During a history,the patient states,"It really hurts back there,and sometimes it itches,too.I have even seen blood on the tissue when I have a bowel movement.Is there something there?" The nurse should expect to see which of these upon examination of the anus?

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These symptoms are consistent with an external hemorrhoid.An external hemorrhoid,when thrombosed,contains clotted blood and becomes a painful,swollen,shiny blue mass that itches and bleeds with defecation.When the external hemorrhoid resolves,it leaves a flabby,painless skin sac around the anal orifice.An internal hemorrhoid is not palpable,but may appear as a red mucosal mass when the person performs a Valsalva maneuver.A rectal prolapse appears as a moist,red doughnut with radiating lines.

During a History,the Patient States,"It Really Hurts Back There,and Sometimes