3-4
Basic ToolsVital Signs AppearanceGastric Contents[examine if (+) history of melena or hematemesis]Abdomen Rectal Examination
Clinical Findings•^
Pulse > 100 beats per minute
Systolic BP < 90
Orthostatic change in VS (systolic BP drop of 20 mm Hg or pulse
rise 20 beats per minute)
-^
Temperature (above 101.5 F)
-^
Pallor of anemia, diaphoresis
NG aspirate•^
Bile; no blood or coffee grounds
-^
Coffee ground
-^
Bright red blood
-^
Rigid abdomen with guarding
-^
Abdominal distention without bowel sounds
-^
Abdominal distention with high pitched and tinkling bowel sounds
-^
Disproportionate pain to abdominal exam
-^
Melena (black, sticky, and tar-like stool)
Interpretations•^
Probable hypovolemia
-^
Probable hypovolemia
-^
Signicant hypovolemia
-^
Suggests infection or inammation
-^
Suggests signicant blood loss
-^
No active bleeding
-^
Recent bleeding
-^
Active bleeding
-^
Peritonitis
-^
Ileus
-^
Small bowel obstruction
-^
Intestinal ischemia, infarction, sickle crisis, or abdominal
aneurysm
-^
Recent UGI bleeding
Table 3-2 Abdominal Pain Objective Signs.