Exam by body system

How to examine for ascites

Other platforms explain it with text and video. In VMS you practice it on the patient.

MD / DOPA
Practice it in VR with Blocky

Ascites is fluid in the belly. Percussion is the key to finding it.

Step by step

  1. Look

    Swollen flanks, tight shiny skin, umbilical hernia. [1]

  2. Percuss

    From the middle out to the flanks: dull flanks suggest fluid. [1]

  3. Shifting dullness

    Mark the dull spot, roll the patient to the other side, wait, percuss again: dullness moves. [1]

  4. Fluid wave

    Hand on one flank, tap the other, with the patient's hand on the midline. [1]

  5. Liver signs

    Jaundice, spider veins, red palms, swollen legs. [2]

  6. Record

    Findings and weight. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

Sources

  1. Stanford Medicine 25 (bedside exam)
  2. NCCPA PANCE Content Blueprint
  3. Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)

Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). VMS is not affiliated with these organizations. Updated: 2026-10-11.