Nursing Assessment of the Genitourinary System III: Percussion and Auscultation

The nursing assessment of the genitourinary system uses critical techniques, such as percussion and auscultation.

Fist percussion, commonly known as the "kidney punch," assesses kidney tenderness by striking the costovertebral angle between the spine and the 12th rib.

Pain elicited during this test may suggest conditions such as pyelonephritis or kidney stones.

Similarly, bladder percussion is most effective when it contains at least 150 milliliters of urine.

A dull sound is produced above the symphysis pubis. With severe bladder distention, the dullness may extend toward the umbilicus.

Auscultation is used to identify bruits, which are low-pitched murmurs caused by turbulent blood flow.

Bruits may indicate vascular conditions such as renal artery stenosis or abdominal aortic aneurysm.

To detect these sounds, place the stethoscope's diaphragm slightly to the right and left of the midline in the upper abdominal quadrants.

The abdomen is also assessed for ascites, which refers to fluid accumulation in the peritoneal cavity.

Ascites may result from kidney dysfunction or liver disease.