How to prepare a patient for an abdominal exam

22nd Feb 2021

It’s important to prepare your patient for an abdominal exam so that they are aware of what the exam entails and are comfortable with the process. When you prepare the patient, focus on the four main components from the acronym CAPE:

  1. Comfort (physical and emotional)
  2. Attire
  3. Position
  4. Exposure (of the abdomen)

Male clinician with a cape beside a list for comfort, attire, position, and exposure. Cartoon.

Figure 1. When preparing a patient for an abdominal exam, focus on the four components of the acronym CAPE, 1, comfort, 2, attire, 3, position, and 4, exposure.

 

Comfort

First, make sure that the environment is welcoming, comfortable, and private. The space needs to be quiet enough for you and your patient to converse. 

Always wash your hands, introduce yourself, and confirm that you have the correct patient by addressing them by their name. Ask the patient for verbal consent to perform the exam. 

Make sure that the area where the patient is changing feels secure. Ensure that others will not walk in during the exam since their abdomen will be exposed. 

 

Attire 

Comfortable attire is very helpful for both the patient and the clinician. Ideally, you should provide the patient with a hospital gown and ask them to change into it while you step out of the room. Ask them to have it loosely tied so that the robe is easy to lift up and adjust.

Be clear with the patient which articles of clothing need to be removed and provide them with a sheet to cover their lower half for comfort. Make sure the bed is lowered to facilitate the patient getting into it, and help avoid accidents.

 

Position

The patient’s position is important during the exam. To start, have the head of the bed raised (up to 45°) while keeping the rest of the bed flat. Have the patient sit down on the side of the bed and then lay supine (e.g., lying down on their back) to examine the abdomen. 

If needed, assist the patient in laying down. Some patients with mobility issues may need two people to help them onto the bed. Placing a pillow behind the head or under the knees can help relieve some patients with limited mobility issues, and often makes for a more comfortable position. Make sure that the patient’s arms are at their side and not folded across the abdomen. 

 

Expose 

Next, you’ll need to help the patient expose their abdomen while they’re laying down. Let the patient know that you’ll need to lift up the gown for the exam. To properly perform the exam, the entire abdomen needs to be exposed. This includes all four quadrants from the xiphoid to the suprapubic region. 

Keep the patient comfortable and remember to cover their pelvis and legs with a towel or sheet—especially if they are wearing a skirt or dress. 

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Recommended reading

  • de Dombal, FT. 1988. The OMGE acute abdominal pain survey. Progress report, 1986. Scand J Gastroenterol Suppl144: 35–42. PMID: 3043646
  • Jin, XW, Slomka, J, and Blixen, CE. 2002. Cultural and clinical issues in the care of Asian patients. Cleve Clin J Med69: 50, 53–54, 56–58. PMID: 11811720
  • Tseng, W-S and Streltzer, J. 2008. “Culture and clinical assessment”. In: Cultural Competence in Health Care. Boston: Springer. 
  • Wong, C. 2020. Liver fire in traditional Chinese medicine. verywellhealthhttps://www.verywellhealth.com