RECTAL EXAMINATION – Purpose, Method and Position, Preliminary Assessment, Preparation of the Patient and the Environment, Equipments, Procedure and Complications
Rectal examination is an essential part of every comprehensive physical examination involves inspection and palpations.
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 instruct the client to bed downward as through having a bowel movement. This relaxes them
- 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 fingers and note the tone of the anal sphincter
- Rotate the pad of the index finger 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 slight 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 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
