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

Ch 24: Female genitalia and rectal assessment Flashcards

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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
Give two examples of acute infections
1. Pelvic inflammatory disease (PID) | 2. UTI with Nephrolithiasis or renal calculi
26
Give signs and symptoms for UTI with renal calculi and what you want to assess for
``` S & S (renal calculi) -flank pain CVA tenderness hematuria Dull/sharp pain ```
27
What medication is given for UTIs -what does it treat What are important patient teaching is related to this drug
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 
28
Give gastrointestinal illnesses that development to urgent assessments and where they are located within the abdomen
``` Gastrointestinal illnesses: -peritonitis :  -appendicitis : Right lower quadrant -pancreatitis : Epigastric -cholecystitis : Right upper quadrant -***strangulated hernia : femoral inguinal region etopic pregnancy ```
29
With ectopic pregnancies = urgent assessment what do you want to ask and why (the why as in what do they cause )
With ectopic pregnancies ask when was your last pregnancy because a pregnancy in Fallopian tube may cause peritonitis
30
 But obtaining subjective data major areas of data collection include
``` Menstrual obstetrical menopause gynecological sexual history ```
31
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
-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 
32
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)
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
 in regards to menopause for subjective data what is important information to ask the patient What are signs and symptoms of perimenopause
Age on starting last Pap smear Immunizations Perimenopause: - irregular periods - Hot flashes, night sweats - mood swings - vaginal dryness
34
If a patient comes in complaining of vaginal discharge what is vital to get from the patient and why
If patient comes in complaining of vaginal discharge get: Color Odor Consistency Amout -Done to assess for STI
35
Within sexual history for subjective data what are the five 5’s And why are they gathered
Five P’s: - Partners - practices - protection - Past STI - prevent pregnancy Gather to assess patient risks
36
Among adolescents, how should you assess the patient especially if what what should you teach During the exam (Give 2 actual examples)
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
What ages is the HPV vaccine recommended from, how many doses and who is the greatest risk for HPV, why
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
Give relevant risk factors to assess for when Obtaining subjective data
- 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
 What increases your risk for developing cancer as a woman | (Think genes)
Having a family history of breast cancer with abnormal BRCA 1and 2 genes + Exposure to DES
40
What are medications that change the menstral cycle, appetite, libido of women What medication increases the risk of yeast infections
Medication that change menstrual cycle, appetite, libido: -antidepressants/antihypertensives Medication to increase the risk of yeast infections: -antibiotics 
41
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
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
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
If patient has discharge stating to be white cheesy patches and to be on antibiotics : •patient has candidiasis
43
What are common symptoms in relation to the female genitalia and rectal assessments
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
In teenagers who present with pelvic pain/ tenderness what do you want to assess for and what is the reason (sti )
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
What are 3 causes of Amenorrhea 
amenorrhea: absence of period Causes: -Pregnant, ovulating, anorexia nervosa
46
What is considered to be sexual dysfunction among women when Seeking medical treatment
Sexual dysfunction considered in women with low libido and low lubrication
47
What are structural difficulties you must inquire about and what they cause among patients
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
What are additional questions you can ask pregnant women
Ask about any cramping Abnormal Pap smears Any bleeding or spotting requires further investigation Past STI‘s 
49
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
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
What are signs and symptoms of UTI’s among children
Dysuria Itching Infection
51
Come on you’re older population how do you know to assess for cancer
If those an older population have any bleeding post mensies during menopause assess for cancer
52
What are additional questions you wanna ask your older population -menopause symptom
Among older population (menopause)ask for the presence of vaginal dryness
53
What do you suspect if an older patient presents with vaginal pressure Give signs and symptoms
If patient presents with vaginal pressure = vaginal prolapse S&S: - urinary incontinence - cystocele: prolapsed bladder to vagina
54
If an older patient presents with a rectal pressure what do you suspect
Rectal pressure = rectocele or mass : Assess for prolapsed rectum to vagina
55
If there is a menstraul disorder involving excessive bleeding what do you want to assess for
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
What are lifespan considerations for women of different cultures/religions
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
What are vital instructions to give the patient in preparation of a Pap smear (pelvic exam) (3things)
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
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
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
What is vital to do for the patient in relation to their pap smears What was the woman do before getting pap smear
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
What kind of specular do we use for a Pap smear nowadays
We use plastic specula
61
Why is the lithotomy position used for Pap smears and vaginal exams
The lithotomy position gives direct visualization of the genitalia
62
What does it mean to see the nurses inspecting the introitus
Inspecting the introitus means the nurse is inspecting the vaginal opening
63
What are signs and symptoms a pregnant woman Is going through a ruptured membranes and what kind of assessment does it become
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
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
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
What cultural population has the highest risk for cervical cancer and the highest death rate from cervical cancer
Hispanics/Latinas have increased rates of cervical cancer and are more likely to die from cervical cancer
66
What cultural population has the highest risk of breast cancer and the worst outcome -Why
Mexicans have the highest risk for breast cancer in the worst outcome do to delayed care
67
Give common laboratory and diagnostic tests and what their purpose is
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
How do you conduct a clean catch/midstream for culture and sensitivity
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
What are nursing diagnosis related to female genitalia and rectal assessments
Ineffective sexuality pattern Risk for infection Ineffective health maintenance
70
What are outcomes related to female genitalia and rectal assessments
Patient reports coreect risk factors, causes, prevention strategies for STI Patient accurately reports disease process, treatment goals, potential S/E
71
What are nursing interventions for female genitalia rectal assessments
Offer variety of options for safe sex practices to provide choices, promote respect for differences
72
What does candidiasis present with What does the patient report with candidiasis while having sex
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
What can candidiasis be related to | 3 things
Chronic infection DM HIV
74
What does bacterial vaginosis present with 
1.creamy white to Grey secretions coding vaginal walls 2.STRONG fishy odor  3.vaginal itching/burning
75
How does chlamydia present What will you see upon inspection of Patients cervix With chlamydia
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
What will gonorrhea present to the patient with What will patient with gonorrhea report: What will the cervix of someone with gonorrhea look like
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
 What is Chancre and what is there to know about chancre
chnacre = syphilis | -w is a painless lesion
78
What is the lesion associated with HPV
Condyloma acuminatum is associated with HPV Described as fleshy pink/grey papilloma (wart like projections ) at vulva, vaginal, anu

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