male and female genitalia

Question 1

male external genitalia

Answer 1

• penis
• scrotum
• inguinal area

Question 1

subjective data

Answer 1

• Frequency, urgency, & nocturia –> how often are you peeing
• Dysuria – difficulty going
• Hesitancy & straining
• Urine color – pale = overly hydrated. dark = dehydrated
• Past genitourinary history
• Penis-pain, lesion, discharge
• Scrotum-lump, self-care behaviors
• Sexual activity (# of partners) & contraceptive use
• Sexually transmitted infection (STI) contact –> asymptomatic until fullblown

Question 2

objective data for men

Answer 2

• Client Preparation
  
  • Position the male standing and it gown
    
    • Examiner should be sitting and u only lift gown high enough to see parts
  • Be matter-of-fact
  • Examiner’s demeanor should be confident, relaxed, unhurried, & businesslike
  • Use a firm, deliberate touch
• Equipment and Supplies
  
  • Disposable gloves
  • Flashlight (for possible transillumination) (can illuminate a mass)
  • Glass slide for cytology specimen –> for discharge

Question 3

penis inspection and palpation

Answer 3

• Inspect
  
  • base and pubic hair
  • skin of the shaft
• Palpate the shaft
• Inspect the foreskin
• Inspect the glans
• Palpate for urethral discharge

Question 4

scrotal inspection and palpation

Answer 4

• Inspect
  
  • size, shape and position
  • scrotal skin
• Palpate the scrotal contents
  
  • testis
  • epididymis
  • spermatic cord
• Transilluminate the scrotal contents
  
  • Only if abnormal swelling or mass was noted
  • Normal scrotal contents do not transilluminate

Question 5

inguinal inspection and palpation

Answer 5

• Inspect for inguinal and femoral hernia
• Palpate for inguinal hernia, femoral hernia and inguinal lymph nodes
  
  • Use NAVEL (ask patient to “bear down”
    
    • Nerve
    • Artery
    • Vein
    • Empty space
    • Lymphatics

Question 6

TSE

Answer 6

• Teach every male (13 years –adulthood)
• Points to include
  
  • T: timing, once a month
  • S: shower, warm water relaxes scrotal sac
  • E: examine, check for changes, report changes
    immediately
• Message for teaching is to emphasize familiarity with body in addition to cancer detection

Question 7

urinalysis

Answer 7

• Color : pale yellow to amber
• pH: 4.5-8.0
• Specific gravity: dilute at 1.003 to concentrated at 1.030
• Little or no protein
• No glucose
• Fewer than 5 red blood cells or white blood cells

Question 8

urinary fxn – BUN

Answer 8

• Measures urea, an end-product of protein metabolism
• 10-20 mg/dl
• Rises with a decrease in fluid volume or an increase in protein intake

Question 9

urinary fxn – creatine

Answer 9

• An end-product of muscle metabolism
• 0.7-1.5 mg/dl

Question 10

external female genitalia

Answer 10

• Vulva
• Mons pubis
• Clitoris
• Urethral meatus
• Vaginal orifice
• Hymen – not always seen

Question 11

internal female genitalia

Answer 11

• need speculum
• Vagina
• Cervix
• Uterus
• Fallopian Tubes

Question 12

subjective data for female

Answer 12

• Menstrual history
• Obstetric history
• Menopause (no period for 6 months in a row)
• Patient-centered care
• Acuter pelvic pain
• Urinary symptoms
• Vaginal discharge
• Past history
• Sexual activity
• Contraceptive Use
• Sexually transmitted infection contact

Question 13

objective data for females

Answer 13

• Client Preparation
  
  • Assemble equipment first & place within easy reach
  • Familiarize yourself with the vaginal speculum before the examination
• Equipment and Supplies
  
  • Sitting stool
  • Light
  • Vaginal Speculum: Graves (varied lengths & widths) or Pederson (narrow blades)
  • Water-soluble lubricant
  • Cotton-tipped applicators
  • Materials for cytologic study

Question 14

positioning for women

Answer 14

• Sitting at first to establish trust & rapport
• Empty the bladder before the exam
• Lithotomy position for the actual exam
  
  • Body supine
  • Feet in stirrups
  • Knees apart
  • Buttocks at the end of examination table
  • Arms at side or across chest
• Drape fully and expose only genitalia
• Examiner sits on a stool
• Communicate!!
• Use the educational or mirror pelvic examination to educate the woman during the exam and make her an active participant

Question 15

inspection of female external genitalia

Answer 15

• mons pubis
• labia majora and perineum
• labia minora, clit, urethral meatus, vaginal opening
• note: skin coloration, hair distribution, symmetry, lesions or cysts (can be normal)

Question 16

female external genitalia palpation

Answer 16

• Bartholin’s glands –> can palpate if full
  
  • 5 & 7 o’clock positions
• Urethra
• Pelvic musculature

Question 17

internal genitalia inspection

Answer 17

• Speculum examination
  
  • size of vaginal opening and angle of the vagina
  • Cervix & os
  • Vagina
• obtain cervical smears & cultures
• inspect vaginal wall

Question 18

internal female genitalia palpation

Answer 18

• begin bimanual exam
  
  • palpate vaginal wall, cervix, uterus, and ovaries
• perform rectovaginal exam: mid to late 30s when u start
  
  • change gloves

Question 19

prostate assessment

Answer 19

• Surrounds neck of bladder and urethra
• Lies between bladder, urethra, and rectum in male clients
• Consists of 2 lobes separated by a shallow grove called median sulcus
• Functions
  
  • Secrete thin, milky substance that:
  • promotes sperm motility
• Can be palpated through the anterior wall of the rectum
  
  • chestnut or heart-shaped
    organ

Question 20

rectum assessment

Answer 20

• Anus & Rectum
  
  • Anal Canal
  • Sphincters
    
    • external: composed of skeletal muscle. under voluntary control
    • internal: composed of smooth muscle. under involuntary control
• Anal columns
• Anorectal junction
• Anal valve
• Anal crypt
• Rectum
• Valves of Houston

Question 21

subjective data of rectum

Answer 21

• Usual bowel routine
• Change in bowel habits
• Rectal bleeding or blood in the stool
• Medications (laxatives, stool softeners, iron)
• Rectal conditions (pruritus, fissure(crevis), hemorrhoids, fistula(open hole))
• Family history
• Patient-centered care (diet of high fiber foods, most recent examinations)

Question 22

objective data

Answer 22

• Client Preparation
  
  • Perform on all adults and particularly those in middle & late years
  • Positions
    
    • Male
      
      • Left lateral decubitus
      • Standing with toes pointed together
      • Lithotomy
• Female – for rectal exam
  
  • Left lateral decubitus
  • Lithotomy

Question 23

inspect perianal area

Answer 23

• Anus and Rectum
  
  • lumps
  • ulcers
  • lesions
  • rashes
  • redness
  • fissures
  • thickening of the epithelium
• Sacrococcygeal area

Question 24

palpation

Answer 24

* Anus * Rectum * Prostate Gland * Note * size * Shape * surface --> smooth * consistency * mobility * sensitivity

Question 25

equipment and supplies rectal exam

Answer 25

* Gloves * Water-soluble lubricant * Penlight * Fecal occult blood test container