Communication

• Ask client to take deep belly breaths throughout
• Double check with client before you undrape their abdomen or touch their abdomen

Positioning

• Two pillows under knee, one pillow under head
• Tuck towel into shoulders and undrape linen to below the ASIS

Specific Treatment

• Instruct client to do deep breaths as you slowly place hands on abdomen
• Begin with circular effleurage , state 20 – 40 strokes, going close
• Clear off any lotion
• Muscles to treat:
  • Rectus Abdominis:
    • Ribs 5-7, xiphoid to pubic bone
    • Fascial work, state they may feel a burning sensation
    • Direct fascial, indirect spreading, skin rolling, S/C-bowing
  • External Oblique:
    • Lateral aspect of body to iliac crest
    • Direct fascial, indirect spread, skin rolling, S/C-bowing, myofascial stretch from iliac and out/away at ribs (state this will happen for 30 seconds )
  • Internal Oblique:
    • Slowly into diaphragm area, lateral into ribs
    • Commnicate deep breaths and sink in when they exhale
    • Drag up at iliac crest
    • Myofascial stretch (push up and down at ribs and iliac crest for 30 seconds ), direct fascial, indirect spread, skin rolling, S/C-bowing
• Circule effleurage for 30 – 40 strokes

Constipation Treatment

• Start on left side with broad vibrations
• State you are starting at the sigmoid
• Push down and work up in clock-wise motion
• Fine vibrations over “gurgly” areas
• Circule effleurage for 20 – 40 strokes
• C-Scoop
• Circular effleurage for 20 – 40 strokes

Cold Wash Communicatino

• Purpose: to bring blood flow to client’s G.I track and help with bowel movement
• Benefits: to bring relief from constipation and decrease pain
• It will be very cold, so have an extra blanket or sweater for client and put a blanket over top of towel
• Let client know, their body heat will warm towel up within 5 minutes, but keep it there for 15-20 minutes
• If the client doesn’t gain any relief from it, let them know they can stop
• Ask if they have any questions