Do you assess your patients penis daily?
0Mar 17, '10 by NurseyPoo7Had a patients wife come to me the other day regarding her husbands penis being swollen (along with his LE edema). Later in the day, an ancillary staff came to me stating pts wife was upset with me because I didnt properly assess the patient regarding the penis swelling and she wanted to tell the MD (although manager and another ancillary stated the pts wife was happy with care and said our staff was great, but this other ancillary staff is known for starting drama). Pt had no hx of CHF or urological issue.... I was swamped with other pts r/t discharges, new post-op and one pt who had come back from a procedure, but I did get a chance a few hrs later (after taking a 3pm lunch break after being there since 6:30am) to page MD (who had already been and assessed pt himself) and got order for small dose IV Lasix.
Long story short, I informed charge nurse and manager what this ancillary said - and I asked other nurses on the floor... "Do you look at your patient's penis everyday?" Everyone said no. (I will assess if pt was admitted or had a known issue with his penis).
Just curious... When you do your assessment (mainly on a med surg floor.. not critical care or urology), do you look at your patients genitals (this can include vaginas too!)?
9Mar 17, '10 by TigerGalLEI guess it depend on the patient's mental status and condition. If a patient is A x O "walkie talkie" I don't assess their penis unless I'm helping them to the bathroom or something. If they are A x O then I expect they could tell me if something was wrong down there. If my patient's mental status is altered or if the patient is bed ridden I do a full head to toe skin assessment every shift.
8Mar 17, '10 by imintroubleThere are enough old men bozos who take every opportunity to show off their "stuff" without me going around looking for it. With a confused pt I do a careful body assessment as they usually can't tell me everything that's wrong. When someone is O x 3 I expect them to share their concerns. In short I don't look at ANYBODYS genitalia everyday, unless their admitting DX warrants that look. If they're admitted with pneumonia, I zero in on the resp status. Fractured hip, CSM, incision site. AMS, neuro status....... It amazes me that everyday nurses are beat up for what they didn't do, as opposed to what we do.
4Mar 17, '10 by TweetyWas the patient upset with the MD too that they didn't do a thorough physical exam?
Most of my patients are A&O coming in for elective surgery to their knees or hips, so no I don't assess genitalia unless there's an indication I should.
We let them do their own foley care if they have one, and are doing their own AM washup (We'll wash their back and butt, but they gotta wash their front!). If they've been on antibiodics for several days, I'll ask them to be on the lookout for a red fungal type rash and ask them about that.
If they are confused, I'll check them out head to toe usually.
0Mar 17, '10 by creativemomWe're on a med surg floor (not urology) but colo rectal and our nurses do look at "the area" and ALL parts of the patients body when doing the assessment. Usually a pcna (nurse assistant is present to help look at parts as well to be their "witness") This is because we've found in the past really "odd" things under or on the patient.
You won't believe how many patients will put things under them. ie pens, pencils, bottles, books, tape, cell phones, etc. I had one pt place a switch blade under him. You can imagine my surprise when the pt turned and it popped open at me!
For whatever reasons this is also the time we learn that the pt has a fungal issue, rash, STD, etc and we get the doctor to treat them. Or we learn that the pt has a history of having swollen testicles and refuses to tell the doctor in advance of surgery!
We've learned our lessons and now it's just the thing we all do without question...
However I'm in agreement that many male pts just can't wait to show off their body parts at all hours of the day/night. Which can be frustrating when you're trying to educate the pt or ambulate them.
4Mar 17, '10 by leslie :-Di don't unless there is concern.
i remember one time, a pt yelled out, "what happened to my balls????!!!"
i took a peek, and the entire area was engorged...
i mean, really, really edematous.
stuff like that is valid reason.
i got the doctor and told him mr. __________ had "scrotomegaly"
the doctor laughed his butt off, telling me there was no such dx.
anyways, pt wasn't laughing.
dr. wanted me to make a 'support' and pack with ice.
it doesn't seem there is a tried and true remedy for such things.
2Mar 17, '10 by vivacious1healerQuote from TigerGalLEI guess it depend on the patient's mental status and condition. If a patient is A x O "walkie talkie" I don't assess their penis unless I'm helping them to the bathroom or something. If they are A x O then I expect they could tell me if something was wrong down there. If my patient's mental status is altered or if the patient is bed ridden I do a full head to toe skin assessment every shift.
Agreed with the above.
The only thing I will add is that I follow the foley tubing to make sure it's not under the legs or kinked in some fashion (can't tell you how many times I find that at the beginning of my shift!) and then with that ask if the patient has had any problems with the foley, pressure in the bladder, etc....