A client with a history of cardiovascular disease and new-onset abdominal cramping is undergoing a physical examination at an outpatient clinic. Which techniques should the nurse implement during this assessment? Select all that apply.
- Auscultate the four abdominal quadrants for bowel sounds prior to initiating percussion or palpation.Answer
- BBegin the gastrointestinal evaluation by deeply palpating the area of reported cramping to isolate the source of pain.
- Apply the bell of the stethoscope lightly to the skin to auscultate for low-pitched extra heart sounds.Answer
- DDelegate the initial auscultation of baseline lung and heart sounds to the unlicensed assistive personnel (UAP).
- Press the diaphragm of the stethoscope firmly against the skin to detect high-pitched gastrointestinal sounds.Answer
- FPosition the client completely flat in a supine position to accurately inspect for jugular venous distention.
Answer
The correct techniques include auscultating the abdomen before palpation, using the bell lightly for low-pitched sounds, and using the diaphragm firmly for high-pitched sounds.
Proper physical assessment requires specific sequences and equipment usage. For the gastrointestinal system, auscultation must precede percussion and palpation to avoid artificially stimulating bowel motility, which could alter baseline findings. When using a stethoscope, the bell is designed to capture low-pitched sounds (such as extra heart sounds or bruits) and should be applied lightly. Conversely, the diaphragm is designed for high-pitched sounds (such as normal bowel and breath sounds) and requires firm pressure against the skin.
Step-by-Step Solution
Key Concept
Physical assessment techniques and sequencing