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Digital Rectal Exam

Introduction

Greetings
Hand wash
Verify the patient's identity
Explanation of the examination
Obtain consent
Offer presence of a chaperone
Ask about any current pain
Position patient

Left lateral position with knees bent towards chest

Inspection

Check for skin excretions
Look for skin tags
Identify any external haemorrhoids
Look for anal fissures
Check for external bleeding
Identify any anal fistulas

Palpation

Lubricate examining finger
Insert finger into anal canal
Assess prostate gland

Palpate anteriorly, noting size, symmetry, and texture

Assess anal canal

Rotate finger 360° to assess entirety of rectum

Assess anal tone
Ask patient to squeeze examining finger
Withdraw finger and inspect for blood/mucous
Ask patient to cough

Check for rectal prolapse

Conclusion

Clean patient and cover
Summarize findings
Suggest further tests if needed

Exam Progress

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