I have a question regarding re-bound tenderness and am interested in what you think.
I am currently finishing up Peds. and reading about GI diseases and complications. I was reading about Appendicitis and have a question regarding assessing for Appendicitis using "rebound tenderness".
I know that appendicitis may present with abd. pain/tenderness in the Lower Right Quadrant (where the appendix is located).
I also know that if you are going to assess for rebound tenderness you would press into the abd. then release quickly. If the patient experiences more pain when you release your hand, that is positive for rebound tenderness and means that there is peritonitis/inflammation of the bowel, possibly appendicitis.
Now, the issue I have with my Peds. book and study guide is that the book makes no reference as to what quadrant you would perform rebound tenderness. My study guide (in one of the questions) says that you would perform rebound tenderness in the Right Quadrant. The problem I have with this is that if I remember correctly last semester when we were learning about GI assessment our Assessment book said to never palpate or do rebound tenderness testing in the same quadrant as the appendix or where the patient if feeling the most pain because you could rupture the appendix or perforate the bowel if you press directly on the painful area. My understanding was that to perform rebound tenderness you should move to the opposite side of where the patient is experiencing pain and then press and release.
I don't have my Assessment book on me right now and was just wondering what other students and nurses out there were taught and practiced.
Thanks and interested in hearing your responses, wondering if my book is just all wrong.