● Make the patient comfortable in the supine position, with a pillow under the head and perhaps under the knees. Slide your hand under the low back to see if the patient is relaxed and lying flat on the table.
● Ask the patient to keep the arms at the sides or folded across the chest. When the arms are above the head, the abdominal wall stretches and tightens, which hinders palpation.
● Draping the patient. To expose the abdomen, place the drape or sheet at the level of the symphysis pubis, then raise the gown to below the nipple line just above the xiphoid process. The groin should be visible but the genitalia should remain covered. The abdominal muscles should be relaxed to enhance all aspects of the examination, especially palpation.
● Before you begin, ask the patient to point to any areas of pain so that you can examine these areas last.
● Warm your hands and stethoscope. To warm your hands, rub them together or place them under hot water.
● Approach the patient calmly and avoid quick unexpected movements. Avoid having long fingernails which can scratch or scrape the patient's skin.
● Stand at the patient's right side and proceed in a systematic fashion with inspection, auscultation, percussion, and palpation. Visualize each organ in the region you are examining. Watch the patient's face for any signs of pain or discomfort.
● If necessary, distract the patient with conversation or questions. If the patient is frightened or ticklish, begin palpation with the patient's hand under yours. After a few moments, slip your hand underneath to palpate directly.
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