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Diseases » Overweight » Tests
 

Diagnostic Tests for Overweight

Overweight: Diagnostic Tests

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Overweight includes:

  • Body Mass Index (BMI) - BMC 25..<30 is overweight; BMI >= 30 is obesity
  • Weight-for-height charts
  • Skinfold thickness measurement
  • Bioelectrical impedance analysis (BIA)

Overweight Tests: Book Excerpts

Home Diagnostic Testing

These home medical tests may be relevant to Overweight:

Overweight Diagnosis: Book Excerpts

Tests and diagnosis discussion for Overweight:

Am I at Risk for Type 2 Diabetes: NIDDK (Excerpt)

Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight, normal weight, overweight, or obese. Use the body mass index table below to find your BMI.

  • Find your height in the left-hand column.
  • Move across in the same row to the number closest to your weight.
  • The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.

Body Mass Index Table

For a printer-friendly version of this table, use the pdf.*
  Normal Overweight Obese
BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36
Height
(inches)
Body Weight (pounds)
58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172
59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178
60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184
61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190
62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196
63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203
64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209
65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216
66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223
67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230
68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236
69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243
70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250
71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257
72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265
73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272
74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280
75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287
76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295

  Obese Extreme Obesity
BMI 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
Height
(inches)
Body Weight (pounds)
58 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258
59 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267
60 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276
61 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285
62 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295
63 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304
64 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314
65 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324
66 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334
67 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344
68 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354
69 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365
70 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376
71 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386
72 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397
73 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408
74 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420
75 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431
76 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443

Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. (Source: excerpt from Am I at Risk for Type 2 Diabetes: NIDDK)

Helping Your Overweight Child: NIDDK (Excerpt)

If you think that your child is overweight, it is important to talk with your child's doctor. A doctor is the best person to determine whether your child has a weight problem. Physicians will measure your child's weight and height to determine if your child's weight is within a healthy range. A physician will also consider your child's age and growth patterns to determine whether your child is overweight. Assessing overweight in children is difficult because children grow in unpredictable spurts.

For example, it is normal for boys to have a growth spurt in weight and catch up in height later.  It is best to let your child's doctor determine whether your child will "grow into" a normal weight. If your doctor finds that your child is overweight, he or she may ask you to make some changes in your family's eating and activity habits. (Source: excerpt from Helping Your Overweight Child: NIDDK)

NIDDK _ Statistics Related to Overweight and Obesity: NIDDK (Excerpt)

A number of methods are used to determine if an individual is overweight or obese. Some of them are based on mathematical calculations of the relation between height and weight--others are based on measurements of body fat. These methods are described below.

Body Mass Index

Body Mass Index (BMI) can be used to measure both overweight and obesity in adults. It is the measurement of choice for many obesity researchers and other health professionals. BMI is a direct calculation based on height and weight, and it is not gender-specific. Most health organizations and published information on overweight and its associated risk factors use BMI to measure and define overweight and obesity. BMI does not directly measure percent of body fat, but it provides a more accurate measure of overweight and obesity than relying on weight alone.

BMI is found by dividing a person's weight in kilograms by height in meters squared. The mathematical formula is:

weight (kg)/height squared (m2).

To determine BMI using pounds and inches, multiply your weight in pounds by 704.5,* then divide the result by your height in inches, and divide that result by your height in inches a second time (Source: excerpt from NIDDK _ Statistics Related to Overweight and Obesity: NIDDK)

NIDDK _ Statistics Related to Overweight and Obesity: NIDDK (Excerpt)

The National Institutes of Health (NIH) identify overweight as a BMI of 25-29.9 kg/m2, and obesity as a BMI of 30 kg/m2 or greater. However, overweight and obesity are not mutually exclusive, since obese persons are also overweight.1 Defining overweight as a BMI of 25 or greater is consistent with the recommendations of the World Health Organization 2 and most other countries. (Source: excerpt from NIDDK _ Statistics Related to Overweight and Obesity: NIDDK)

NIDDK _ Statistics Related to Overweight and Obesity: NIDDK (Excerpt)

Weight-for-height charts are another measure used to determine if a person is overweight (although they do not measure body fat). These charts, which have been used by doctors and other health care workers for decades, usually give a range of acceptable weights for a person of a given height. Many versions of weight-for-height charts exist, some showing different acceptable weight ranges for men and women. Health care workers often disagree over which is the best chart to use. The 2000 Dietary Guidelines for Americans, published jointly by the U.S. Departments of Agriculture and Health and Human Services, provide the most up-to-date weight-for-height chart. The healthy weight range in this chart corresponds to a BMI between 18.5 and 25. (Source: excerpt from NIDDK _ Statistics Related to Overweight and Obesity: NIDDK)

NIDDK _ Statistics Related to Overweight and Obesity: NIDDK (Excerpt)

Measurements of Body Fat

There are a number of ways to measure body fat. Historically, the standard method is to weigh a person underwater; this procedure is limited to laboratories with specialized equipment.

Other simpler methods for measuring body fat include skinfold thickness measurements and bioelectrical impedance analysis (BIA). Skinfold thicknesses are measures of the subcutaneous (lying just beneath the skin) fat at specific sites of a person's body, such as the triceps (the back of the upper arm). Accurate measurements of skinfold thickness depend on the skill of the examiner and may vary widely when measured by different examiners.

To measure body fat using BIA, a harmless amount of an electrical current is sent through the body. The body's ability to conduct an electrical current reflects the total amount of water in the body. Generally, a higher percent body water indicates a larger amount of muscle and lean tissue. Mathematical equations are used to translate the percent body water measure into an indirect estimate of body fat and lean body mass. A standard method should be used to measure bioelectrical impedance because dehydration, recent exercise, skin and room temperature, and placement of electrodes all can affect test results. To obtain the most precise reading, the person being tested should fast for at least 4 hours and lie down for at least several minutes prior to testing. BIA may not be accurate in severely obese individuals, and it is not useful for tracking short-term changes in body fat brought about by diet or exercise.

In addition to body weight and height measurements, health professionals may also rely on a person's waist measurement to determine the location of excess body fat and the corresponding health risks. Analogous to BMI, health risks increase as waist circumference increases. A woman whose waist measures more than 35 inches and a man whose waist measures more than 40 inches may be at particular risk for developing health problems. Studies indicate that increased abdominal or upper body fat is related to the risk of developing heart disease, diabetes, high blood pressure, gallbladder disease, stroke, and certain cancers, and is associated with overall mortality (likelihood of death). Body fat concentrated in the lower body (around the hips, for example) may be less harmful in terms of mortality and morbidity (likelihood of disease), with the exception of varicose veins and orthopedic problems (Source: excerpt from NIDDK _ Statistics Related to Overweight and Obesity: NIDDK)

NIDDK _ Statistics Related to Overweight and Obesity: NIDDK (Excerpt)

The definitions or measurement characteristics for overweight and obesity have varied over time, from study to study, and from one part of the world to another. The varied definitions affect the prevalence statistics of studies and make it difficult to compare data from different studies and from different countries. (Source: excerpt from NIDDK _ Statistics Related to Overweight and Obesity: NIDDK)

Diet: NWHIC (Excerpt)

The words obesity and overweight are generally used interchangeably. However, according to the Institute of Medicine report, their technical meanings are not identical. Overweight refers to an excess of body weight that includes all tissues, such as fat, bone and muscle. Obesity refers specifically to an excess of body fat. It is possible to be overweight without being obese, as in the case of a body builder who has a substantial amount of muscle mass. It is possible to be obese without being overweight, as in the case of a very sedentary person who is within the desirable weight range but who nevertheless has an excess of body fat. However, most overweight people are also obese and vice versa. Men with more than 25 percent and women with more than 30 percent body fat are considered obese. The USFDA has released a chart detailing recommended weights relative to height; women should be in the lower end of their appropriate weight range, according to the chart. (Source: excerpt from Diet: NWHIC)

Diagnosis of Overweight: medical news summaries:

The following medical news items are relevant to diagnosis of Overweight:

Diagnostic Tests for Overweight: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the diagnostic tests for Overweight.

OBESITY, PATHOLOGIC: DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)

Routine laboratory tests include a CBC, urinalysis, chemistry panel, 2-hr postprandial blood sugar, and thyroid profile. If an insulinoma is strongly suspected, a 24- to 36-hr fast, a 5-hr glucose tolerance test, and tolbutamide tolerance test may be done. If Cushing's syndrome is suspected, a serum cortisol and cortisol suppression test should be done. Pelvic ultrasound will help diagnose polycystic ovaries. Chromosomal analysis will help diagnose Klinefelter's syndrome. Perhaps a psychiatrist should be consulted.

 

» READ BOOK EXCERPT ONLINE »

Source: Algorithmic Diagnosis of Symptoms and Signs, 2003

Abdominal distention: History and physical examination
(Handbook of Signs & Symptoms (Third Edition))

If the patient’s abdominal distention isn’t acute, ask about its onset and duration and associated signs. A patient with localized distention may report a sensation of pressure, fullness, or tenderness in the affected area. A patient with generalized distention may report a bloated feeling, a pounding heart, and difficulty breathing deeply or when lying flat. (See Abdominal distention: Common causes and associated findings.)

The patient may also feel unable to bend at his waist. Make sure to ask about abdominal pain, fever, nausea, vomiting, anorexia, altered bowel habits, and weight gain or loss.

Obtain a medical history, noting GI or biliary disorders that may cause peritonitis or ascites, such as cirrhosis, hepatitis, or inflammatory bowel disease. (See Detecting ascites, page 4.) Also, note chronic constipation. Has the patient recently had abdominal surgery, which can lead to abdominal distention? Ask about recent accidents, even minor ones, such as falling off a stepladder.

Perform a complete physical examination. Don’t restrict the examination to the abdomen because you could miss important clues to the cause of abdominal distention. Next, stand at the foot of the bed and observe the recumbent patient for abdominal asymmetry to determine if distention is localized or generalized. Then assess abdominal contour by stooping at his side. Inspect for tense, taut skin and bulging flanks, which may indicate ascites. Observe the umbilicus. An everted umbilicus may indicate ascites or umbilical hernia. An inverted umbilicus may indicate distention from gas; it’s also common in obesity. Inspect the abdomen for signs of inguinal or femoral hernia and for incisions that may point to adhesions. Both may lead to intestinal obstruction. Then auscultate for bowel sounds, abdominal friction rubs (indicating peritoneal inflammation), and bruits (indicating an aneurysm). Listen for succussion splash — a splashing sound normally heard in the stomach when the patient moves or when palpation disturbs the viscera. However, an abnormally loud splash indicates fluid accumulation, suggesting gastric dilation or obstruction.

Next, percuss and palpate the abdomen to determine if distention results from air, fluid, or both. A tympanic note in the left lower quadrant suggests an air-filled descending or sigmoid colon. A tympanic note throughout a generally distended abdomen suggests an air-filled peritoneal cavity. A dull percussion note throughout a generally distended abdomen suggests a fluid-filled peritoneal cavity. Shifting of dullness laterally with the patient in the decubitus position also indicates a fluid-filled abdominal cavity. A pelvic or intra-abdominal mass causes local dullness upon percussion and should be palpable. Obesity causes a large abdomen without shifting dullness, prominent tympany, or palpable bowel or other masses, with generalized rather then localized dullness.

Palpate the abdomen for tenderness, noting whether it’s localized or generalized. Watch for peritoneal signs and symptoms, such as rebound tenderness, guarding, rigidity, McBurney’s point, obturator sign, and psoas sign. Female patients should undergo a pelvic examination; males, a genital examination. All patients who report abdominal pain should undergo a digital rectal examination with fecal occult blood testing. Finally, measure the patient’s abdominal girth for a baseline value. Mark the flanks with a felt-tipped pen as a reference for subsequent measurements.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Abdominal distention: History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))

If the patient’s abdominal distention isn’t acute, ask about its onset and duration and associated signs. A patient with localized distention may report a sensation of pressure, fullness, or tenderness in the affected area. A patient with generalized distention may report a bloated feeling, a pounding heartbeat, and difficulty breathing deeply or breathing when lying flat. The patient may also feel unable to bend at his waist. Be sure to ask about abdominal pain, fever, nausea, vomiting, anorexia, altered bowel habits, and weight gain or loss.

Obtain a medical history, noting GI or biliary disorders that may cause peritonitis or ascites, such as cirrhosis, hepatitis, or inflammatory bowel disease. (See Detecting ascites.) Also note chronic constipation. Has the patient recently had abdominal surgery, which can lead to abdominal distention? Ask about recent accidents, even minor ones, like falling off a stepladder.

Perform a complete physical examination. Don’t restrict the examination to the abdomen because you could miss important clues to the cause of abdominal distention. Next, stand at the foot of the bed and observe the recumbent patient for abdominal asymmetry to determine if distention is localized or generalized. Then assess abdominal contour by stooping at his side. Inspect for tense, glistening skin and bulging flanks, which may indicate ascites. Observe the umbilicus. An everted umbilicus may indicate ascites or an umbilical hernia. An inverted umbilicus may indicate distention from gas; it’s also common in obese individuals. Inspect the abdomen for signs of an inguinal or femoral hernia and for incisions that may point to adhesions; both may lead to intestinal obstruction. Then auscultate for bowel sounds, abdominal friction rubs (indicating peritoneal inflammation), and bruits (indicating an aneurysm). Listen for a succussion splash—a splashing sound normally heard in the stomach when the patient moves or when palpation disturbs the viscera. An abnormally loud splash indicates fluid accumulation, suggesting gastric dilation or obstruction.

Next, percuss and palpate the abdomen to determine if distention results from air, fluid, or both. A tympanic note in the left lower quadrant suggests an air-filled descending or sigmoid colon. A tympanic note throughout a generally distended abdomen suggests an air-filled peritoneal cavity. A dull percussion note throughout a generally distended abdomen suggests a fluid-filled peritoneal cavity. Shifting of dullness laterally when the patient is in the decubitus position also indicates a fluid-filled abdominal cavity. A pelvic or intra-abdominal mass causes local dullness upon percussion and should be palpable. Obesity causes a large abdomen with generalized rather then localized dullness and without shifting dullness, prominent tympany, or palpable bowel or other masses.

Palpate the abdomen for tenderness, noting whether it’s localized or generalized. Watch for peritoneal signs and symptoms, such as rebound tenderness, guarding, rigidity, McBurney’s point, obturator sign, and psoas sign. Female patients should undergo a pelvic examination; males, a genital examination. All patients who report abdominal pain should undergo a digital rectal examination with fecal occult blood testing. Finally, measure abdominal girth for a baseline value. Mark the flanks with a felt-tipped pen as a reference point for subsequent measurements. (See Abdominal distention: Causes and associated findings, pages 6 and 7.)

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Obesity: Diagnostic Approach
(Field Guide to Bedside Diagnosis)

Body mass index (BMI) 5 mass (kilograms)/height (meters)2. Overweight is
a BMI 25 to 30 kg/m2 and obesity is a BMI .30 kg/m2. A body mass index .30 correlates with increased risk of type 2 diabetes, sleep apnea syndrome, fatty liver, gallstones, gout, degenerative joint disease, and accelerated atherogenesis. Abdominal obesity (waist–hip ratio .0.95 in men and .0.85 in women) with excess visceral (intra-abdominal) fat is associated with elevated trigylceride, insulin and glucose levels, and confers an especially increased incidence of adverse outcomes.

Less than 1% of patients with obesity have an endocrine or other secon-dary cause.

Rapid weight gain is usually due to fluid accumulation, seen with congestive heart failure, renal failure or chronic liver disease. Ascites with the latter can
produce a prominent abdomen, which can be mistaken for obesity by the patient.

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Abdominal distention: Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Perform a complete physical examination. Don’t restrict the examination to the patient’s abdomen because you could miss important clues to the cause of his abdominal distention. Stand at the foot of the bed and observe the recumbent patient for abdominal asymmetry to determine if distention is localized or generalized. Then assess abdominal contour by stooping at his side. Inspect for tense, glistening skin and bulging flanks, which may indicate ascites. Observe the umbilicus. An everted umbilicus may indicate ascites or umbilical hernia. An inverted umbilicus may indicate distention from gas; it’s also common in obesity. Inspect the abdomen for signs of inguinal or femoral hernia and for incisions that may point to adhesions. Both may lead to intestinal obstruction. Then auscultate for bowel sounds, abdominal friction rubs (indicating peritoneal inflammation), and bruits (indicating an aneurysm). Listen for succussion splash — a splashing sound normally heard in the stomach when the patient moves or when palpation disturbs the viscera. However, an abnormally loud splash indicates fluid accumulation, suggesting gastric dilation or obstruction.

Next, percuss and palpate the abdomen to determine if distention results from air, fluid, or both. A tympanic note in the left lower quadrant suggests an air-filled descending or sigmoid colon. A tympanic note throughout a generally distended abdomen suggests an air-filled peritoneal cavity. A dull percussion note throughout a generally distended abdomen suggests a fluid-filled peritoneal cavity. Shifting of dullness laterally with the patient in the decubitus position also indicates a fluid-filled abdominal cavity. A pelvic or intra-abdominal mass causes local dullness upon percussion and should be palpable. Obesity causes a large abdomen without shifting dullness, prominent tympany, or palpable bowel or other masses, and with generalized, rather then localized, dullness.

Palpate the abdomen for tenderness, noting whether it’s localized or generalized. Watch for peritoneal signs and symptoms, such as rebound tenderness, guarding, rigidity, McBurney’s point, obturator sign, and psoas sign. Female patients should undergo a pelvic examination; males, a genital examination. All patients who report abdominal pain should undergo a digital rectal examination with fecal occult blood testing. Finally, measure abdominal girth for a baseline value. Mark the flanks with a felt-tipped pen as a reference for subsequent measurements.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Obesity: Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

  • If physicalexam and linear growth are normal, combination of genetic influencesand environmental factors is almost always the cause of obesity.
  • If decreased linear growth occurs,glucocorticoid excess, hypothyroidism, and growth hormone deficiencyshould be considered.
  • Many unusual syndromes associated withobesity may be distinguished by their clinical findings and moleculargenetic analysis.
  • » READ BOOK EXCERPT ONLINE »

    Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

    Abdominal distention: History and physical examination
    (Nursing: Interpreting Signs and Symptoms)

    If the patient's abdominal distention isn't acute, ask about its onset and duration and associated signs. A patient with localized distention may report a sensation of pressure, fullness, or tenderness in the affected area. A patient with generalized distention may report a bloated feeling, a pounding heart, and difficulty breathing deeply or when lying flat.

    The patient may be unable to bend at the waist. Make sure to ask about abdominal pain, fever, nausea, vomiting, anorexia, altered bowel habits, and weight gain or loss.

    Obtain a medical history, noting GI or biliary disorders that may cause peritonitis or ascites, such as cirrhosis, hepatitis, or inflammatory bowel disease. (See Detecting ascites.) When did the patient last have a bowel movement? Note chronic constipation. Has the patient recently had abdominal surgery, which can lead to abdominal distention? Ask about recent accidents, even minor ones such as falling off a stepladder.

    Perform a complete physical examination. Don't restrict the examination to the abdomen because you could miss important clues to the cause of abdominal distention. Next, stand at the foot of the bed and observe the recumbent patient for abdominal asymmetry to determine if distention is localized or generalized. Then assess abdominal contour by stooping at his side. Inspect for tense, taut skin and bulging flanks, which may indicate ascites. Observe the umbilicus. An everted umbilicus may indicate ascites or umbilical hernia. An inverted umbilicus may indicate distention from gas; it's also common in obesity and pregnancy. Inspect the abdomen for signs of inguinal or femoral hernia and for healed incisions that may point to adhesions. Both may lead to intestinal obstruction. Auscultate for bowel sounds, abdominal friction rubs (indicating peritoneal inflammation), and bruits (indicating an aneurysm). Listen for succussion splash—a splashing sound normally heard in the stomach when the patient moves or when palpation disturbs the viscera. An abnormally loud splash indicates fluid accumulation, suggesting gastric dilation or obstruction.

    Next, percuss and palpate the abdomen to determine if distention results from air, fluid, or both. A tympanic note in the left lower quadrant suggests an air-filled descending or sigmoid colon. A tympanic note throughout a generally distended abdomen suggests an air-filled peritoneal cavity. A dull percussion note throughout a generally distended abdomen suggests a fluid-filled peritoneal cavity. Shifting of dullness laterally with the patient in the decubitus position also indicates a fluid-filled abdominal cavity. A pelvic or intra-abdominal mass causes local dullness upon percussion and should be palpable. Obesity causes a large abdomen without shifting dullness, prominent tympany, or palpable bowel or other masses, with generalized rather then localized dullness.

    Palpate the abdomen for tenderness, noting whether it's localized or generalized. Watch for peritoneal signs and symptoms, such as rebound tenderness, guarding, rigidity, McBurney's point, obturator sign, and psoas sign. Female patients should undergo a pelvic examination; males, a genital examination. All patients who report abdominal pain should undergo a digital rectal examination with fecal occult blood testing. Finally, measure the patient's abdominal girth for a baseline value. Mark the flanks with a felt-tipped pen as a reference for subsequent measurements.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007


     » Next page: Diagnosis of Overweight

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