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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.

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competencies
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
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
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
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
Objective
  • Common chief complaints: urinary frequency, pain on urination
  • Colour, odour and amount of urine
factors affecting elimination
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
slide8
Activity and muscle tone
  • Pathological conditions – urinary tract abnormalities, UTI, diabetes, kidney stones
  • Medications – diuretics, anticoagulants
normal elimination
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
slide10
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
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
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
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
inspection1
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
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
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
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