Question

QUIZ 5 NUR 101 PM M.L. is a 20-year-old female nursing student who is being seen in the OB-GYN clinic for a yearly physical who complains of abdominal pain. Subjective Data The patient asks about birth control options States she feels fine physically, no complaints at this time Enrolled in college for nursing Has a steady boyfriend, 1-year relationship Sexually active Nonsmoker Exercises 3 times a week Objective Data Vital signs: T 37 P64 R 12 BP 104/64 Weight: 135 Height: 5 feet, 3 inches Last menstrual cycle = 10 days ago Current birth control method = condoms Questions

Answer 1

Question: What techniques of physical assessment might be used in this visit?

Answer: The physical assessment techniques are (i) Positioning

(ii) Inspection

(iii) Auscultation

(iv) Percussion

(v) Palpation.

i. Positioning: 1. Tell the patient to lie down and expose the belly of the patient.

2. Until palpating the abdomen, warn the patient if your hands are cold.

ii. Inspection : 1. Remember the abdomen's general contour

2. Check any changes in the color of the skin, scars, etc.

iii. Auscultation: 1. Before percussion and palpation, abdominal auscultation should be done as physical stimulation of the abdomen may cause a shift in bowel sounds.

2. The purpose of the Auscultation is to assess the bowel sound.

3. Auscultate all over the four quadrants of the abdomen.

4. Listen to the noises carefully.

5. Normal findings: every 5–10-sec gurgling intestine sounds.

iv. Percussion:  1. Purpose: to determine intra-abdominal organs size and location

2. Percussion across all four quadrants

3. Natural findings: fluid-filled or solid organs (liver, spleen) with tympanic sound over air-filled stomach / intestinal sections.

v. Palpation: 1. The purpose of palpation is to assess internal organs and to identify any sources of pain (if present).

2. Ask the patient if they have abdominal pain or tenderness before palpation. If so, in the non-painful region, begin palpation.

3. Observe the face of the patient during abdominal palpation as it is the main indicator of pain severity and location.