A nurse notices abdominal distention when inspecting a patient's abdomen. What action does the nurse take next to gain further objective data?
A) Place a measuring tape around the superior iliac crests.
B) Assist the patient to turn on to the left side and then the right side.
C) Ask the patient to cough while lying supine.
D) Use the fingertips to sharply strike one side of the abdomen.

Question

Quizplus · Accepted Answer

Placing a measuring tape around the superior iliac crests is the procedure for measuring abdominal girth. Assisting the patient to turn on to the left side and then the right side is unnecessary. The distention will remain in a side-lying position. Having the patient cough is used to assess for bulges rather than distention. Using the fingertips to sharply strike one side of the abdomen is part of the procedure to test for a fluid wave, which is not indicated in this patient.

A Nurse Notices Abdominal Distention When Inspecting a Patient's Abdomen