Abdominal Assessment

The abdominal assessment is one of the most complex and clinically significant physical examinations performed by the registered nurse. The abdomen houses organs from multiple body systems -- gastrointestinal, hepatobiliary, urinary, reproductive, vascular, and lymphatic -- and advanced assessment skills are essential for early detection of acute surgical emergencies, internal hemorrhage, and organ dysfunction. The registered nurse must integrate anatomical knowledge with systematic assessment techniques to generate accurate clinical findings and initiate appropriate interventions. The peritoneal cavity is lined by the peritoneum, a serous membrane consisting of two layers: the parietal peritoneum (lining the abdominal wall, innervated by somatic nerves producing sharp, well-localized pain) and the visceral peritoneum (covering the abdominal organs, innervated by autonomic nerves producing dull, poorly localized pain). This distinction is clinically critical because the transition from vague visceral pain to sharp parietal pain indicates progression from organ inflammation to peritoneal irritation, signaling a potential surgical emergency. The peritoneal cavity normally contains approximately 50 mL of serous fluid that lubricates organ surfaces; significant accumulation constitutes ascites. The retroperitoneal space contains the kidneys, adrenal glands, pancreas (body and...