(3) Ask the patient about urinary patterns such as retention, urgency and
frequency. Ask the patient if he has noticed blood in his urine or if he has pain when
urinating. Ask the patient to urinate into a specimen cup. Assess the sample for color,
odor, and clarity.
(4) Provide the patient with a gown. and drape appropriately. Be sure to
wear gloves. Expose the genitalia and inguinal areas and proceed with the examination.
(5) Inspect the inguinal and femoral areas carefully for bulges. A bulge that
appears on straining suggests a hernia.
Look for nits or lice at the bases of the pubic hairs.
(7) Have the male patient assume a supine position. Begin assessment of the
male genital system by inspecting the penis. Look for ulcers, scars, nodules, or signs of
inflammation. Compress the glans gently between your index finger and thumb to open
the urethral meatus and inspect it for discharge.
(8) Inspect the scrotum. Note any swelling, lumps, or veins. Palpate each
testis and epididymis. Note their size, shape, consistency, and tenderness.
(9) During the examination, the male patient may have an erection and
probably be embarrassed about it. Explain to him that this is a normal response, and
finish your examination in an unruffled manner.
(10) Ask the female patient to empty her bladder before you begin the
examination. To assess the perineal area, position her in a dorsal recumbent position with
her head and shoulders slightly elevated to relax the abdominal muscles and so that both
you and the patient can see each other's face. Explain in advance what you are about to
(11) Assess the perineal area for character of skin and abnormal masses or
discharge. Spread her labia with a gloved hand and inspect the urethral meatus; it should
appear pink and free of swelling or discharge. In any patient, inflammation and discharge
may signal urethral infection. Ulceration usually indicates a sexually transmitted disease.
i. Musculoskeletal Assessment. Musculoskeletal assessment begins the
instant you see the patient. Good observation skills will enable you to gain information
about muscle strength, obvious physical or functional deformities or abnormalities, and
movement symmetry. If the patient's chief complaint involves a different body system, the
musculoskeletal assessment should represent only a small part of the overall assessment.
If the health history or physical findings suggest musculoskeletal involvement, analyze the
patient's complaints and perform a complete musculoskeletal assessment.