Today our topic of discussion is Rectal Examination.
Rectal Examination
RECTAL EXAMINATION
Rectal examination is an essential part of every compre- hensive physical examination involves inspection and palpations (Fig. 28.50).
Purpose
- To identify the rectal problems
- To identify the enlargement of any part
- This performs only the inspection of the anus.
Methods and Position
- The rectal examination done by visual examination and digital examination of the anus and the rectum are indispensable for detecting and identifying lesions involving these structures
- Rectal examination may be done with the patient in the knee chest position, Sims lateral, or inverted position, on a special protoscopic table.
Preliminary Assessment
- Check the physician orders
- Explain the procedure to the patient
- Check the articles available in the patient unit
- Check the correct position of the patient
- Check the any precautions.
Preparation of the Patient and Environment
- Lubricate your index finger and instinct the client to beds downward as through having a bowel movement.
- This relaxes them and sphincles
- Slowly insert your finger into the rectum in the direction of the umbilicus
- The end canal distance from the end opening to the anorectal junction) is short (3 cm)
- The posterior wall of the rectum follows the curve of the cay coccyx and sacrum
- Never force digital insertion. If lesion and painful bleeding occurs disconnection the examination
- Ask the client to the end sphincters around your finger and note the tone of the end spooled
- Ask the client to tighten the and sphincters around your and note the tone of the anal sphincter
- Rotate the pad of the index finger a long the anal and rectal feeling for nodules masses and tenderness
- Note the location of any abnormalities of the rectum.
Equipments
- Gloves
- Lubricate Gauze piles
- Cotton
- Kidney tray
- Normal saline
- Soaps.
Procedure
- Inspect the anus and surroundings tissue for colon, integrity and skin lesion
- Then ask the client to bear down as through defecting
- Beading down creates sight pressure on the skin that may accentuate rectal lapse polyps
- Describe the location of all abnormal findings in items of check with the 2 o’clock position between the pubic symphysis
- Palpate the rectum for any sphincter ani take care of the patient who is under the effect of anesthesia
- Palpate the prostate gland.
Complications
- Internal hemorrhoids
- Rectal prolapse
- Polyps
- Tissue damage
- Tenderness.
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