Lab 10: Urinary System Assessment PDF

Lecture 10/ lab/ Urinary system assessment 1. Gather stethoscope and a gloves 2. Perform safety steps: o Perform hand hygiene. o Check the room for transmission-based precautions. o Introduce yourself, your role, the purpose of your visit, and a...

Lecture 10/ lab/ Urinary system assessment 1. Gather stethoscope and a gloves 2. Perform safety steps: o Perform hand hygiene. o Check the room for transmission-based precautions. o Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take. o Confirm patient ID using two patient identifiers (e.g., name and date of birth). o Explain the process to the patient and ask if they have any questions. o Be organized and systematic. o Use appropriate listening and questioning skills. o Listen and attend to patient cues. o Ensure the patient’s privacy and dignity. o Assess ABCs. 3. Conduct a focused interview related to genitourinary concerns. Ask relevant, focused questions based on patient status. 4. Position the patient in a comfortable position and drape the patient, exposing only the areas needed for assessment. Inspection: Assess for changes in the following: 5. Skin: Pallor, changes in turgor, bruises and/or texture. 6. Mouth: Stomatitis, ammonia breath odor. 7. Face and extremities: Generalized edema or peripheral edema. 8. Abdomen: Striae, abdominal contour. 9. Midline mass in lower abdomen may indicate urinary retention. 10. Unilateral mass is indicating enlargement of one or both kidneys from large tumor or polycystic kidney. 11. Weight: Weight gain secondary to edema; weight loss and muscle wasting in kidney failure. 12. General state of health: Fatigue, lethargy, and diminished alertness.  13. Look for presence of urethral catheter, ileal conduit, nephrostomy tube(s), suprapubic catheter, and condom catheter. Palpation: 14. Encourage the patient to empty their bladder prior to palpation. When palpating the abdomen, ask the patient to bend their knees when lying in a supine position to enhance relaxation of abdominal muscles. 15. To palpate the right kidney; place your left hand behind and support the patient ‘s right side between the rib cage and the iliac crest. Elevate the right flank with the left hand. 16. Use your right hand to palpate deeply for the right kidney. 17. Palpate the suprapubic abdomen to assess for pain, possible urinary retention Percussion: 18. Place your non dominant hand over costovertebral angle. Produce one firm thud over left then right area. Tenderness in the flank area may be detected by fist percussion. Normally a firm blow in the flank area should not elicit pain. Auscultation: 19. The bell of the stethoscope used to auscultate the abdominal aorta and renal arteries for a bruit, which indicates impaired blood flow to the kidneys. 20. Use the diaphragm of the stethoscope to auscultate the bowels, since they may also affect the urinary system. 21. Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time. 22. Ensure safety measures when leaving the room: a. CALL LIGHT: Within reach b. BED: Low and locked (in lowest position and brakes on) c. SIDERAILS: Secured d. TABLE: Within reach  e. ROOM: Risk-free for falls (scan room and clear any obstacles) 23. Perform hand hygiene. 24. Document the assessment findings and report any concerns according to agency policy.