The patient presents to the clinic with dysuria and hematuria. How does the nurse proceed to assess for kidney inflammation?

Question

a. Lightly palpates each abdominal quadrant
b. Inspects abdomen for abnormal movement or shadows using indirect lighting
c. Uses deep palpation posteriorly
d. Percusses posteriorly the costovertebral angle at the scapular line

Answer 1

ANS: D
With the patient sitting or standing erect, use direct or indirect percussion to assess for kidney inflammation. With the ulnar surface of the partially closed fist, percuss posteriorly the costovertebral angle at the scapular line. If the kidneys are inflamed, the patient feels tenderness during percussion. Use a systematic palpation approach for each quadrant of the abdomen to assess for muscular resistance, distention, abdominal tenderness, and superficial organs or masses. Light palpation would not detect kidney tenderness because the kidneys sit deep within the abdominal cavity. Posteriorly, the lower ribs and heavy back muscles protect the kidneys, so they cannot be palpated. Kidney inflammation will not cause abdominal movement. However, to inspect the abdomen for abnormal movement or shadows, the nurse should stand on the patient's right side and inspect from above the abdomen using direct light over the abdomen.