190 CHAPTER 24 MALE GENITALIA

Normal Abnormal Data

Questions Findings Findings Missing

Past History

1. Previous problems related to your pelvic area

(surgeries, treatments, and results)?

2. Date of last testicular exam by physician or nurse

practitioner? Results?

3. Tested for HIV? Why tested? Results?

Family History

1. Family history of prostate or testicular cancer?

What type, and which family member(s)?

Lifestyle and Health Practices

1. Number of sexual partners?

2. Kind of birth control method?

3. Current or past exposure to chemicals or

radiation?

4. Usual daily activity?

5. Heavy lifting?

6. Genital problems that affect daily activities?

7. Fertility concerns? Effect on relationship?

8. Sexual preference?

9. Concerns related to sex?

10. Stress related to sex?

11. Knowledge of sexually transmitted diseases

and prevention?

12. Do you perform testicular self-examination?

Date last performed?

Activity E PERFORMING PHYSICAL ASSESSMENT

Use the following Physical Assessment Checklist as your guide to performing an assessment of male
genitalia. Column 1 can be used by you to guide your physical assessment. Column 2 may be used by
your instructor to evaluate your skills as necessary.

Physical Assessment Checklist

Findings Performance
(Normal or (Satisfactory,
Abnormal) Needs Improvement,
and Notes Unsatisfactory)

Assessment Skill N A S N U

1. Gather equipment (gloves, stool, gown, penlight). 䊐 䊐 䊐 䊐 䊐

2. Explain procedure to client. 䊐 䊐 䊐 䊐 䊐
3. Ask client to put on gown. 䊐 䊐 䊐 䊐 䊐

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 CHAPTER 24 MALE GENITALIA 191

Findings Performance
(Normal or (Satisfactory,
Abnormal) Needs Improvement,
and Notes Unsatisfactory)

Assessment Skill N A S N U

Penis

1. Inspect the base of penis and pubic hair for growth pattern and 䊐 䊐 䊐 䊐 䊐
excoriation, erythema, or infestation (client is standing while you sit).

2. Inspect the skin of the shaft for rashes, lesions, or lumps. 䊐 䊐 䊐 䊐 䊐

3. Palpate the shaft for hardened areas or areas of tenderness. 䊐 䊐 䊐 䊐 䊐
4. Inspect the foreskin (if present) for color, location, and integrity. 䊐 䊐 䊐 䊐 䊐
5. Inspect the glans for size, shape, lesions or redness, and location 䊐 䊐 䊐 䊐 䊐
of the urinary meatus on the glans (if uncircumcised, ask him to
retract his foreskin to allow for observation).

6. Palpate for urethral discharge by gently squeezing the glans 䊐 䊐 䊐 䊐 䊐

between the index finger and thumb.

Scrotum

1. Inspect the size, shape, and position (penis is held out of the way). 䊐 䊐 䊐 䊐 䊐
2. Observe for swelling, lumps, or bulges. 䊐 䊐 䊐 䊐 䊐
3. Inspect the skin for color, integrity, and the presence of lesions or 䊐 䊐 䊐 䊐 䊐
rashes. (Spread out the scrotal folds of skin to perform an accurate
inspection. Lift the sac to inspect the posterior skin.)

4. Palpate the scrotal contents (testes and epididymis) between your 䊐 䊐 䊐 䊐 䊐

thumb and first two fingers. Note size, shape, consistency, and
presence of tenderness or nodules. Palpate each spermatic cord
and vas deferens, noting nodules, swelling, or tenderness.

5. Transilluminate the scrotal contents (if a mass or swelling was 䊐 䊐 䊐 䊐 䊐

noted). Look for a red glow.

Inguinal Area
1. Inspect for inguinal and femoral hernia, watching for bulges while 䊐 䊐 䊐 䊐 䊐
the client bears down.

2. Palpate for inguinal hernia, observing for bulges or masses. Have 䊐 䊐 䊐 䊐 䊐

client shift weight to the left to palpate the right inguinal canal.
Place index finger into the right scrotum, and press upward to the
slit-like opening of the external inguinal ring. With finger in canal
or external inguinal ring, ask him to bear down or cough. Repeat
for left side.

3. Palpate for femoral hernia on the front of the thigh in the femoral 䊐 䊐 䊐 䊐 䊐
canal area. Ask him to bear down or cough while feeling for bulges.
Repeat on the other side.

4. Inspect and palpate for scrotal hernia (if a mass was detected during 䊐 䊐 䊐 䊐 䊐
inspection or palpation of the scrotum). Ask client to lie down, and
note whether the bulge disappears. If it remains, auscultate it for
bowel sounds. Then gently palpate the mass, and try to push it up
into the abdomen unless it is too tender.

Copyright © 2010. Lippincott Williams and Wilkins.

192 CHAPTER 24 MALE GENITALIA

Findings Performance
(Normal or (Satisfactory,
Abnormal) Needs Improvement,
and Notes Unsatisfactory)

Assessment Skill N A S N U

Analysis of Data

1. Formulate nursing diagnoses (wellness, risk, actual). 䊐 䊐 䊐 䊐 䊐

2. Formulate collaborative problems. 䊐 䊐 䊐 䊐 䊐
3. Make necessary referrals. 䊐 䊐 䊐 䊐 䊐

CHAPTER POSTTEST
Activity F MULTIPLE CHOICE
Choose the one best answer for each of the following multiple-choice questions.
1. During assessment of an elderly male client, the client tells the nurse that he has had diffi-
culty urinating for the past few weeks. The nurse should refer the client to the physician for
possible
a. inguinal hernia.
b. sexually transmitted disease.
c. impotence.
d. prostate enlargement.
2. A 25-year-old client asks the nurse how often he should have a testicular examination. After
instructing the client about the American Cancer Society’s guidelines, the nurse determines
that the client has understood the instructions when he says he should have a testicular
examination every
a. year.
b. 2 years.
c. 3 years.
d. 4 years.
3. A 45-year-old male client tells the nurse that he has had problems in having an erection for
the last couple of weeks but is “doing better now.” The nurse should explain to the client
that
a. transient periods of erectile dysfunction are common.
b. impotence in males should be investigated.
c. transient impotence may be indicative of prostate enlargement.
d. inguinal hernias have been associated with transient impotence.
4. A male client tells the nurse that his occupation requires heavy lifting and a great deal of
strenuous activity. The nurse should assess the client for
a. signs and symptoms of prostate enlargement.
b. erectile dysfunction.
c. inguinal hernia.
d. urinary tract infection.

Copyright © 2010. Lippincott Williams and Wilkins.