DRE Flashcards
How do you start the explanation DRE?
been asked to perform an examination of your back passage have you had this done before
How does DRE explanation start?
- will involve me inspecting the area and inserting a gloved and lubricated finger into the back passage in order to investigate the cause of your symptoms further.
- it might be a little uncomfortable, but it should only last a very short time.
- If at any point you want me to stop, please let me know.
What is important to say about DRE?
will be acting as the chaperone. Is it ok for me to proceed?
What must you offer with DRE?
offer to turn around while the patient undresses to maintain dignity and use this time to gather your items and provide a sheet with which the patient can cover themselves after they have changed
What is the correct position for the patient?
- For the purpose of the examination, I would need you to be exposed from the waist downwards. I’ll turn around while you undress.
- Please lie on your left side on the bed with your knees bent up to the chest. Here is a sheet which you can cover yourself with once you’ve done so.
- Just say you’re ready once you’re happy for me to start and I’ll come over.
What equipment is needed for a DRE?
- Gloves
- Apron
- Lubricant
- Papertowel
How do you explain with inspection with DRE?
- First, I am going to have a look down below. This will involve me separating your buttocks slightly. Ideally, I would like a light source to be present.
- Could you bear down/squeeze your bottom?
What is important?
- Inspects surrounding skins and separates buttocks to view perianal area
- Let the patient know what you’re doing before you do it
- Indicate that you would like a light source to be present.
What are possible things to see on inspection on DRE?
- Skin excoriation
- Skin tags
- Haemorrhoids
- Anal fissures
- Anal fistulae
What are skin tags?
- fleshy extra skin hanging from anus
2. are usually harmless growths that may be mistaken for warts or haemorrhoids
What can skin tags usually caused by?
- inflammation
2. injury or leftover skin after haemorrhoid removal
What could excoriations marks be from?
- are as a result of anal itchiness
- which can be due infection
- haemorrhoids
- bowel incontinence
- long-term constipation/diarrhoea
- repeated glyceryl trinitrate cream topical application (used to treat anal fissures).
When can anal fissures (skin tears) happen?
occur with long term straining of hard faeces such as with chronic constipation or in inflammatory bowel disease
What is anal fistulae?
small opening often with discharge
When are anal fistulae can be present?
can also be present in inflammatory bowel disease (particularly Crohn’s disease
