Abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. It is is detected by palpation. Rigidity may be voluntary or involuntary . Voluntary abdominal rigidity reflects the patient's fear or nervousness upon palpation; involuntary abdominal rigidity reflects potentially life-threatening peritoneal irritation or inflammation.
Involuntary abdominal rigidity most commonly results from G.I. disorders, but may also result from pulmonary and vascular disorders and from effects of insect toxins. Usually, it's accompanied by fever, nausea, vomiting, and abdominal tenderness, distention, and pain.
Action Stat!
After palpating abdominal rigidity, quickly take the patient's vital signs. Although the patient may not gravely ill or have markedly abnormal vital signs, abdominal rigidity calls for emergency evaluation and interventions.
Prepare to administer oxygen and to insert I.V. catheter for fluid and blood replacement. The patient may require drugs to support blood pressure. Prepare him for urinary catheterization, and monitor intake and output.
A nasogastric tube may need to be inserted to relieve abdominal distention. Because emergency surgery may be necessary, the patient should be prepared for laboratory tests and imaging studies.
Assessment Tip:
Distinguishing voluntary from involuntary abdominal rigidity is a must for accurate assessment. Review this comparison so that you can quickly tell the two apart.
1. Voluntary rigidity
- usually symmetrical
- more rigid on inspiration (expiration causes muscle relaxation)
- eased by relaxation techniques, such as positioning the patient comfortably and talking to him in a calm, soothing manner
- usually asymmetrical
- equally rigid on inspiration and expiration
- unaffected by relaxation techniques
- painful when the patient sits up using his abdominal muscles alone
- abdominal aortic aneurysm
- insect toxins
- mesenteric artery ischemia
- peritonitis
- monitor the patient closely for signs of shock
- place the patient in a position of comfort
- administer analgesics, as ordered by doctor and evaluate their effect
- withhold food and fluids
- administer an I.V. antibiotics as ordered if emergency surgery is required
- prepare the patient for diagnostic tests which may include blood, urine, and stool studies; chest and abdominal x-rays, computed tomography, magnetic resonance imaging, gastroscopy, and colonoscopy
- explain diagnostic tests or surgery the patient will need
- tell the patient about any food or fluid restrictions
- show him how to position himself for comfort
- explain the underlying disorder and treatment plan
abdominal pain
abdominal masses location
abdominal masses
abdominal distention
detecting ascites
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