METHODOLOGICAL INSTRUCTIONS
FOR ADN STUDENTS OF THE 1 COURSE OF NURSING INSTITUTE
LESSON ¹ 6 (Practical – 6 hours)
Themes:
1. Assessment of Abdomen.
Aim:
The overall goal related to cancer is to reduce the number of new cancer cases, as well as illness, disability, and death caused by cancer. Three specific objectives are related to colorectal cancer: reduce the death rate from colorectal cancer, increase the proportion of adults who are screened for colorectal cancer, and increase the number of primary care providers who counsel clients about blood stool tests for colorectal screening.
Professional orientation of students:
Main function of gastrointestinal tract is to absorb nutrients, which is very important function, so nurse has to now how to do assessment of the abdomen.
Methodology of Practical Class. 900-1115
Algorithm of students’ communication with patients
Objective examination:
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Explain to a patient, what examinations will be carried out and get his/her informed consent.
5. Find a contact with the patient and make an attempt to gain his/her trust.
6. Inform about the possibility of appearing of unpleasant feelings during the examination.
7. Prepare for the examination (clean warm hands, cut nails, warm phonendoscope, etc.).
8. Examination (demonstration of clinical skill).
9. Explain to the patient results of his/her lab tests correctly and accessibly.
10. Conversation accomplishment.
Work 1. Work in groups: Assessment of the Abdomen.
Work 2. Personal work: Complete the multiple choice test
Students’ individual work: 1145 – 1230
Individual Students Program.
Objectives for Students’ Independent Studies
You should prepare for the practical class using the existing textbooks and lectures. Special attention should be paid to the following:
². Abdomen .
1. Review of anatomy and physiology of abdomen
2. Assessment following this order:
A. ABDOMEN
1. Assesses abdomen with client in a supine position, knees slightly flexed, pillow under head, and arms at sides
2. Removes gown or drape to expose only the abdominal area from the xiphoid to the pubis
3. Inspects skin surfaces of the abdomen for color, symmetry, vascularity, hair distribution, intactness, and absence of lesions
4. Inspects abdomen for size, contour, symmetry, peristalsis, and pulsations
5. Auscultates abdomen prior to percussion and palpation
6. Auscultates all four quadrants for presence of bowel sounds
7. Auscultates aorta, renal, iliac, and femoral arteries for arterial and venous sounds
8. Percusses all four quadrants for presence of air using indirect percussion
9. Palpates skin surfaces of the abdomen for temperature, turgor, texture, thickness, and hydration
10. Uses light palpation over all four quadrants
11. Uses deep palpation over all four quadrants
12. Uses deep palpation to determine the edge of the liver
13. Palpates inguinal nodes
14. Percusses the kidneys for costovertebral angle (CVA) tenderness
Seminar discussion of theoretical issues: 1230 – 1400
Student’s Individual Work (1415-1500)
Students who have passed Moodle tests the day before class are free from test control during the class
Tests evaluation and situational tasks.
1. In which position should the client be placed for abdominal assessment?
a. Sitting up on the examination table
b. In a high-Flawler’s position
c. Supine
d. In a left lateral position
2. In which client would a pulsation within the epigastric area be considered a normal finding during the inspection?
a. A very thing client
b. an obese client
c. a client with ascites
d. An elderly client
3. Auscultation of the abdomen should
a. Precede inspection
b. Precede palpation
c. Follow palpation
d. Follow percussion
Students should know:
- know the structure and function of abdominal organs;
- know the location of abdominal organs;;
- discriminate normal bowel sounds;
- understand the rationale and methods of examination of the abdomen;
- accurately record the assessment.
Students should be able to:
- perform a complete assessment of the abdomen
Correct answers of test evaluations and situational tasks:
1. C
2. A
3. B
References:
A. - Basic:
B. - Additional:
1. Wilson, Giddens. Health Assessment for Nursing Practice. New York: Mosby. 2005
2. Wilson, Giddens. Student Lab Guide for Health Assessment for Nursing Practice. New York: Mosby. 2005
Prepared by Olga Namisnyak.
Methodical instruction was discussed and adopted at the Department sitting
12.06.2013. Minute ¹ 13