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Download PN1healthassessment\Genitourinary Assessment Week 13
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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
