Rectal examination Flashcards
How do you start a rectal examination?
- introduce self
- check name & DOB
- explain procedure
- gain consent
- ask for chaperone
- wash hands
What steps should you take prior to the examination?
- prepare equipment
- posiion patient
- put on gloves
- inspect peri-anal region
- lubricate right index finger
- warns patient that they are about to insert the index finger and informs patient they may have the sensation of needing to open their bowels
How should you perform a rectal examination?
- insert gloved finger
- ask patient to clench against fingers to check anal tone
Examines:
- right lateral wall
- posterior wall
- left later wall
- anterior wall
Withdraw finger and examine glove
What should you do after the examination?
- clean peri-anal area
- cover patient
- inform patient that exam is complete
How should you end a rectal exam?
- dispose of waste in the clinical waste bin
- wash hands
- summarise findings
- thank patient
How should you explain a rectal examination to a patient?
you will be examining
the patients back passage with a gloved index finger and lubrication. Explain this is done to examine
the bowel and prostate/cervix. Reassure them that it may be uncomfortable but not painful.
Why is a chaperone required during a rectal exam?
for the patients comfort and as a witness against any false allegations of
inappropriate behaviour.
What equipment should you organise prior to the exam?
- gloves
- lubrication
- tissue
How should a patient be positioned?
lying on their left side with their knees brought up towards the chin
What should you inspect the peri-anal region for?
- erythema
- discolouration
- skin lesions
- fissures
- fistulae
- external haemorrhoids
- leakage of faeces
- blood or mucus
What are causes of abnormally pale stools?
biliary obstruction
What is a cause of pale and greasy stools?
steatorrhoea
What is the cause of black and tarry stools?
melaena
- bleeding from the upper GI tract
What is the cause of grey or black stools?
- oral iron or bismuth therapy
What is the cause of silvery stools?
- steatorrhoea plus upper GI bleeding
- e.g. pancreatic cancer
