Renal System Examination

Question 1

What is the first step?

Answer 1

General inspection

Question 2

What are you looking for on general inspection?

Answer 2

Colour
Tremor
O2
Dialysis Machine
Vomit bowl

Question 3

What do you do after general inspection?

Answer 3

Inspect the hands

Question 4

What do you inspect the hands for?

Answer 4

Clubbing
Peripheral Cyanosis
Leukonychia

Question 5

What else to you check on the hands?

Answer 5

Asterixis
Skin turgor

Question 6

What do you access after hands ?

Answer 6

Arms

Question 7

What do you inspect on the arms?

Answer 7

if there is Arteriovenous Fistula ( Inspect, Palpate, Auscultate )
Palpate radial pulse
Offer to measure BP

Question 8

What do you access after arms?

Answer 8

Face

Question 9

What do you look for on the face?

Answer 9

Malar Rash
Conjunctival Pallor
Gingival hypertrophy

Question 10

What do you look at after the face?

Answer 10

Neck

Question 11

What do you examine for on the neck?

Answer 11

Jugular Venous Pressure
Evidence of scarring from dialysis catheter

Question 12

What do you examine after the neck?

Answer 12

Chest

Question 13

What do you assess the chest for?

Answer 13

Inspect
Palpate for pleural effusion
Palpate Apex Beat
Auscultate heart murmurs
Percuss lung fields
Auscultate lung bases

Question 14

What do you examine after the chest?

Answer 14

Abdomen

Question 15

What do you do to the abdomen?

Answer 15

Abdominal inspection ( scars, catheter etc )
Palpate 9 regions lightly
Palpate 9 regions firmly
Ballot the kidneys
Assess for shifting dullness
Auscultate renal bruits

Question 16

What do you examine after the abdomen?

Answer 16

Sacral and peripheral pitting oedema

Question 17

What do you do to complete the examination?

Answer 17

Blood pressure
Fundoscopy
Urinalysis
U&Es