Male GU assessment 1
MENNONITE COLLEGE OF NURSING
AT ILLINOIS STATE UNIVERSITY
NUR 431 Diagnostic Reasoning for Advanced Nursing Practice
Assessment of the Male Genitourinary System
I. Health History
A. Biographical - Age, race
B. Chief complaint - e.g. pelvic/rectal discomfort, hematuria, dysuria, nocturia, sexual dysfunction
C. History of present illness - i.e. location, quality, quantity, timing (onset, frequency, duration), setting, factors that increase/decrease sx., associated manifestations
D. Past medical/surgical history - e.g. cryptorchid, STDs, medications (antihistamines, proscar), vasectomy, diabetes
E. Family history (first degree relations)/Social history (occupation, hobbies)
F. ROS - Smoking, sexual activity
II. Male psyche: “If it ain’t broke…!”
III. Exam equipment
Gloves, KY jelly, flashlight
IV. Breast/axillae assessment
A. Teach, explain, get permission
B. Inspect: bilateral symmetry, size
C. Palpate: sitting
V. Bladder
A. Anatomy
B. Disease process
1. Signs/symptoms
2. TCCA (transitional cell carcinoma)
a. incidence
b. age
c. risk factors
VI. Assessment of the penis
A. Anatomy
B. Disease process
1. Signs/symptoms
2. Hypospadias
3. STD lesions
4. Penile cancer: Erythroplasia of Queyrat
Bowen’s disease
C. Teach, explain, get permission
Hygiene
D. Exam
1. Position
2. Inspect
3. Palpate
a. retract foreskin/replace foreskin
b. shaft
VII. Testicular assessment
A. Anatomy
B. Disease process
1. Signs/symptoms
2. Varicocele
3. Hydrocele
4. Spermatocele
5. Epididymitis
6. Hernia
7. Testicular cancer
a. incidence
b. age
c. risk factors
C. Teach, explain, get permission
TSE – insufficient evidence to recommend (ACS), health care provider exam with general physical exam
D. Exam
1. Position
2. Inspect
3. Palpate
VIII. Assessment of the prostate
A. Anatomy
B. Disease process
1. Signs/symptoms
2. Prostatitis
3. BPH
4. PAC (prostatic adenocarcinoma)
a. Incidence
b. Age
c. Risk factors
C. Teach, explain, get permission
D. Exam
1. Position
2. Inspect
3. Palpate: DRE
E. PSA – option age 50+ with 10-year life expectancy (ACS); insufficient evidence (USPSTF)