Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Physical Assessment of the Male Genitalia, Inguinal Area, Anus, Rectum, and Prostate Gland, Lecture notes of Health sciences

A comprehensive overview of the physical assessment of the male genitalia, inguinal area, anus, rectum, and prostate gland. It covers the normal and abnormal findings that healthcare professionals should be aware of during a physical examination. Key points, such as the importance of wearing disposable gloves, inspecting and palpating various anatomical structures, and documenting the findings. It also discusses potential risk diagnoses, such as the risk for ineffective therapeutic regimen management, ineffective health maintenance, and impaired skin integrity in the rectal area. This information is crucial for healthcare providers, particularly those working in the field of urology, andrology, or men's health, to ensure accurate assessment, diagnosis, and appropriate management of male reproductive health issues.

Typology: Lecture notes

2022/2023

Available from 10/27/2024

Oishiiii
Oishiiii 🇵🇭

22 documents

1 / 7

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
PHYSICAL ASSESSMENT OF THE MALE GENITALIA,
INGUINAL AREA, ANUS, RECTUM, AND PROSTATE
GLAND
Review of the Male Reproductive System
Male Genitalia
Inguinal Area
Anus and Rectum
Prostate Gland
KEY POINTS
Wear disposable gloves.
Prepare the client thoroughly for the physical
examination to put the client at the greatest ease.
Perform the examination professionally and
preserve the client’s modesty.
Preserve client’s privacy.
Inspect and palpate penis, scrotum, and inguinal
area for inflammation, infestations, rashes, lesions,
and lumps.
During the testicular examination, describe the
importance of testicular self󶂢examination and
explain how to perform the examination as you are
performing it.
Understand the structures and functions of the
anorectal region.
Make sure to have a chaperone in the room
while performing the examination.
EQUIPMENT
Stool
Gown
Disposable non-latex gloves
Flashlight (for possible transillumination)
Stethoscope (for possible auscultation)
Water soluble lubricant
BEFORE THE PHYSICAL EXAMINATION
1. Prior to performing the procedure, introduce
self and verify the client’s identity using agency
protocol.
2. Explain to the client what you are going to do,
why it is necessary, and how he can participate.
3. Perform hand hygiene, apply gloves, and
observe other appropriate infection prevention
procedures.
4. Provide for client privacy.
COLLECTING OBJECTIVE DATA
Preparing the Client
1. Before the examination, instruct the client to
empty his bladder so that he will be comfortable. If
a urine specimen is necessary, provide the client
with a container.
pf3
pf4
pf5

Partial preview of the text

Download Physical Assessment of the Male Genitalia, Inguinal Area, Anus, Rectum, and Prostate Gland and more Lecture notes Health sciences in PDF only on Docsity!

PHYSICAL ASSESSMENT OF THE MALE GENITALIA,

INGUINAL AREA, ANUS, RECTUM, AND PROSTATE

GLAND

Review of the Male Reproductive System Male Genitalia Inguinal Area Anus and Rectum Prostate Gland

KEY POINTS

  • Wear disposable gloves.
  • Prepare the client thoroughly for the physical examination to put the client at the greatest ease.
  • Perform the examination professionally and preserve the client’s modesty.
  • Preserve client’s privacy.
  • Inspect and palpate penis, scrotum, and inguinal area for inflammation, infestations, rashes, lesions, and lumps.
  • During the testicular examination, describe the importance of testicular self examination and explain how to perform the examination as you are performing it.
  • Understand the structures and functions of the anorectal region.
  • Make sure to have a chaperone in the room while performing the examination. EQUIPMENT
  • Stool
  • Gown
  • Disposable non-latex gloves
  • Flashlight (for possible transillumination)
  • Stethoscope (for possible auscultation)
  • Water soluble lubricant BEFORE THE PHYSICAL EXAMINATION
  1. Prior to performing the procedure, introduce self and verify the client’s identity using agency protocol.
  2. Explain to the client what you are going to do, why it is necessary, and how he can participate.
  3. Perform hand hygiene, apply gloves, and observe other appropriate infection prevention procedures.
  4. Provide for client privacy. COLLECTING OBJECTIVE DATA Preparing the Client
  5. Before the examination, instruct the client to empty his bladder so that he will be comfortable. If a urine specimen is necessary, provide the client with a container.
  1. If the client is not wearing an examination gown for a total physical examination, provide a drape and ask him to lower his pants and underwear.
  2. Explain to the client that he will be asked to stand (if able) for most of the examination of the genitalia. PHYSICAL EXAMINATION Male Genitalia PENIS: Inspect the base of the penis and pubic hair. Sit on a stool with the client facing you and standing. Normal Findings:  Pubic hair is coarser than scalp hair.  The normal pubic hair pattern in adults is hair  covering the entire groin area.  (^) The base of the penis and the pubic hair are free of  excoriation, erythema, and infestation. Abnormal Findings:  Absence or scarcity of pubic hair may be seen in  clients receiving chemotherapy.  Presence of lice or nit (eggs) infestation at the  base of the penis or pubic hair is known as  pediculosis pubis. Inspect the skin of the shaft. Observe for rashes, lesions, or lumps. Normal Findings:  The skin of the penis is wrinkled and hairless and is normally free of rashes, lesions, or lumps. Abnormal Findings:  Rashes, lesions, or lumps may indicate STI or cancer. Palpate the shaft. Palpate any abnormalities noted during inspection. Also note any hardened or tender areas. Normal Findings:  The penis in a non erect state is usually soft, flaccid, and non tender. Abnormal Findings:  Tenderness may indicate inflammation or infection. Inspect the foreskin. Observe for color, location, and integrity of the foreskin in uncircumcised men. Normal Findings:  The foreskin, which covers the glans in an uncircumcised male client, is intact and uniform in color with the penis. Abnormal Findings: Discoloration of the foreskin may indicate scarring or infection. Inspect the glans. Observe for size, shape, and lesions or redness. Note the location of the urinary meatus on the glans. Normal Findings:  The glans size and shape vary, appearing rounded, broad, or even pointed.  The surface of the glans is normally smooth, free of lesions and redness.  (^) The urinary meatus is slit-like and normally found in the center of the glans. Abnormal Findings:  (^) Chancres (red, oval ulcerations) from syphilis, genital warts, and pimple-like lesions from herpes are sometimes detected on the glans and foreskin.  Phimosis; Paraphimosis.  Hypospadias; Epispadias. Palpate for urethral discharge. Gently squeeze the glans between your index finger and thumb. Normal Findings:  The urinary meatus is normally free of discharge. Abnormal Findings:  (^) A yellow discharge is usually associated with gonorrhea.  A clear or white discharge is usually associated with urethritis.

Normal Findings:  Normally scrotal contents do not transilluminate. Abnormal Findings:  Swellings or masses that contain serous fluid (hydrocele, spermatocele) — light up with a red glow.  Swellings or masses that are solid or filled with blood (tumor,  hernias, or varicocele) — do not light up with a red glow. Assessment of scrotal mass found during examination.Auscultation - Ask the client to lie down. Note whether the mass disappears. If it remains, auscultate it for bowel sounds. Finally, gently palpate the mass and try to push it upward into the abdomen Normal Findings:  (^) Normal findings are not expected Abnormal Findings:  Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia.  Bowel sounds will not be heard over a hydrocele. PHYSICAL EXAMINATION Inguinal Area Inspect for inguinal and femoral hernia. Inspect the inguinal and femoral area for bulges. Normal Findings:  The inguinal and femoral area are normally free from bulges. Abnormal Findings:  Bulges that appear at the external inguinal ring or at the femoral canal when the client bears down may signal a hernia. Palpate for inguinal hernia and inguinal nodes. Normal Findings:  Bulging or masses are not normally palpated. Abnormal Findings:  A bulge or mass may indicate a hernia. Palpate inguinal lymph nodes. If nodes are palpable, note size, consistency, mobility or tenderness. Normal Findings:  No enlargement or tenderness is normal. Abnormal Findings:  Enlarged or tender lymph nodes may indicate an inflammatory process or infection of the penis or scrotum. Palpate for femoral hernia. Palpate on the front of the thigh in the femoral canal area. Ask the client to bear down or cough. Feel for bulges. Repeat on the opposite thigh. Normal Findings:  (^) Bulges or masses are not normally palpated. Abnormal Findings:  Bulge or mass palpated as client bears down or coughs. PHYSICAL EXAMINATION Anus and Rectum Selected positions for Anorectal Examination Inspect the perianal area. Spread the client’s buttocks and inspect the anal opening and surrounding area.

Normal Findings:  The anal opening should appear hairless, moist, and tightly closed.  The skin around the anal opening is more coarse and more darkly pigmented.  The surrounding perianal area should be free of redness, lumps, ulcers, lesions, and rashes. Abnormal Findings:  Lesions may indicate STIs, cancer, or hemorrhoids.  A thrombosed external hemorrhoid appears swollen, itchy, painful, and bleeds when  the client passes stool. A previously thrombosed hemorrhoid appears as a skin tag that protrudes from the anus.  A painful mass that is hardened and reddened suggests a perianal abscess.  (^) A swollen skin tag on the anal margin may indicate a fissure in the anal canal.  Redness and excoriation may be from scratching an area infected by fungi or pinworms.  A small opening in the skin that surrounds the anal opening may be an anorectal fistula  Thickening of the epithelium suggests repeated trauma from anal intercourse. Inspect the anal opening for any bulges or lesions. Ask the client to perform Valsalva’s maneuver by straining or bearing down. Normal Findings:  No bulging or lesions appear. Abnormal Findings:  Bulges of red mucous membrane  (^) may indicate a rectal prolapse.  Hemorrhoids or an anal fissure may also be seen. Inspect the sacrococcygeal area. Inspect this area for any signs of swelling, redness, dimpling, or hair. Normal Findings:  Area is normally smooth, and free of redness and hair. Abnormal Findings:  A reddened, swollen, or dimpled area covered by a small tuft of hair located midline on the lower sacrum suggests a pilonidal cyst Palpate the anus Normal Findings:  The client can normally close the sphincter around the gloved finger.  The anus is normally smooth, non tender, and free of nodules and hardness. Abnormal Findings:  Poor sphincter tone may be the result of a spinal cord injury, previous surgery, trauma, or a prolapsed rectum.  Tightened sphincter tone may indicate anxiety, scarring, or inflammation.  Tenderness may indicate hemorrhoids, fistula, or fissure.  Nodules may indicate polyps or cancer.  Hardness may indicate scarring or cancer. Palpate the rectum Note tenderness, irregularities, nodules and hardness.

  • Fecal matter on gloved finger reveals semi-soft, brown stool. NURSING DIAGNOSIS Wellness Diagnosis:
  • Readiness for enhanced self-health management of reproductive system.
  • Readiness for enhanced self-health management.
  • Requests information on testicular selfexamination (TSE).
  • Requests information on ways to prevent an STI.
  • Requests information on birth control.
  • Requests information on proper liftingtechniques to prevent hernia formation.
  • Readiness for enhanced bowel elimination pattern.
  • Requests information on purpose and need for colorectal examination. Risk Diagnoses:
  • Risk for Ineffective Therapeutic Regimen Management (monthly testicular self-examination, TSE) related to lack of knowledge of the importance of TSE.
  • Risk for Injury related to poor lifting techniques.
  • Risk for Infection related to unprotected sexual intercourse.
  • Risk for Ineffective Sexuality Pattern related to impending surgery.
  • Risk for Ineffective Health Maintenance related to lack of knowledge of need for recommended colorectal and prostate examinations
  • Risk for Impaired Skin Integrity in rectal area related to chronic irritation secondary to diarrhea. Actual Diagnoses:
  • Fear of testicular cancer related to existing risk factors.
  • Disturbed Body Image related to hernia repair.
  • Pain: Dysuria related to gonorrhea, infection, or genital reproductive surgery.
  • Acute Pain: Rectal.
  • Ineffective Therapeutic Regimen Management related to lack of knowledge of testicular self- examination.
  • Sexual Dysfunction related to decreased libido secondary to fear of urinary incontinence, pain in surgical site, anxiety, or fear.
  • Sexual Dysfunction related to erectile dysfunction secondary to psychological or physiologic factors.
    • Sexual Dysfunction related to lack of ejaculation secondary to surgical removal of seminal vesicles and transection of the vas deferens.
    • Ineffective Sexuality Patterns related to feelings of loss of masculinity and sexual attractiveness secondary to chronic diarrhea or pain.
    • Anxiety related to impending genital reproductive surgery and lack of knowledge of outcome of surgery.
    • Diarrhea related to chronic inflammatory bowel disease.
    • Situational Low Self-Esteem related to loss of control over bowel elimination.