Female Genitourinary Assessment

Question 1

What genital changes may occur in a newborn?

Answer 1

External genitalia may be engorged at birth, recedes at around 2 weeks

Question 2

How many stages are there for the Tanner table?

Answer 2

5

Question 3

What is the first stage of the tanner table?

Answer 3

Prepubertal (can see velus hair similar to abdominal wall)

Question 4

What is the second stage of the tanner table?

Answer 4

Sparse growth of long, slightly pigmented hair, straight or curled, at base of penis or along labia

Question 5

What is the third stage of the tanner table?

Answer 5

Darker, coarser and more curled hair, spreading sparsely over junction of pubes

Question 6

What is the fourth stage of the tanner table?

Answer 6

Hair adult in type, but covering smaller area than in adult; no spread to medial surface of thighs

Question 7

What is the fifth stage of the tanner table?

Answer 7

Adult in type and quantity, with horizontal distribution (“feminine”)
What changes occur in the genitourinary system during pregnancy?

Question 8

What changes occur in the genitourinary system during pregnancy?

Answer 8

• Cervix looks cyanotic in the first 4-6 weeks
• Uterus being ascent (increases by 500-1000 times)
• Pressing on the bladder by 10-12 weeks
• Begins the displace intestine, rise to level of liver by 20-24 weeks
• Thicker, white vaginal secretions (acidic protection)

Question 9

When would a nurse expect to see reproductive changes start in young girls?

Answer 9

Puberty may being its onset between the ages of 8.5-13 years

Question 10

What changes may occur to the genitourinary system with aging?

Answer 10

• Menopause
• Ovaries and uterus shrink, ovaries become not palpable
• Uterus can prolapse into vagina
• Cervix shrink, paler in colour
• Vaginal dryness, fragile mucosa
• Thinning of pubic hair, less fat on mons pubis, external genitalia shrink

Question 11

Is female genital mutilation legal in Canada?

Answer 11

Female genital mutilation is illegal in Canada, and most western countries

Question 12

What kinds of health issue may arise with female genital mutilation?

Answer 12

It can lead to sex and childbirth difficulties, and painful menstruation

Question 13

What is amenorrhea?

Answer 13

An abnormal absence of menstruation

Question 14

What is menarche?

Answer 14

The first occurrence of menstruation

Question 15

What is menorrhagia?

Answer 15

Menstrual periods with abnormally heavy or prolonged bleeding.

Question 16

What is para?

Answer 16

Any women who has given birth once or more

Question 17

What is gravida?

Answer 17

The total number of confirmed pregnancies that a woman has had, regardless of the outcome.

Question 18

When does a woman know she is in menopause?

Answer 18

• When she does not have a menstrual cycle for one year or longer
• Hormonal shifts may occur: hot flashes, numbness and tingling, headaches, sweats, palpitations, mood swings, vaginal dryness and itching
• Perimenopause occurs between 40-55 years

Question 19

When should women start to have PAP tests

Answer 19

Screening every 3 years for sexually active women from ages 25-69 years

Question 20

What are PAP tests for?

Answer 20

They screen for cervical cancer

Question 21

How should a patient prepare for a PAP test?

Answer 21

• Not done while on period, or if patient is in an infectious state
• No douching, intercourse or object in vagina before specimen collection 24 hours before exam

Question 22

What should patient expect when experiencing a PAP test ( positioning, equipment, procedure)?

Answer 22

• Patient should empty bladder prior to exam
• Lie in a lithotomy position with draping
• She should be explained about showed the equipment
• Talked to throughout the procedure
• Mirror pelvic examination

Question 23

Are practitioners required by law to report sexual abuse of minors?

Answer 23

Yes, if there are any concerns of sexual abuse, they need to be reported.

Question 24

What should a clinician include in assessing adolescents for a genitourinary history?

Answer 24

• Talk about the start of her period, breast and pubic hair development
• Becoming sexually active
• Hpv vaccines
• Sexual abuse

Question 25

What is atrophic vaginitis?

Answer 25

Vaginal itching, discharge, pain with intercourse

Question 26

What is uterine prolapse?

Answer 26

Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken, providing inadequate support for the uterus. The uterus then slips down into or protrudes out of the vagina.

Question 27

What additional questions might you ask an older woman when taking a genitourinary history?

Answer 27

Ask if they have any postmenopausal bleeding, atrophic vaginitis, uterine prolapse, and ask about her sexual satisfaction

Question 28

Where are the Skenes glands located?

Answer 28

On the anterior wall of the vagina, around the lower end of the urethra

Question 29

Where are the Bartholian glands located?

Answer 29

located slightly posterior and to the left and right of the vaginal opening

Question 30

What is Chadwicks sign?

Answer 30

• Bluish discoloration of the cervix, vagina, and labia from increase blood flow
• Can be observes 6-8 weeks after conceptions
• Its presence is an early sign of pregnancy