Abdominal Assessment: Order & Tips

Nursing Knowledge

Abdominal Assessment: Order & Tips

Abdominal assessments play a pivotal role in a nurse’s practice, involving a thorough evaluation of the abdominal cavity and its contained organs. This comprehensive process helps in identifying potential health complications, tracking the course of existing conditions, and tailoring appropriate care. Keep reading for a guide on the techniques used in abdominal assessments, including inspection, auscultation, percussion, and palpation. It also highlights the standard and abnormal findings to be cognizant of, along with precautions to ensure safe and effective assessments.
Last updated: April 16, 2024

Table of contents

What is an abdominal assessment in nursing? 

An abdominal assessment is a systematic examination of the client’s abdomen conducted to gather information about the health of the abdominal organs. It helps identify any abnormalities, pain, or changes in the digestive system.

What is the correct order of steps for an abdominal nursing assessment?

Note: The assessment order for abdominal assessments varies from other areas of the body. 

The recommended order for assessing the abdomen is inspection, auscultation, percussion, and then palpation.

This order is different because auscultation of bowel sounds could be altered if palpation or percussion were performed first, potentially leading to inaccurate findings. Auscultating before touching ensures the hearing of the natural state of the abdomen. 

How to perform an abdominal assessment: steps 

  1. Inspection: assess for shape, skin abnormalities, masses, movement
  2. Auscultation: assess presence of bowel sounds as well as frequency and location; auscultate vascular sounds.
  3. Percussion: assess presence of tympany or dullness.
  4. Palpation: assess for consistency, tenderness, masses, rigidity. 

Note: Do not palpate the abdomen if an undiagnosed mass is present or bruits are auscultated. Contact provider first. 

Note: Complete each assessment in all 4 quadrants.

Showing percussion of all 4 quadrants

Percussion of all 4 quadrants

Image by Lecturio.

Normal and abnormal findings in abdominal assessments

Table: Abdominal assessment findings

Normal findingsAbnormal findings
InspectionAbdomen soft, symmetric, without distention; no visible lesions or scarsAscites, Grey–Turner’s sign, Caput medusa
AuscultationBowel sounds present and active in all 4 quadrants; no bruitsNo bowel sounds; bruit
PercussionGeneral tympany with scattered dullness in all quadrants; dullness heard in upper right quadrant over the liverDullness in LLQ could indicate stool, mass, or fluid.
PalpationAbdomen soft with no masses, swelling, pain, or rigidityPain, mass

What is tympany and dullness? 

  • Tympany: sounds like a drum, heard over air-filled structures
  • Dullness: sounds like a quiet thud, heard over fluid or solid organs

Frequency of bowel sounds: normal and abnormal 

  • Normoactive: 5–30 sounds per minute
  • Hypoactive: < 5 sounds per minute
  • Hyperactive: > 30 sounds per minute
  • Absent: no bowel sounds after 3 minutes of listening

Contents of abdominal cavity

  • Liver
  • Spleen
  • Stomach
  • Pancreas
  • Kidneys
  • Gallbladder
  • Small and large intestines
  • Bladder
  • Reproductive organs


Abdominal Assessment: Order & Tips

Free Download

Nursing Cheat Sheet

Overview of abdominal physical assessment, including normal and abnormal findings

Master the topic with a unique study combination of a concise summary paired with video lectures. 

User Reviews