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Soru

Zorluk: KolayTechniques of Physical Assessment

A nurse is preparing to perform a physical assessment on a client's abdomen. Which sequence of examination techniques should the nurse follow?

  1. Inspection, auscultation, percussion, and palpationCevap
  2. B
    Inspection, palpation, percussion, and auscultation
  3. C
    Palpation, inspection, auscultation, and percussion
  4. D
    Auscultation, inspection, palpation, and percussion

Cevap

The nurse should follow the sequence of inspection, auscultation, percussion, and palpation.
The correct sequence for an abdominal assessment is inspection, auscultation, percussion, and palpation. Auscultating immediately after inspection ensures that the bowel sounds heard are accurate and have not been artificially stimulated or altered by the physical pressure of palpation or percussion.

Adım Adım Çözüm

1
Identify the body system being assessed.
The system to be assessed is the gastrointestinal system (abdomen).
Different body systems require specific modifications to the general physical assessment sequence.
2
Recall the standard physical assessment sequence versus the abdominal assessment sequence.
Standard sequence is inspect, palpate, percuss, auscultate. Abdominal sequence is inspect, auscultate, percuss, palpate.
Manipulating the abdomen through palpation or percussion before listening can stimulate bowel motility and create false bowel sounds.

Anahtar Kavram

Abdominal Assessment Sequence
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Konular

Techniques of Physical Assessment

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