During abdominal examination of a 6-year-old who squirmed, which technique should the nurse use to facilitate palpation?

• A. Postpone the abdominal palpation until the next examination.
• B. Touch the abdomen firmly as the child takes short, quick breaths.
• C. Press the abdomen with the child bearing down and holding the breath.
• D. Place the child's hand under the examiner's hand while palpating.

Answer: (D)

During a pediatric abdominal exam, the goal is to reduce involuntary guarding and gain cooperation. Letting the child participate by placing his or her hand under the examiner’s hand creates a shared touch that calms the child and provides a stable, cooperative surface for palpation. The examiner can feel through the child’s hand and apply gentle, controlled pressure, which helps relax the abdominal wall and makes palpation easier and more accurate. Other approaches—delaying the examination, pressing firmly while the child breathes quickly, or asking the child to bear down and hold the breath—tend to provoke fear and muscular guarding, making palpation harder and less reliable. This collaborative technique is especially useful when a young child is squirming.