When performing a scrotal examination, Nurse Payne finds a nodule. What should the nurse do next?
A. Notify the physician.
B. Change the client’s position and repeat the examination.
C. Perform a rectal examination.
D. Transilluminate the scrotum.
Correct Answer: D. Transilluminate the scrotum.
A nurse who discovers a nodule, swelling, or other abnormal findings during a scrotal examination should transilluminate the scrotum by darkening the room and shining a flashlight through the scrotum behind the mass. A scrotum filled with serous fluid transilluminates as a red glow; a more solid lesion, such as a hematoma or mass, doesn’t transilluminate and may appear as a dark shadow.
Option A: Although the nurse should notify the physician of the abnormal finding, performing transillumination first provides additional information. Fortunately, with a careful history and physical examination, physicians can usually identify those patients with potentially serious conditions. Because of the possibility of emergent and life-threatening causes, and because a swollen scrotum is usually of great concern to patients, immediate evaluation is always required.
Option B: Scrotal masses are best categorized by their anatomic origin. Because the anatomy of the scrotum is easy to appreciate on physical examination, identifying normal anatomy by inspection and palpation will usually lead to an accurate differential diagnosis of most scrotal masses
Option C: The nurse can’t uncover more information about a scrotal mass by performing a rectal examination. Careful physical examination should include attention to the location of the swelling in relation to the normal anatomic structures within the scrotum, and transillumination to check for testicular masses.
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