Rapport with patient
- Introductions
- Position to 45 degrees first
- Expose neck
- Inspection of patient & surroundings (Note Mental State)
- Diagnostic Facies
- Pigmentation
- IV access
- Vascath
- AV Fistula
- IDC
- Dialysis bag
Ask for relevant Vitals
- Postural BP
- Temperature
Examination of Hands
- Arthropathy
- Assessing for renal flap
- Nails
- Brown lines
- Distal arc
- Leuconychia
- Palms
- Polycythaemia
- Vasculitis
Examination of Arms
- Bruising
- Scratch marks
- Wasting
Assess AV fistula
- Thrill
- Bruit
Examination of Eyes
- Jaundice
- Conjuncitval Pallor
- Iritis /Scleritis
- Band keratopathy
Examination of Mouth
- Stomatitis
- Foetor
- Ulceration
- Mucosal moisture
Assess JVP
Reposition supine on 1 pillow
Exposure of Abdomen ‘nipples to knees’
Inspection of Abdomen
- Distension
- Tenchkoff
- Scars
- Masses
- Kidney Transplant
Palpation
- Superficial Palpation
- Outline masses
- Ask if any area tender first
- Deep Palpation
- Palpate for AAA
- Ballot kidneys
- Palpate and percuss bladder
- Palpate Liver and Spleen if PCKD
- Liver edge
- Liver height
- Spleen
- Ascites
- Shifting dullness
- Fluid thrill
Groin Examination
- Auscultation
- Renal Bruits
- Ask to perform rectal examination
- Prostatomegaly
- Ask for pelvic examination if female
- Examine Groin (Repeat examination standing)
- Testicles
- Epididymis
- Cremasteric ref
- Inguinal nodes
- Herniae
- Urethra
- Reposition sitting on edge of bed
Examine Back
- Flank tenderness
- Oedema
- Bruising
- Examination of Lower Limbs
- Oedema
- Bruising
Ask for Adjuncts
- Urinalysis - Weight
- Fluid balance
Ask to examine other systems
- Cardiovascular for CCF
- Neurological for peripheral neuropathy
- Fundoscopy for retinopathy