A 50-year-old female complains of severe pain to the right
lower quadrant of her abdomen. You should:
• A:palpate the left upper quadrant of her abdomen first.
• B:keep her supine with her legs fully extended.
• C:quickly palpate that area first to assess for rigidity.
• D:suspect that she has an acute problem with her liver. -
CORRECT ANSWER-You selected A; This is correct!
Reason:When assessing a patient with abdominal pain,
determine where the pain is most severe (in this case, the
right lower quadrant) and then palpate the quadrant furthest
from that area first (in this case, the left upper quadrant). If
you palpate the painful area first, the patient is less likely to
allow you to assess the remainder of his or her abdomen; it
also causes the patient unnecessary pain. Pain to the right
lower quadrant suggests a problem with the appendix (eg,
appendicitis), not the liver. Patients with abdominal pain
commonly prefer to lie on their side with their legs drawn
into their abdomen; this position often provides pain relief by
taking pressure off of the abdominal muscles. If the patient
prefers this position, do not discourage it.
A 30-year-old man with a history of schizophrenia cut his
wrists and is bleeding profusely. He is confused, combative,
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