When assessing the anus, the nurse should inspect for: (Select all that apply)
A.
Bleeding
B.
Hemorrhoids
C.
Pain
D.
Prostate enlargement
The Correct answer and Explanation is:
When assessing the anus, the nurse should inspect for the following:
Correct Answers:
- A. Bleeding
- B. Hemorrhoids
- C. Pain
Explanation:
When assessing the anus, the nurse’s primary focus is on identifying any abnormalities or signs of distress that may indicate underlying health issues. The assessment involves both inspection and palpation, where appropriate. Here’s a detailed explanation of the correct options:
A. Bleeding
Bleeding from the anus is a significant finding that requires careful assessment. It may present as bright red blood on the surface of the stool, in the toilet bowl, or on toilet paper. Bleeding can be a symptom of various conditions, such as hemorrhoids, anal fissures, colorectal polyps, or even colorectal cancer. The nurse should document the amount, color, and frequency of bleeding, as these details are crucial for diagnosis and treatment.
B. Hemorrhoids
Hemorrhoids are swollen veins in the lower rectum and anus. They can be internal (inside the rectum) or external (under the skin around the anus). Hemorrhoids can cause symptoms like itching, pain, swelling, and bleeding. During inspection, the nurse should look for any visible external hemorrhoids or signs of discomfort that might suggest internal hemorrhoids. The presence of hemorrhoids is common, but they can cause significant discomfort and may require medical intervention if severe.
C. Pain
Pain during an anal assessment can indicate several issues, including anal fissures, abscesses, or infections. It is crucial for the nurse to note if the patient experiences pain upon palpation or during bowel movements. Pain can also be associated with hemorrhoids or other anal conditions. Understanding the nature, location, and severity of the pain can help in diagnosing the underlying cause and determining the appropriate treatment.
Incorrect Option:
- D. Prostate Enlargement Prostate enlargement is not something that can be inspected during an anal assessment. The prostate is a gland located near the bladder and is assessed through a digital rectal examination (DRE) by palpation, not inspection. This examination is performed to evaluate the size, shape, and texture of the prostate gland, and is typically part of a broader assessment for conditions like benign prostatic hyperplasia (BPH) or prostate cancer. However, it is not part of the visual inspection of the anus itself.
In summary, when inspecting the anus, the nurse should focus on identifying signs such as bleeding, hemorrhoids, and pain, as these can be indicators of common anorectal conditions. Prostate enlargement, while related to the rectal area, is not assessed through visual inspection of the anus but rather through a palpation technique.