Nursing Assessment of the Genitourinary System II: Inspection and Palpation

The nursing assessment of the genitourinary system starts with an inspection and palpation to detect urinary abnormalities.

Begin by inspecting the mouth for signs of uremic fetor, which suggests advanced kidney disease.

Check the skin for pallor, yellow-gray discoloration, or bruising, which may indicate renal dysfunction.

Look for generalized edema in the face and extremities, which often signals fluid retention from kidney problems, such as nephrotic syndrome.

Next, inspect the abdomen: A midline mass could indicate bladder distention, whereas a flank mass may suggest kidney enlargement from tumors or polycystic kidney disease.

To palpate the right kidney, place the left hand behind the patient’s right side, between the rib cage and iliac crest.

Use the right hand to palpate deeply, feeling for the kidney’s smooth, rounded lower pole that descends on inspiration.

When palpating the bladder: If distended, the bladder will feel smooth, firm, and tender.

Finally, assess for costovertebral angle tenderness between the 12th rib and spine, suggesting kidney infection or inflammation.