CHAPTER |

The Female Genitalia

THE HEALTH HISTORY

Common or Concerning Symptoms Menarche, menstruation, menopause, postmenopausal bleeding Pregnancy Vulvovaginal symptoms Sexual activity

ASSESSING THE FEMALE GENITALS

PLANNING Delegation Due to the substantial knowledge and skill required, assessment of the female genitals and inguinal lymph node is not delegated to UAP. However, persons other than the nurse may record any aspect that is observed during usual care. Abnormal findings must be validated and interpreted by the nurse. Equipment Clean gloves Drape Supplemental lighting, if needed

CHAPTER |
IMPLEMENTATION Performance 1. Prior to the procedure, introduce self and verify the clients identity using agency protocol. Explain to the client what you are going to do, why is it necessary, and how she can cooperate. Discuss how the results will be used in planning further care or treatments. 2. Perform hand hygiene, apply gloves, and observe appropriate infection control procedures. 3. Provide for client privacy. Request the presence of another woman if desired, required by agency policy, or requested by the client. 4. Inquire regarding the following: age of onset of menstruation, last menstrual period (LMP), regularity of cycle, duration, amount of daily flow, and whether the menstruation is painful; incidence of pain during intercourse; vaginal discharge; number of pregnancies, number of live births, labor or delivery complications; urgency and frequency of urination at night; blood in urine, painful urination, incontinence; history of sexually transmitted disease, past and present. 5. Cover the pelvic area with a sheet or drape at all times when not being examined. Position the client supine with feet elevated on the stirrups of an examination table. Alternatively, assist the client into the dorsal recumbent position with knees flexed and thighs externally rotated.

IMPLEMENTATION ASSESSMENT NORMAL FINDINGS ABNORMAL FINDINGS

6. Inspect the distribution, There are wide Scant pubic hair (may amount, and characteristics of variations; generally indicate hormonal pubic hair. kinky in the menstruating problem) adult, thinner and straighter after menopause. Distributed in the shape Hair growth should not of an inverse triangle. extend over the abdomen. 7. Inspect the skin of the pubic area for parasites, inflammation, swelling, and lesions. To assess pubic skin adequately, separate the labia majora and labia minora. Pubic skin lesions. no Lice, lesions, scars, fissures, swelling, erythema, excoriations, Skin of vulva area slightly varicosities, or darker than the rest of leukoplakia. the body. Labia round, full, and relatively symmetric in adult females. 8. Inspect the clitoris, urethral Clitoris does not exceed 1 Presence of lesions. orifice, and vaginal orifice when cm in width and 2 cm in separating the labia minora. length. intact,

Sample only, for formatting purposes only.