Assessing the Gastrointestinal System
Kim Maryniak, PhD, RNC-NIC, NEA-BC
It is important to begin the assessment by obtaining a thorough history of abdominal or gastrointestinal complaints. You will need to elicit information about any complaints of gastrointestinal disease or disorders. Gastrointestinal disease can have various signs and symptoms, including change in appetite, weight gain or loss, dysphagia, intolerance to certain foods, nausea and vomiting, change in bowel habits, and abdominal pain (Jarvis, 2016).
Physical examination techniques should be used in an organized manner from least disturbing or invasive to most invasive to the patient (Jarvis, 2016). Inspection is first, as it is non-invasive. Auscultation is performed following inspection; the abdomen should be auscultated before percussion or palpation to prevent production of false bowel sounds.
It is also important to assess abdominal pain and other gastrointestinal symptoms, such as distention, nausea, and vomiting. After eliciting information about any experienced signs or symptoms of gastrointestinal disease, ask about your patients past abdominal or gastrointestinal history, medications, and nutritional status. The patient history is extremely important in assessing abdominal pain. Pain may be chronic or acute and related to inflammation, infection, allergy, or food intolerance. It can also result from trauma or obstruction. There are also a few physical exam techniques that can be used to assess acute abdominal pain. These are the iliopsoas muscle test, obturator test, and Blumberg test (Porter & Kaplan, 2016; Wilson & Giddens, 2017).
To learn more about the focused gastrointestinal assessment and sharpen your assessment skills, refer to the RN.com course Focused Gastrointestinal Assessment.
Jarvis, C. (2016). Physical examination and health assessment (7th ed.). St. Louis, MO: W.B. Saunders
Porter, R., & Kaplan, J. (eds.). (2016). Merck manual professional version. Whitehouse Station, NJ: Merck Sharp & Dohme Corp
Wilson, S. & Giddens, J. (2017). Health assessment for nursing practice (6th ed.). St. Louis, MO: Elsevier.
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