02.12 Genitourinary (GU) Assessment

In this video we’re going to show you a couple of techniques for genitourinary assessments. Now, it’s really important to note that these assessments are usually deferred - either completely because the patient has no GU complaints - or at least until time for their bed bath or perineal care. Make sure you know your facility’s policy on this, but also just make sure you’re preserving your patient’s dignity at all times. That usually why we defer - so that we don’t have to expose them multiple times when that is not necessary.

For both male and female patients you want to start by just asking them if they have had any issues or any burning with urination. This will be your first clue that something’s up. You also should ALWAYS tell the patient what you’re doing, get permission to do the assessment, and use a chaperone whenever necessary.
For males, you want to start with inspection. You’re looking for any discharge or bleeding at the tip of the penis. You’re looking for any lesions on the penis or scrotum, looking at the vasculature, and hair distribution, as well as the general shape for any abnormalities. You also want to look at the inguinal region for any bulging or masses that could indicate a hernia.
Then you’ll move to palpation. Gently palpate the testes between your thumb and first finger on both sides. They should be oval, they should move freely, and they should only be a little tender.
RN palpates testes on both sides.
When assessing a female patient, it’s also important to ask about their menstrual history and when their last menstrual period was. You’ll start by examining the external genitalia - the labia majora should be symmetrical and well-formed with equal hair distribution. You also want to palpate the labia for any masses that could indicate blocked ducts
Then you’ll want to use two fingers to gently spread the labia major to inspect the clitoris and the labia minora. They should be dark pink, moist, and also symmetrical.
Then you should inspect the urethral opening and vaginal canal for any drainage, bleeding, redness, or swelling. Make sure you also make note of any odor.
When you’re done, make sure you cover the patient back up to protect their privacy and dignity.
Make sure we’re always being respectful of our patients when we’re doing these assessments that are a bit more sensitive and private. Sometimes, if we just ask the right questions, we’ll know whether the physical portion of the assessment can be deferred or not.

Now, go out and be your best selves today. And, as always, happy nursing.