Genitourinary Assessment Flashcards
males
penis, passage of urine, canal for semen, circumcised or not, testicles, epididymis, vas deferens, seminal vesicles, prostate gland
When does puberty begin for males?
9-13, testosterone, secondary sex characteristics
prostate gland
walnut shaped, urethra runs through
kidneys
removes/filters waste, maintains volume status, regulates acid/base, regulate bp, endocrine - erythropoietin/vitamin D
frequency
go multiple times
Male history/present complaints
dysuria, frequency, urgency, polyuria, hematuria, nocturia, urinary incontinence, penile discharge, pain in genital region, lesions. onset, frequency, duration/quality, associated symptoms
dysuria
difficulty urinating
polyuria
excessive urination
nocturia
urination at night
urgency
need to urinate immediately
hematuria
blood in urine
male past medical history
history of problems, sexual history, chronic conditions, past surgeries, finding on self exam. family medical history - deaths, chronic disease, congenital birth defects
male social history
tobacco, alcohol, recreational drugs, exercise, occupation
Review of important systems male
general - fever, skin - rash, respiratory - cough, GI - n/v, musculoskeletal - aches/edema
exam set up
gloves, comfortable temp, gown, draping, flashlight, supine
Exam techniques
blunt percussion CVA, palpate kidneys, percussion to determine bladder volume
Female urinary system
urethra carries urine from bladder to outside by urinary meatus. 3.5cm long, opening above vagina introitus
Female health history
common complaints - pelvic pain, vaginal bleeding, discharge, lesions, dysuria, hematuria, frequency, urgency, incontinence, abnormal bleeding
Female past medical history
onset of menses, last GYN/GU exam, pregnancies, sexual activity, past GU problems
Female social history
stress, hobbies, personal hygiene, tobacco, alcohol, recreational drugs
GYN exam
assistant in room, empty bladder before, draping, assess, inspect
Female manifestations in other systems
fever/chills, respiratory, n/v, altered mental status
Newborns
should void w/n 24 hrs, foreskin. males assess for hypospadias, epispadias, cryptorchidism. females - mother’s estrogen can cause mucoid discharge/psuedomenstruation
hypospadias
opening of urethra on underside of penis instead of tip
Epispadias
urethra ends in opening on upper aspect of penis
Cryptorchidism
one or both testes fail to descend from abdomen to scrotum
Pregnancy
uterus enlarges as pregnancy progresses, hormonal changes, pressure from uterus/increase in blood volume, can cause renal structure changes. often experience nocturia, frequency, urgency
pediatrics
generally UTIs over 2, regression from potty training could be UTI, UTIs increase in sexually active adolescents
elders
bladder muscles weaken, vaginal pH changes with menopause, meds can cause urinary frequency, UTIs in older adults have different symptoms - shortness of breath, confusion, chest pain, assess sexual activity
hernias
inguinal, umbilical
Inguinal hernia
tissue protrudes through weak spot in abdominal muscles - bulge can be painful when coughing/bending over/sneezing/lifting heavy object
Umbilical hernia
bowel or fatty tissues protrudes into umbilicus
Types of urinary incontinence
stress, urge, mixed, temporary
Stress incontinence
during activities like coughing, laughing, sneezing, exercising
Urge incontinence
strong sudden urge
Mixed incontinence
mix of stress and urge, may leak w/ laugh or sneeze
Temporary incontinence
illness like UTI that causes frequent/sudden urination
