TEACH FOR NURSES LESSON PLAN
Chapter 22: Abdomen
CHAPTER OBJECTIVES
1. Identify the organs located within each of the four abdominal quadrants.
2. Identify pertinent topics that must be reviewed during the abdominal portion of the interview.
3. Use measures that will enhance abdominal wall relaxation.
22-2
STUDENT RESOURCES
understand
• Textbook Chapter 22
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
• Audio glossary (Evolve)
• Pocket Companion for Physical Examination and Health Assessment*
apply
• Case Studies (Evolve)
• Elsevier Adaptive Quizzing*
• HESI Case Studies*
• NCLEX Review Questions (Evolve)
• Study Guide*
INSTRUCTOR RESOURCES
22-3
in class
• PowerPoint Presentations (Evolve)
• Image Collection (Evolve)
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
SURFACE LANDMARKS
INTERNAL ANATOMY
The Pregnant Woman
The Aging Adult
CULTURE AND GENETICS
Review Figures 22.1 and
22.2, explaining that the
internal organ locations
are approximations
mannequin with
removable organs to help
the students become
familiar with organ
locations.
• Small Group Activity: Using the photographs in the text as a guide, have students name the
abdominal organs on a peer. This exercise can be done in groups of three, with students taking turns
with each role. Student 1 is the patient, student 2 follows the text, and student 3 acts as the
examiner.
• Online Activity: Have students research online several fast food companies and their responses to
the prevalence of obesity in the United States.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
students offer suggestions
for relief of constipation.
to this problem (e.g., apple
slices in the McDonald’s
Happy Meals).
high metabolism.
SUBJECTIVE DATA
Additional History for
Infants and Children
Review the examination
questions, focusing on
changes in appetite and
noting that many stressors
• Activity: Have students assess their neighborhood for food choices and report on what options are
available for families, students, and aging adults in terms of cost and accessibility.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
choices.
OBJECTIVE DATA
INSPECT THE ABDOMEN
Contour
Hair Distribution
Demeanor
restlessness, tensing, and
Demonstrate the
examination with a
volunteer.
Discuss the contour of the
abdomen, having students
Examine reasons for striae,
including ascites, Cushing
syndrome, pregnancy,
weight gain, and rapid
adolescent growth.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
uneven respirations are
not normal during an exam
and should be evaluated
further.
and hypoactive. Play an
audio clip of normal and
abnormal bowel sounds
for the class.
Emphasize that ultrasound
PERCUSSION
General Tympany
Liver Span, Splenic
Dullness, and Bladder
Percussion
Demonstrate how to
percuss to determine
tympany and dullness.
On the same student who
volunteered to have the
organs marked on his or
• Online Activity: Have students listen to percussion sounds on a medical or educational website.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
is the most definitive
assessment tool.
Spleen
Kidneys
Aorta
DEVELOPMENTAL
COMPETENCE
The Infant
The Child
The Aging Adult
palpate tender areas last
to avoid muscle rigidity
that would interfere with
the rest of the
examination.
of the gallbladder and
appendix and ways to
assess pain arising from
these organs, because
these types of pain are
common conditions.
Examine abnormalities in
the infant, such as
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
umbilical hernia and
diastasis recti, and their
treatments.
Emphasize the need for
IN-CLASS/ONLINE CASE STUDY
J.P. is a 50-year-old man who presents to the gastroenterologist with cramping and diarrhea.
Subjective Data
Pain level is a 6/10 location = right and left lower abdomen
Objective Data
Vital signs: T 37 P 80 R 14 BP 120/68
Bowel sounds hyperactive in all four quadrants
Medications: Infliximab (Remicade) infusions every 6 weeks, fluoxetine (Prozac) 25 mg per day
Weight = 145, last visit weight = 152
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Questions
1. What other assessments should be included for this patient?
2. What questions should the nurse ask with regard to the abdominal pain?
3. From the readings, subjective data, and objective data, what is the most probable cause of the abdominal pain?
4. Develop a problems list from the subjective and objective findings.
5. What should be included in the plan of care?
6. What interventions should be included in the plan of care for this patient?
2. Questions should include the following:
3. Based on the readings and history, this patient is likely having an exacerbation of his Crohn disease. Inflammation may occur from mouth to
4. The problems list should include the following:
a. Weight loss
NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
o Objective Data
• Evidence-Based Practice/Spirit of Inquiry
o Liver Span, Splenic Dullness, and Bladder Percussion
• Safety/Nursing Judgment
o Vascular Sounds
• Informatics/Nursing Judgment
o Liver
o Documentation and Critical Thinking
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
22–11
A full Concept-Based Curriculum Map covering the entire book can be found in the “Download by Resource Type” folder on Evolve.
THEME: Homeostasis and Regulation
• Concept: Nutrition
BSN ESSENTIALS
• Essential III: Scholarship for Evidence-Based Practice
o Liver Span
• Essential IV: Information Management and Application of Patient Care Technology
o Liver Span, Splenic Dullness, and Bladder Percussion
• Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.