Follow up with a focused gastrointestinal and genitourinary assessment. Unusual findings in urine output may indicate compromised urinary function. Pain and tenderness may indicate underlying inflammatory conditions such as peritonitis. Hypoactive or absent bowel sounds may be present after abdominal surgery, or with peritonitis or paralytic ileus. Hyperactive bowel sounds may indicate bowel obstruction, gastroenteritis, or subsiding paralytic ileum. Markedly visible peristalsis with abdominal distension may indicate intestinal obstruction. Determine frequency and type of bowel movements.Ībdominal distension may indicate ascites associated with conditions such as heart failure, cirrhosis, and pancreatitis.Check urine output for frequency, colour, odour.Four quadrants for pain and bladder/bowel distension (light palpation only).Note the heart rate and rhythm, identify S1 and S2, and follow up on any unusual findings with a focused cardiovascular assessment. ![]() Unusual findings should be followed up with a focused respiratory assessment.Īuscultate apical pulse at the fifth intercostal space and midclavicular line The presence of crackles or wheezing must be further assessed, documented, and reported. ![]() Jugular distension of more than 3 cm above the sternal angle while the patient is at 45º may indicate cardiac failure. Use of accessory muscles may indicate acute airway obstruction or massive atelectasis.
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