Question 1- The techniques and assessment of an adult rectum
A rectal assessment is done on clients
with abdominal pain and any anxiety for blood loss. There are
different positions for the assessment of the rectum which
include:
- Standing position: The client should be upright with toes
pointing in and he should bend over a table.
- Sims position: Here, the client reclines on the left side with
the leg straight while the right hip/knee needs to be curved.
- Knee chest position: In this position, the client will be lying
on the table, face down(as in prone) and the knees bending forward
up to the chest.
Equipment
- Gloves
- Emollient/ lubricant
- Guaiac testing kit
- Towel or tissue paper
- Anoscopy / proctoscopy
Inspection
- Inspection the skin and anal margin
- Check if there are any fissures, hemorrhoids, warts, or
oozing.
Palpation
- With emollient on the index finger, tell the client to take a
deep breath and place the finger in a 6 o'clock position.
- Tell the patient to compress the finger with their anal
muscles, after identification of the external sphincter tone.
- Palpate the prostate gland and then the rectal wall beginning
from the 6 o'clock point clockwise to the 12 o'clock point (180
degrees) and come back to the 6 o'clock point and palpate the other
part of the rectal wall identifying the presence of mass, nodule,
pilonidal sinus, fistula, and tenderness.
Usual abnormal finding - Occult blood.