Do you assess your patients penis daily?

Had a patients wife come to me the other day regarding her husbands penis being swollen (along with his LE edema). Later in the day, an ancillary staff came to me stating pts wife was upset with me because I didnt properly assess the patient regarding the penis swelling and she wanted to tell the MD (although manager and another ancillary stated the pts wife was happy with care and said our staff was great, but this other ancillary staff is known for starting drama). Pt had no hx of CHF or urological issue.... I was swamped with other pts r/t discharges, new post-op and one pt who had come back from a procedure, but I did get a chance a few hrs later (after taking a 3pm lunch break after being there since 6:30am) to page MD (who had already been and assessed pt himself) and got order for small dose IV Lasix.

Long story short, I informed charge nurse and manager what this ancillary said - and I asked other nurses on the floor... "Do you look at your patient's penis everyday?" Everyone said no. (I will assess if pt was admitted or had a known issue with his penis).

Just curious... When you do your assessment (mainly on a med surg floor.. not critical care or urology), do you look at your patients genitals (this can include vaginas too!)?
I guess it depend on the patient's mental status and condition. If a patient is A x O "walkie talkie" I don't assess their penis unless I'm helping them to the bathroom or something. If they are A x O then I expect they could tell me if something was wrong down there. If my patient's mental status is altered or if the patient is bed ridden I do a full head to toe skin assessment every shift.

There are enough old men bozos who take every opportunity to show off their "stuff" without me going around looking for it. With a confused pt I do a careful body assessment as they usually can't tell me everything that's wrong. When someone is O x 3 I expect them to share their concerns. In short I don't look at ANYBODYS genitalia everyday, unless their admitting DX warrants that look. If they're admitted with pneumonia, I zero in on the resp status. Fractured hip, CSM, incision site. AMS, neuro status....... It amazes me that everyday nurses are beat up for what they didn't do, as opposed to what we do.

I would think it was weird if I was a A&O X 4 pt and the nurse asked to look at my genitals. As others have said, I only take a look if they are confused for skin issues.

Was the patient upset with the MD too that they didn't do a thorough physical exam?Most of my patients are A&O coming in for elective surgery to their knees or hips, so no I don't assess genitalia unless there's an indication I should. We let them do their own foley care if they have one, and are doing their own AM washup (We'll wash their back and butt, but they gotta wash their front!). If they've been on antibiodics for several days, I'll ask them to be on the lookout for a red fungal type rash and ask them about that.If they are confused, I'll check them out head to toe usually.

We're on a med surg floor (not urology) but colo rectal and our nurses do look at "the area" and ALL parts of the patients body when doing the assessment. Usually a pcna (nurse assistant is present to help look at parts as well to be their "witness") This is because we've found in the past really "odd" things under or on the patient.You won't believe how many patients will put things under them. ie pens, pencils, bottles, books, tape, cell phones, etc. I had one pt place a switch blade under him. You can imagine my surprise when the pt turned and it popped open at me!For whatever reasons this is also the time we learn that the pt has a fungal issue, rash, STD, etc and we get the doctor to treat them. Or we learn that the pt has a history of having swollen testicles and refuses to tell the doctor in advance of surgery!We've learned our lessons and now it's just the thing we all do without question...However I'm in agreement that many male pts just can't wait to show off their body parts at all hours of the day/night. Which can be frustrating when you're trying to educate the pt or ambulate them.

Only if there is some issue with it, or if they have a catheter. I've never heard of it being part of normal pt assessment or for fluid overload.

i don't unless there is concern.i remember one time, a pt yelled out, "what happened to my balls????!!!"i took a peek, and the entire area was engorged...i mean, really, really edematous.stuff like that is valid reason.i got the doctor and told him mr. __________ had "scrotomegaly"the doctor laughed his butt off, telling me there was no such dx.anyways, pt wasn't laughing.dr. wanted me to make a 'support' and pack with ice.it doesn't seem there is a tried and true remedy for such things.leslie

Quote from TigerGalLEI guess it depend on the patient's mental status and condition. If a patient is A x O "walkie talkie" I don't assess their penis unless I'm helping them to the bathroom or something. If they are A x O then I expect they could tell me if something was wrong down there. If my patient's mental status is altered or if the patient is bed ridden I do a full head to toe skin assessment every shift.

Quote from leslie :-D dr. wanted me to make a 'support' and pack with ice.leslie

This post reminded me of time I was soooo embarrassed. The patient was an elderly gentleman who was also hard of hearing. He had a foley in that had been draining okay, but sometime during the shift, he started draining bloody urine into the bag, he also had some blood on his gown. I went into his room and pulled the curtain, I told him I needed to check his foley and penis...he kept yelling " What?" And I kept getting louder....."I need to see your penis." He was really HOH. Finally, he understood, I did what I had to do, opened the curtain and there was his son....soon as he seen me, he started laughing hysterically! He couldn't even talk, just point and laugh. Then, the other nurses on the floor started...."Did you see his penis, Kathy?" Apparently they could her me at the nurse's station! It was too funny.

It depends on the situation. If the patient is A&O and independent then like someone already mentioned I would expect them to tell me and this has happened before. In our physical assessment questionaire part we ask about the genitourinary system also and daily when you assess their voiding patterns. Sometimes if you are bathing someone you would do a quick assessment and of course we assess in critical care patients when you do your initial head to toe/visual survey.

Doesn't this person receive daily hygiene? whomever is helping him with his daily bath should be spoken to, as a former PCA in a hospital, i know that if i saw any "parts" swollen i would report it to the RN.