Gently compress Pt’s soft tissue with your thumb over a bony area for at least 5 sec; observe for indentation. If no indentation is noted, the Pt does not have pitting edema.

Gastrointestinal Assessment

History	Pain, bloating, changes in bowel pattern, diarrhea, constipation, changes in weight or appetite, indigestion, reflux, nausea, vomiting, stomach ulcers, Helicobacter pylori, hemorrhoids, GI bleed, UC, IBS, blood or mucus in stool, NSAID use.
Medication	Antacids, proton pump inhibitors, H2 antagonists, laxatives, antiemetics, antibiotics, antispasmodics.
Abdominal Pain (differential diagnosis)	RUQ: Cholecystitis, hepatitis, MI, pancreatitis, perforated ulcer. LUQ: Gastritis, peptic ulcer, MI, pancreatitis, splenic enlargement. RLQ: Appendicitis, ectopic pregnancy, gynecological disease, renal calculi, testicular torsion, aortic dissection. LLQ: Diverticulitis, colitis, aortic dissection, renal calculi, ectopic pregnancy, gynecological disease, testicular torsion. Epigastric: MI, ulcer, pancreatitis. Diffuse: Gastroenteritis, IBS, ischemic bowel, diabetic ketoacidosis.
Inspect (abdomen)	Skin, distention, scars, obesity, herniations, bruising, pulsations.
Auscultate (bowel tones; before palpate)	Hypoactive: Every minute. Normal: Every 15–20 sec. Hyperactive: As often as every 3 sec.
Percuss (abdomen)	Dullness: Solid organ (liver). Tympany: Hollow organs (bowels). Resonance: Air-filled organs (lungs). Flatness: Dense tissue (muscle, bone).
Palpate (abdomen; after auscultate)	Pulsations (aortic aneurysm). Masses (stool, tumors). Tenderness (appendicitis). Rigidity (GI bleeding, guarding).