HA | Abdomen
Episode notes
Welcome to STAT Stitch Deep Dive: Beyond the Bedside, where real nurses break down the most high-yield topics in nursing school and clinical practice.
In this full-length episode, we dive deep into the Assessment of the Abdomen—a comprehensive breakdown for nursing students, new grads, and NCLEX prep warriors. You’ll learn how to confidently assess the abdomen, recognize red-flag findings, and connect pathophysiology to bedside action.
We’ll cover: • Peptic Ulcer Disease (PUD) & GERD—their pathophysiology, manifestations, and critical management. • High-priority nursing interventions for abdominal pain, bowel changes, and GI bleeding. • The correct assessment sequence (Inspection → Auscultation → Percussion → Palpation) and why it matters. • Red-flag signs like rebound tenderness, Murphy’s, and Rovsing’s—and what they reveal. • Older adult considerations, deadly drug interactions, and abnormal organ enlargement findings.
💡 Perfect for your Health Assessment course, Med-Surg review, or NCLEX prep, this episode connects classroom concepts with real-world clinical reasoning.
🎧 Tune in to learn how to protect your patient, interpret what you hear, and recognize the subtle differences between urgent, emergent, and routine findings.
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High-Yield Abdominal Assessment — Nursing Review Assess the abdomen for GI disorders like PUD and GERD, focusing on inspection, auscultation, percussion, and palpation.
Pathophysiology: PUD—erosion of gastric/duodenal mucosa from H. pylori or NSAID use. GERD—backflow of stomach acid into the esophagus causing tissue irritation, scarring, or Barrett’s esophagus.
Key Manifestations: PUD: Burning epigastric pain (worse on empty stomach), fatigue, weight loss, vomiting, or tarry stools (bleeding). GERD: Hoarseness, cough, reflux, asthma-like symptoms, or chest discomfort. Abdominal Pain: Assess with COLDSPA—sharp pain suggests peritonitis or obstruction. Bowel Changes: Diarrhea → dehydration/electrolyte imbalance; constipation → obstruction or bleeding.
Nursing Management: For PUD—avoid NSAIDs/alcohol/tobacco, take meds as directed, report bleeding or severe pain. For GERD—avoid trigger foods (spicy, acidic, caffeine, chocolate), eat small meals, remain upright 2 hrs post-meal, elevate HOB, lose weight if overweight.
Assessment Tips: Empty bladder, supine position with knees flexed. Order: Inspection → Auscultation → Percussion → Palpation. Auscultate 1 min per quadrant; listen 5 min if no sounds. Absent BS = ileus; high-pitched tinkling = obstruction.
Safety Red Flags: 🚫 Do not palpate pulsating midline mass → suspect AAA. Rebound tenderness = peritonitis. Murphy’s sign = cholecystitis. Rovsing/Psoas/Obturator signs = appendicitis. Enlarged spleen = risk of rupture—use gentle technique.
Older Adults: ↓ Pain sensitivity, ↑ UTI risk, ↓ appetite, screen for AAA (men 65–75 with smoking hx).
Drugs to Watch: NSAIDs, steroids, anticoagulants, SSRIs, bisphosphonates—all increase PUD/GERD risk.
Key Takeaway: Prioritize life-threatening findings—stop palpation for pulsating mass, assess bowel sounds carefully, and educate clients on lifestyle modifications for GI health.