Transcript PN1healthassessment\Genitourinary Assessment Week 13

Genitourinary Assessment
Competencies




To Describe information to be
obtained during a genitourinary
assessment
To identify techniques to use during
a genitourinary assessment
To perform a genitourinary
assessment on a patient
To discuss gerontological variations
Health History



Age: variations associated with age,
i.e STD’s for youth, elimination
problems for adults
Family history
Social history: sexual practices,
substance use
Subjective Data





Does the client have difficulty
urinating? Is there burning?
Does the flow start and stop?
What is the frequency of urination?
Do they experience incontinence or
dribbling of urine?
Do they have difficulty controlling
their urine?
Subjective



For female clients: did the urinary
pattern change after childbirth
Do they have spontaneous urination
with coughing, sneezing etc
For male clients do they have
discharge from the urethral
meatus?
Objective


Common chief complaints: urinary
frequency, pain on urination
Colour, odour and amount of urine
Factors affecting elimination



Aging: kidney functioning, bladder
tone & contractility, neuromuscular
problems.
Food & fluids – caffeine (diuretic
effect), foods high in water &/or
sodium content.
Psychological variables – stress,
cultural issues, embarrassment



Activity and muscle tone
Pathological conditions – urinary
tract abnormalities, UTI, diabetes,
kidney stones
Medications – diuretics,
anticoagulants
Normal Elimination



Urine should be straw coloured
(pale yellow), with no offensive
odour or sediment
Our total blood volume passes
through the kidneys about every
half hour filtering waste
Bladder is smooth muscle sac with 3
layers



Stretch receptors in the bladder
signal the need to void
Usually about 200-300 mLs of urine
in bladder will activate this process
but can distend to hold 3000-4000
mLs of urine
Typically urinate about every 3-4
hours
Terms associated with Elimination






Anuria: no urine
Dysuria: difficulty in voiding
Frequency: increased incidence of
voiding
Glycosuria: glucose in urine
Nocturia: frequency during the
night
Urgency: strong desire to void
Kidneys



Located high and deep under the
diaphragm
Best to assess for kidney at the
costovertebral angle
Primary function of the kidneys is
filtration and elimination of
metabolic wastes
Inspection




Have client empty their bladder and
lie on the bed
Would normally inspect the
reproductive organs at this time
Looking for any noticeable
deviations from normal
Most often covered as part of
reproductive exam
Inspection


Assessing for any visible signs of
infection from the urinary meatus
With men must assess whether or
not the person has been
circumcised
Palpation



To palpate for urethral discharge
gently squeeze the glans between
the index finger and the thumb
The urinary meatus is normally free
from discharge
Any discharge should be cultured
Prostate Gland



An important part of the exam for
men
The prostate is palpated on the
anterior surface of the rectum
An enlarged prostate my indicate
benign prostatic hypertrophy, a
condition that affects men as they
age and may cause urinary
difficulties
Lifespan Variations



Bladder capacity decreases to 250
mL owing to periurethral atrophy
May have 1-2 periods of nocturia
Increasing chance of men
developing prostate disease that
may impact on urinary functioning