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Health Assessment > Ch 24: Female genitalia and rectal assessment > Flashcards

Ch 24: Female genitalia and rectal assessment Flashcards

1
Q

Where is the location of the mons pubis and what does it act as

What is its placement also known as

A

Mons pubis located directly over pubic bone

Access cushion the protects pelvic bone during intercourse

Most anterior

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2
Q

Where do the labia majora and labia menorah extend from and to

A

Labia majora and minora extend from mons pubis to perineum

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3
Q

What structure of the vagina is the homologue to the penis and how does it
Respond

A

The clitoris is the female homologue to the penis

It responds in erectile function with stimuli “ pleasure feeling” 

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4
Q

Where is the vaginal introitus located

 where is the perineum located

A

Vaginal introitus located posterior to urethra anterior to hymen

Vaginal perineum located Between the vaginal enteritis and rectum

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5
Q

What is the function of the Skenes gland

what is the function of the Bartholin gland

together what is the main function of the skins and Bartholin’s gland

A

Skenes gland produces clear lube during sex

Bartholin’s gland secrete mucus into vaginal introitus during sex

Together the skins and Bartholin gland function to prevent friction during intercourse

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6
Q

Where is the vestibule

A

Vestaview between labia menorah bound anteriorly by clitoris posteriorly by perineum

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7
Q

What is the vagina considered to be and where does it extends from

A

Vagina considered to be a muscular tube of tissue extending from vaginal introitus to uterus

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8
Q

What does uterus accept and do

Where is the uterus located

What happens if the uterus is not fertilized every month

A

Uterus accepts an implants ovum

Uterus located between bladder and rectum

If not fertilized each month the uterus will shed its endometrium

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9
Q

 What is the cervix what kind of opening does it have and what does the opening resemble

A

The cervix is the opening of the uterus

Cervix has an (OS) opening resembling a doughnut with a small hole at the center

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10
Q

What is the function of the fallopian tube

what are it’s three parts and where does fertilization occur

A

Fallopian tube function : transport ovum from ovaries to uterus

Three parts:
Isthmus
Ampulla-fertilization
Fimbre

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11
Q

When does the ovary develop

when does it shrink

what does it secrete

what does it provide

A

Ovary develops post puberty

Ovary shrinks post menopause

Over secretes estrogen/progesterone

Ovary provide ovum for fertilization

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12
Q

What is the age that menopause occurs and what is a criteria for menopause

Because you’re overies shrink what is no longer being made and what does that increase the risk for (bone)

A

Menopause occurs at 50–52 YOA
Menopause = no period +12 months

Due to over shrinking estrogen is no longer made which increases the risk for osteoporosis

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13
Q

What does the anterior pituitary secrete

What is the hypothalamus AKA
What does it tell the pituitary gland to do

A

Anterior pituitary: FSH/LSH

Hypothalamus a.k.a. inhibitor of prolactin release
-Tells pituitary gland to stop lactation

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14
Q

What do the ovaries regulate

A

Ovaries regulate secondary facial characteristics + growth, proliferation, maturation

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15
Q

Function of progesterone

Function of estrogen

A

Progesterone
-develops corpus luteum for implantation of embryo

Estrogen: develops secondary sex characteristics and contributes to vaginal growth, tubes, uterus

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16
Q

What functions do cyclic hormones drive
4 things
Expression and health

A

 -menstruation

  • reproduction
  • sexuality
  • physical and emotional health
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17
Q

What is a common sight among your pregnant women in the cervix and how does it present

A

Pregnant women have Chadwick’s Sign

A.k.a. early sign of pregnancy is a darkening bluish color to the cervix

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18
Q

What is noted among infants in the opening of the vagina

 why does this occur

How long does it take to resolve

A

Among infants in the vagina there is a noted pink discharge due to maternal estrogen

Pink discharge resolves within 1 to 2 weeks post birth

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19
Q

Among adolescents what is important to build and why

What is not necessary unless Adolescence or sexually active, if they are sexually active what is required

A

Among adolescents it’s important to build rapport establish an open line of communication

Unless an adolescent is sexually active genital assessments are not required

If sexually active adolescent will need annual Pap smear plus STD testing

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20
Q

What are changes that acompany life span considerations related to menopause

Anatomical structures (2)
Ragaue
A

Among women with menopause that have limited/absent estrogen

Noted:

  • decreased uterus size
  • ovaries shrink
  • flattened vaginal Ruege
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21
Q

What is dyspareunia

Who is dyspareunia common in

A

Dyspareunia : painful sex due to dryness 

dyspareunia common in women with menopause

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22
Q

What do your older population (women Who have gone through menopause) have because of limited estrogen what are the common ages
(Risk of)

A

Older population going through menopause have an increased risk of endometrial cancer and vaginal infections due to limited estrogen

Common in ages 45 to 55

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23
Q

When is the median age for menarche

How do African-American girls differ from the median age

A

Median age for Menarche 12 YOA

African-American girls may begin puberty before 8 YOA

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24
Q

What kind of assessment is severe pubic pain

What do you want to do if a woman presents with severe pubic pain

Give a few signs and symptoms of severe pubic pain
And 2 causes

A

Severe pubic pain = emergency

If a woman presents severe pubic pain get an accurate description of the pain

S & S:

  • Swelling/redness/warmth
  • Inflammation of labia
  • Abscess in Bartholin’s gland
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25
Q

Give two examples of acute infections

A
  1. Pelvic inflammatory disease (PID)

2. UTI with Nephrolithiasis or renal calculi

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26
Q

Give signs and symptoms for UTI with renal calculi and what you want to assess for

A 
S & S (renal calculi)
-flank pain 
CVA tenderness 
hematuria 
Dull/sharp pain
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27
Q

What medication is given for UTIs

-what does it treat

What are important patient teaching is related to this drug

A

Medication for UTI: Pyridium (Analgesic)
-Pyridium treats symptoms of UTI

Important patient teachings in regards to Pyridium include:
-** yellow and orange urine because of medications



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28
Q

Give gastrointestinal illnesses that development to urgent assessments and where they are located within the abdomen

A 
Gastrointestinal illnesses: 
-peritonitis : 
-appendicitis : Right lower quadrant
-pancreatitis : Epigastric
-cholecystitis : Right upper quadrant
-***strangulated hernia : femoral inguinal region
etopic  pregnancy
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29
Q

With ectopic pregnancies = urgent assessment what do you want to ask and why (the why as in what do they cause )

A

With ectopic pregnancies ask when was your last pregnancy because a pregnancy in Fallopian tube may cause peritonitis

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30
Q

 But obtaining subjective data major areas of data collection include

A 
Menstrual
obstetrical
menopause
gynecological
sexual history
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31
Q

Among menstrual history

  • how is the in the cycle calculated
  • what is the normal number of days within a cycle
  • How long should the flow last
A

-Menstrual cycle calculated from first day
of last period to first day of next period

Normal days
-28–32 days or 20–40 days

Flow should last 2 to 8 days


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32
Q

When obtaining obstetrical history for subjective data what is vital to know in regards pregnancies

what is the difference between preterm and termed labor
(Weeks)

A

in regards to obstetrical history ask the patient for their gravida if any or any abortions

Termed: + 37 weeks
Pre-term: before 37 weeks

33
Q

 in regards to menopause for subjective data what is important information to ask the patient

What are signs and symptoms of perimenopause

A

Age on starting
last Pap smear
Immunizations

Perimenopause:

  • irregular periods
  • Hot flashes, night sweats
  • mood swings
  • vaginal dryness
34
Q

If a patient comes in complaining of vaginal discharge what is vital to get from the patient and why

A

If patient comes in complaining of vaginal discharge get:

Color
Odor
Consistency
Amout

-Done to assess for STI

35
Q

Within sexual history for subjective data what are the five 5’s And why are they gathered

A

Five P’s:

  • Partners
  • practices
  • protection
  • Past STI
  • prevent pregnancy

Gather to assess patient risks

36
Q

Among adolescents, how should you assess the patient especially if what

what should you teach During the exam
(Give 2 actual examples)

A

Assess the patient in privacy not in front of parent especially if sexually active

For adolescence teach about STI risk and prevention including

  1. STI‘s may cause infertility because of Fallopian tube obstruction
    
    2.Chlamydia and gonorrhea can be without symptoms
37
Q

What ages is the HPV vaccine recommended from, how many doses

and who is the greatest risk for HPV, why

A

HPV vaccine recommended from ages 9–26 YOA, 2-3 doses

Men have the greatest risk of HPV due to strictures and urethral scarring because of STI‘s/STD’s

38
Q

Give relevant risk factors to assess for when Obtaining subjective data

A
  • obesity due to chronic heart disease, CAD
  • osteoporosis: screen past 65 years of age

-hormonal contraceptives plus tobacco
Increased DVT/PE risk

  • medications
  • fam hx Of breast/cervical cancer
  • Exposure to DES
39
Q

 What increases your risk for developing cancer as a woman

(Think genes)

A

Having a family history of breast cancer with abnormal BRCA 1and 2 genes
+ Exposure to DES

40
Q

What are medications that change the menstral cycle, appetite, libido of women

What medication increases the risk of yeast infections

A

Medication that change menstrual cycle, appetite, libido:
-antidepressants/antihypertensives

Medication to increase the risk of yeast infections:
-antibiotics


41
Q

What must a woman have done in order to be placed on Accutane (Isotretinoin )

What is required monthly

 what is the drug considered to be

If the woman is sexually active what is required from her

A

Before being placed on Accutane women MUST have two pregnancy tests negative

Monthly pregnancy tests are required before medication refills

Acutane considered severely teratogenic

If sexually active: patient should use two forms of contraceptives



42
Q

If a patient report discharge and after being assist with COCA you discover:

Patient has white cheesy patches and is on antibiotics

What do you suspect to be the issue

A

If patient has discharge stating to be white cheesy patches and to be on antibiotics :
•patient has candidiasis

43
Q

What are common symptoms in relation to the female genitalia and rectal assessments

A

Pelvic pain
-Assess pain, if childbearing age do pregnancy test as LAST assessment

 vaginal burning, discharge, itching 
-assessed for pediculosis, puritis 

condyloma
-warts in anus

vulvitis
-information of Vulva
Amenorrhea
-absence of period

Dysmenorrhea-
-Painful period 

Premenstrual syndrome(PMS)
-Emotional plus physical symptoms

44
Q

In teenagers who present with pelvic pain/ tenderness what do you want to assess for and what is the reason (sti )

A

And teenagers with a pink: access for obstructed fallopian tube due to the STI (gonorrhea)

-gonorrhea is often asymptomatic and untreated causing fallopian two complications

45
Q

What are 3 causes of Amenorrhea 

A

amenorrhea: absence of period

Causes:
-Pregnant, ovulating, anorexia nervosa

46
Q

What is considered to be sexual dysfunction among women when Seeking medical treatment

A

Sexual dysfunction considered in women with low libido and low lubrication

47
Q

What are structural difficulties you must inquire about and what they cause among patients

A

Structural difficulties include:

-endometriosis causing increased infertility

-Polycystic ovarian syndrome causing hertuism especially around
•abdomen and nipple
Ancanthisis nigricans: hyperpigmentation on Nick and armpits

48
Q

What are additional questions you can ask pregnant women

A

Ask about any cramping

Abnormal Pap smears

Any bleeding or spotting requires further investigation

Past STI‘s



49
Q

In newborns and children:

what is best to avoid and why

how do you assess for sexual abuse (what are signs)

 what do toddlers love to do in regards to their vagina

A

In newborn and children:

-it’s best to avoid bubble baths due to the risk of UTI but if you continue to bathe getting nonfragrant

Assess for sexual abuse if

  • bowel/bladder regression
  • any blood drainage
  • itching in general area could be hygiene related

Toddlers love to insert objects into vagina

50
Q

What are signs and symptoms of UTI’s among children

A

Dysuria
Itching
Infection

51
Q

Come on you’re older population how do you know to assess for cancer

A

If those an older population have any bleeding post mensies during menopause assess for cancer

52
Q

What are additional questions you wanna ask your older population
-menopause symptom

A

Among older population (menopause)ask for the presence of vaginal dryness

53
Q

What do you suspect if an older patient presents with vaginal pressure

Give signs and symptoms

A

If patient presents with vaginal pressure = vaginal prolapse

S&S:

  • urinary incontinence
  • cystocele: prolapsed bladder to vagina
54
Q

If an older patient presents with a rectal pressure what do you suspect

A

Rectal pressure = rectocele or mass

: Assess for prolapsed rectum to vagina

55
Q

If there is a menstraul disorder involving excessive bleeding what do you want to assess for

A

If a patient presents with excessive bleeding due to menstraul disorders assess the number of pads used in 24 hours and how soaked the pads become

56
Q

What are lifespan considerations for women of different cultures/religions

A

Women with different cultures/religions there may be rules as to who can see women unclothed and do pelvic exams

Women may require a chaperone to be present

Women are expected to protect and preserve virginity and private parts

57
Q

What are vital instructions to give the patient in preparation of a Pap smear (pelvic exam)
(3things)

A

WITHIN 24 HRS OF EXAM

  1. Do not be menstruating
  2. Do not have intercourse or any source of penetration
  3. No douching: washing/soaking inside of a vagina
58
Q

When a woman is receiving a Pap smear what position do you want to place her in including head of bed

Why do you want to give a mirror to a woman when receiving a Pap smear

What does teaching during Pap smear provide the patient

A

Position a woman getting a Pap smear in the lithotomy position with head of bed elevated to allow for visualization of vaginal structures

Give women mirror to teach structure and function

Teaching during Pap smears lets the patient relax

59
Q

What is vital to do for the patient in relation to their pap smears

What was the woman do before getting pap smear

A

It is vital to explain step-by-step what you’re doing to relax the patient

Patience miss empty bladder before getting Pap smears

60
Q

What kind of specular do we use for a Pap smear nowadays

A

We use plastic specula

61
Q

Why is the lithotomy position used for Pap smears and vaginal exams

A

The lithotomy position gives direct visualization of the genitalia

62
Q

What does it mean to see the nurses inspecting the introitus

A

Inspecting the introitus means the nurse is inspecting the vaginal opening

63
Q

What are signs and symptoms a pregnant woman Is going through a ruptured membranes and what kind of assessment does it become

A

With a ruptured membranes:

  • assess for footing: babies feet
  • umbilical cord around neck
  • hands

If a pregnant woman suffers a ruptured membrane it becomes an emergency C-section

64
Q

What are Life span considerations for children during physical exam

What are the Lifespan considerations for adolescence during physical exams and what do you want to give them during their genital exam

A

Children: have parent in room

Adolescent: give option to have parent in room
-When doing a vaginal exam on an adolescent use a mirror to educate on genitalia

65
Q

What cultural population has the highest risk for cervical cancer and the highest death rate from cervical cancer

A

Hispanics/Latinas have increased rates of cervical cancer and are more likely to die from cervical cancer

66
Q

What cultural population has the highest risk of breast cancer and the worst outcome
-Why

A

Mexicans have the highest risk for breast cancer in the worst outcome do to delayed care

67
Q

Give common laboratory and diagnostic tests and what their purpose is

A

Urinalysis (UA): UTI

HCG pregnancy test: if no mensies

Pap smear(pelvic exam): cervical cancer screening

Culture and sensitivity: known infection

Cervical swab: HPV

68
Q

How do you conduct a clean catch/midstream for culture and sensitivity

A

3 wipes:
Separate the labia use one tablet each side than one in the middle from top to bottom

Urinate a small stream
Stop
Place cup for collection
 Collect the remaining amount of urine

69
Q

What are nursing diagnosis related to female genitalia and rectal assessments

A

Ineffective sexuality pattern
Risk for infection
Ineffective health maintenance

70
Q

What are outcomes related to female genitalia and rectal assessments

A

Patient reports coreect risk factors, causes, prevention strategies for STI

Patient accurately reports disease process, treatment goals, potential S/E

71
Q

What are nursing interventions for female genitalia rectal assessments

A

Offer variety of options for safe sex practices to provide choices, promote respect for differences

72
Q

What does candidiasis present with

What does the patient report with candidiasis while having sex

A

Candidiasis will present with:

  • Vulvo vaginal edema
  • Thick white secretions along internal walls
  • Puritis/ erythrma

While having sex with candidiasis patient will report:
-dysparenia


73
Q

What can candidiasis be related to

3 things

A

Chronic infection
DM
HIV

74
Q

What does bacterial vaginosis present with



A

1.creamy white to Grey secretions coding vaginal walls

2.STRONG fishy odor

3.vaginal itching/burning

75
Q

How does chlamydia present

What will you see upon inspection of
Patients cervix With chlamydia

A

Chlamydia often asymptomatic but will present with clear white secretions

In patients with chlamydia youll see:
-changes in cervical condition
• reddened mucopurulent from 0S
• easy bleeding upon Pap smear

76
Q

What will gonorrhea present to the patient with

What will patient with gonorrhea report:

What will the cervix of someone with gonorrhea look like

A

Patient presentation:
- yellow vaginal secretions

Patient reports:
patient will report dysuria and dyspareunia

Gonorrhea cervix:
-Per you lent cervical discharge and tenderness and tenderness with pelvic exam

77
Q

 What is Chancre and what is there to know about chancre

A

chnacre = syphilis

-w is a painless lesion

78
Q

What is the lesion associated with HPV

A

Condyloma acuminatum is associated with HPV

Described as fleshy pink/grey papilloma (wart like projections ) at vulva, vaginal, anu

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