillary maneuvers.
What are the steps to abdominal examination?The abdominal examination consists of four basic components: inspection, palpation, percussion, and auscultation. It is important to begin with the general examination of the abdomen with the patient in a completely supine position. The presence of any of the following signs may indicate specific disorders.
What should you consider while preparing the client for abdominal assessment?When preparing a patient for an abdominal exam, focus on the four components of the acronym CAPE, 1, comfort, 2, attire, 3, position, and 4, exposure.
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The nurse performs which action to prepare the patient for an abdominal examination
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