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: December 15, 2025

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

Inspection: assess for shape, skin abnormalities, masses, movement
Auscultation: assess presence of bowel sounds as well as frequency and location; auscultate vascular sounds.
Percussion: assess presence of tympany or dullness.
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 findings	Abnormal findings
Inspection	Abdomen soft, symmetric, without distention; no visible lesions or scars	Ascites, Grey–Turner’s sign, Caput medusa
Auscultation	Bowel sounds present and active in all 4 quadrants; no bruits	No bowel sounds; bruit
Percussion	General tympany with scattered dullness in all quadrants; dullness heard in upper right quadrant over the liver	Dullness in LLQ could indicate stool, mass, or fluid.
Palpation	Abdomen soft with no masses, swelling, pain, or rigidity	Pain, 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

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