Anus, Rectum, and Prostate Assessment

Anus, Rectum,
and Prostate
Assessment
Anus, Rectum, and Prostate Assessment
• Structure and Function of Anus

and Rectum
– Anus:
• Composed of anal canal;
2.5 to 4 cm long
• Final segment of digestive
system;
• Lined with skin that
contain many somatic
nerves making it sensitive
to touch
• Has internal and external
sphincters,
– Anorectal junction: located
just above internal sphincter
Anus, Rectum, and Prostate
Assessment
• Structure and Function
of Anus and Rectum
– Rectum:
• Lowest portion of
large intestine; 12
cm long
• Peritoneum lines
upper two-thirds of
rectum
Assessment
• Structure and Function
of Prostate Gland
– 2.5 to 4 cm long
– Surrounds neck of
bladder and urethra
– Consists of 2 lobes
separated by a
shallow groove
(median sulcus)
Assessment
• Function of Prostate Gland

–Secrete thin, milky substance
that:
•Promotes sperm motility
•Neutralizes female acidic
vaginal secretions
Assessment
• Seminal vesicles: produce ejaculate that

nourishes and protects sperm; normally
not palpable
• Cowper’s or bulbourethral glands:
mucus-producing pea-sized organ is
located posterior to prostate gland;
normally NOT palpable
Nursing Assessment
• Collecting subjective data

–Interview approach (COLDSPA) for
Nursing Assessment
• History of current health problem
• Past and family histories
• Lifestyle and health practices
Nursing Assessment
• History of Present Health Concern

– Bowel Patterns
• Change in bowel movement
• Constipation
• Diarrhea
• Fecal incontinence
– Stool
• Color
• Mucus
– Itching and Pain
Nursing Assessment
• Past Health History

– Anal or rectal surgery
• Congenital deformity of the anus or
rectum
• Hemorrhoids surgery
– Last stool test
– Proctosigmoidoscopy
– DRE
– PSA – prostate-specific antigen
Nursing Assessment
• Family Health
– History of polyps, colon or rectal cancer, or prostate cancer in
the family.
• Lifestyle and Health Practices
– Use of laxatives, stools softeners, enemas, or other bowel
enhancing medications.
– Anal sex
– Medications for prostate
– Diets
– Regular exercise
– Calcium supplement
– Hormone replacement therapy
– Effects of problem in normal activity
Nursing Assessment
• Prostate Cancer
– Most common cancer besides skin cancer, and the second
leading cause of cancer death (after lung cancer) in American
men.
• Colorectal Cancer
– The third most common type of cancer in men and women in
Western industrialized societies.
Nursing Assessment
• Collecting objective data

–Client preparation
•Client positioning for this
examination and several
different several position can be
assumed.
Nursing Assessment
Nursing Assessment
• Equipment:
• Gloves
• Water -soluble lubricant
Nursing Assessment
• Key assessment points

– Obtain an accurate and complete health
history
– Alert clients to risk factors for colorectal
and prostate cancer
– Understand the structure and functions of
the anorectal region
Nursing Assessment
• Key assessment points, continued

– Prepare client thoroughly for physical exam
to put the client at the greatest ease
– Perform exam professionally and preserve
client’s modesty
Physical Assessment
– Anus, Rectum and Prostate

• Inspect: perianal area; sacrococcygeal area;
stool sample
Nursing Assessment
• External haemorrhoid
– are usually painless
papules caused by
varicose veins.
– They can be internal or
external.
– This external
haemorrhoids has become
thrombosed- it contains
clotted blood, it is very
painful and swollen and
itches and bleeds with
bowel movements.
Nursing Assessment
• Perianal abscess
– Is a cavity of pus, caused
by infection in the skin
around the anal opening.
– It causes throbbing pain
and is red, swollen, hard
and tender.
Nursing Assessment
• Anal Fissure
– These splits in the tissue
of the anal canal are
caused by trauma
Nursing Assessment
• Anorectal Fistula
– A small, round opening in
the skin that surrounds the
anal opening
Nursing Assessment
• Rectal Prolapse
– Occurs when mucosa of
the rectum protrudes out
through the anal opening.
Nursing Assessment
• Pilonidal Cyst
– Congenital disorder
characterized by a small
dimple or cyst/sinus that
contain hair. It is located
midline in the
sacrococcygeal area and
has a palpable sinus tract
Nursing Assessment
• Palpate:
–Anus
–Rectum
–Peritoneal cavity
–Prostate
Physical Assessment
Relaxing the anus
Physical Assessment
Palpating the anus
Physical Assessment
Palpating the rectal wall
Physical Assessment
Palpating the prostate gland
Nursing Assessment
Abnormal findings of the rectum
• Rectal Polyps
– These soft structure are
rather common and occur
in varying sizes and
number
Abnormal findings of the rectum
• A rectal carcinoma is
usually asymptomatic until
it is quite advanced.
• A cancer of the rectum
may feel like a firm
nodule, an ulcerated
nodules with rolled edges,
or as it grows a large,
irregularly shaped, fixed
hard nodule.
Abnormal findings of the prostate
gland
• Acute prostatitis
– Prostate is swollen, tender,
firm, and warm to touch.
– Caused by bacterial
infection
Abnormal findings of the Prostate
gland
• BPH
– The prostate is enlarged,
smooth, firm and slightly
elastic.
– Common in men older
than age 50
• Validation and documentation of findings
Chapter 23
– Subjective and objective data
• Analysis of Data
– Wellness nursing diagnosis example
• Readiness for enhanced bowel
elimination pattern
• Analysis of Data Chapter 23
– Risk nursing diagnosis example
• Risk for ineffective health maintenance
related to lack of knowledge of need for
recommended colorectal and prostate
examinations
• Analysis of Data Chapter 23
– Actual nursing diagnosis example
• Acute pain: rectal
– Collaborative problem example
• PC: Prostatic hypertrophy

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Anus, Rectum, and Prostate Assessment

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Anus, Rectum,

• Structure and Function of Anus

• Function of Prostate Gland

• Seminal vesicles: produce ejaculate that

• Collecting subjective data

• History of Present Health Concern

• Past Health History

• Collecting objective data

• Key assessment points

• Key assessment points, continued

– Anus, Rectum and Prostate

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