A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Abdominal assessment in a child follows a systematic sequence designed to minimize interference with bowel sounds and reduce discomfort. The nurse uses a structured approach that begins with noninvasive techniques and progresses to more invasive methods. This order is important because palpation and percussion can alter bowel sounds, leading to inaccurate findings. Proper sequencing ensures reliable assessment of gastrointestinal function and abdominal integrity. A. Superficial palpation: Superficial palpation is used to assess tenderness, muscle guarding, and surface masses, but it is performed after auscultation to avoid altering bowel sounds. Applying pressure too early can stimulate or suppress bowel activity, leading to inaccurate interpretation. It provides initial information about abdominal tenderness and skin integrity. B. Deep palpation: Deep palpation assesses internal organs, masses, and deeper abdominal structures, but it is performed last in the sequence. It can significantly alter bowel sounds and cause discomfort, especially in children. Performing it at the end ensures earlier assessment findings remain accurate and the child experiences minimal distress during the exam. C. Inspection: Inspection is always the first step in abdominal assessment because it is noninvasive and provides baseline information about contour, symmetry, movement, and visible abnormalities. It allows the nurse to observe signs such as distension, scars, or visible peristalsis before any physical manipulation. This preserves the integrity of subsequent assessment findings. D. Auscultation: Auscultation follows inspection because it allows accurate evaluation of bowel sounds before they are altered by palpation. Listening to all quadrants identifies bowel activity, frequency, and character. This step is critical for detecting abnormalities such as hyperactive, hypoactive, or absent bowel sounds.