NU273: Genitourinary and Rectal

key concepts from ppt slides + lecture (based on exam 3 blueprint)

which organs compose the urinary system?

kidneys, ureters, urinary bladder, and urethra

what is the primary function of the ureters within the urinary system?

to transport urine produced by kidneys down to urinary bladder for temporary storage

what is the average length of the female urethra, and what clinical risk does this create?

approx 3-4 cm; its short length increases risk for urinary tract infections (UTIs)

what is the average length of the male urethra, and what clinical complication can arise due to surrounding structures?

approx 20 cm; its longer length makes males prone to urinary obstruction, particularly with prostate enlargement

at approx what volume of urine the bladder do most individuals feel the urge to void?

approx 300ml

what are the expected normal visual findings when inspecting the perianal skin and anus?

intact skin, darker coloration relative to surrounding skin, moist appearance, and a closed anal sphincter

which sphincter muscle at the distal canal provides voluntary control over defecation?

the external sphincter muscle

what key abnormal findings of the rectum and anus require immediate nursing documentation and evaluation?

hemorrhoids, anal fissures, rectal prolapse, or visible lesions

what structures comprise the internal female genitalia (vulva)?

vagina, cervix, uterus, fallopian tubes, and ovaries

what are the primary functions of the female reproductive system?

reproduction, regulation of menstrual cycles, and sex hormone production

what structures make up the male internal reproductive organs?

testes, epididymis, vas deferens, seminal vesicles, and prostate gland

which structure surrounding the neck of the bladder in males secretes fluid and can obstruct urine flow when enlarged?

prostate gland

what are the two essential reproductive functions performed by the testes?

production of sperm and secretion of testosterone

in what standard sequence are physical assessment techniques performed during a genitourinary assessment?

inspection, palpation, percussion, and auscultation

what anatomical regions are observed during inspection in a genitourinary assessment?

external genitalia, abdomen, perianal, and perineal area

how does palpation differ between male and female routine genitourinary physical exams?

male palpation routinely includes scrotum, testes, and inguinal canals; female external palpation is used less often unless evaluating for masses or abscesses

why is percussion performed over the costovertebral angle (CVA) during a renal assessment?

to evaluate for kidney tenderness, which suggests renal inflammation or infection

why is auscultation performed over the renal arteries, and what sound is sought?

to evaluate for vascular stenosis; the nurse listens for bruits

what stethoscope piece is used to auscultate for renal artery bruits?

bell

what are expected findings upon inspecting the female labia, vestibule, and urethral meatus?

symmetrical labia, rounded clitoris, and a midline slit-like or star-shaped urethral opening

what are expected normal findings for the vaginal wall and non-pregnant cervix?

vaginal wall is smooth and moist; cervix is pink, smooth, midline, with a closed external os

what are normal physical variations in the female genitourinary assessment?

scars from previous childbirth or pelvic surgeries, and vaginal mucosal atrophy in postmenopausal women

thickened, white patches found on the female vulvar mucosa are documented as ______

leukoplakia

what unexpected female findings suggest sexually transmitted infections or local inflammatory conditions?

genital ulcers, excoriation, discolored or malodorous discharge, painful lesions, or Bartholin’s gland abscess

what are expected normal inspection findings for the male penile shaft and glans?

skin is wrinkled and hairless with visible vascular structures; glans is smooth; urethral meatus is centrally located at the tip with no discharge or inflammation

what are normal palpation findings for the adult testes?

testes should feel smooth, firm, freely movable, non-tender, and measure 3.5 - 5 cm in diameter

what is the medical term for condition where the foreskin is tight and cannot be retracted over the glans penis?

phimosis

what is the name of the unexpected finding where retracted foreskin becomes trapped behind the glans, causing constriction and tissue edema?

paraphimosis

an abnormal condition where the male urethral opening is misplaced on the ventral or dorsal aspect of the penis is known as ______

hypospadias (or epispadias)

what vaccines are recommended during health promotion education to prevent sexually transmitted cancers?

Human Papillomavirus (HPV) and Hepatitis B Virus (HBV) vaccines

what essential practices ensure gender-sensitive care for transgender clients?

using chosen names and correct pronouns, respecting preferences, and maintaining clinical understanding of gender-affirming hormone therapies and surgeries

what developmental framework guides pediatric sexual maturation assessment?

tanner stages of sexual maturity

what age-related genitourinary changes are commonly encountered in older adults?

Benign Prostatic Hyperplasia (BPH) in men, increased risk of urinary incontinence, and vaginal mucosal atrophy in women

in what order should nursing interventions be initiated for urinary bladder retention?

1. non-invasive voiding techniques (positioning, running water)

2. bladder scanner to quantify residual volume

3. urinary catheterization under sterile technique if non-invasive measures fail

what immediate nursing interventions are required when abnormal genital lesions or purulent discharge are identified?

collect diagnostic swabs of discharge for STI testing, educate patients on safe sexual practices, and arrange medical follow-up

why is testicular torsion classified as a critical surgical emergency?

twisting of the spermatic cord cuts off blood supply to the testicle; delayed surgical intervention leads to ischemic necrosis and testicular loss

what is the priority nursing action upon recognizing signs of testicular torsion?

immediately notify the healthcare provider to prepare the patient for emergency surgical evaluation

how is an inguinal hernia assessed on physical examination?

observe groin or scrotal area for visible bulge while patient coughs or bears down

what signs indicate a strangulated inguinal hernia?

severe acute pain, tender bulge, and tissue discoloration

what immediate nursing preventions help manage acute rectal prolapse or severe hemorrhoids?

apply cold compresses to reduce swelling, position patient with hips elevated to assist reduction, and refer for surgical evaluation

what are the five universal nursing priorities when encountering any abnormal assessment finding?

1. Assess thoroughly

2. Document clearly

3. Notify healthcare team

4. Support emotionally

5. Educate patient