What nursing assessment should be performed when the abdomen is distended in cirrhosis?

What nursing assessment should be performed when the abdomen is distended in cirrhosis?

• A. Provide laxatives
• B. Ask about food intake
• C. Measure abdominal girth according to a set routine
• D. Report immediately to physician

Answer: (C)

Abdominal distention in cirrhosis is typically from ascites, so the key nursing assessment is measuring abdominal girth according to a set routine. This provides objective, quantitative data on fluid accumulation and how it changes over time, which helps evaluate response to therapy and detect worsening ascites. To perform it correctly, measure at the same level around the abdomen (often at the level of the umbilicus) with the patient in the same position, after voiding, using a flexible tape snug but not compressing, and record the measurement daily or per protocol, noting trends. While asking about food intake and monitoring nutrition are important aspects of cirrhosis care, they don’t quantify distension. Laxatives aren’t an assessment of ascites, and while reporting to the physician is important if there are alarm signs, routine management hinges on consistent abdominal girth measurements.

Abdominal distention in cirrhosis is typically from ascites, so the key nursing assessment is measuring abdominal girth according to a set routine. This provides objective, quantitative data on fluid accumulation and how it changes over time, which helps evaluate response to therapy and detect worsening ascites. To perform it correctly, measure at the same level around the abdomen (often at the level of the umbilicus) with the patient in the same position, after voiding, using a flexible tape snug but not compressing, and record the measurement daily or per protocol, noting trends. While asking about food intake and monitoring nutrition are important aspects of cirrhosis care, they don’t quantify distension. Laxatives aren’t an assessment of ascites, and while reporting to the physician is important if there are alarm signs, routine management hinges on consistent abdominal girth measurements.