External Female Genitalia.330.No Pix.Gsu
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    External Female Genitalia.330.No Pix.Gsu External Female Genitalia.330.No Pix.Gsu Presentation Transcript

    • External Female Genitalia Nursing 330 Governors State University Shirley Comer
    • Relevant History
      • Menstrual History Obstetrical History
        • LMP Gravida
        • Age of menarche Para
        • Cycle characteristics abortions
      • Self care practices sexual activity
      • Urinary symptoms Vaginal discharge
      • Contraceptive use STD history
    • Inspection
      • Skin color
        • pink and smooth
      • Hair distribution
        • inverted triangle by age 13
      • Labia Majora
        • symmetrical and plump
      • No lesions
        • may be sebaceous cysts
          • small yellow firm nontender
    • Inspection cont
      • Inspect Clitoris
      • Labia minora
        • dark pink and symmetrical
      • Urethral opening
      • Vaginal opening (introitus)
      • Perineum
        • Episiotomy scar
      • Anus
        • increased pigmentation
    • Palpation
      • Glands
        • Skene’s glands- milk urethra through vagina
        • Bartolin’s glands- palpated in labia majora through vagina
        • Assess
          • Tenderness
          • Induration
          • Discharge
          • pain
    • Assess Support of Pelvis Musculature
      • Palpate perineum
        • Nulliparous-thick and smooth
        • Parous-thin and rigid
      • Ask pt to bear down
        • Should be no bulging or straining or urinary incontinence
    • Practice Exam Question
      • You are assessing your 12 year old female client upon admission to the pediatric unit. While helping her undress you notice a small amount of bloody discharge on her underwear. While questioning her and her mother about her health history, she denies the onset on menarche. What should you do next?
      • A. Ask the mother to step out for a moment and ask the patient about the bloody discharge you observed.
      • B. Tell the patient and her mother that you saw the the blood on her underwear
      • C. Perform an internal speculum exam
      • D. Assume you were mistaken
    • Rationale
      • A is the correct answer. A 12 year old girl may not admit to sexual activity or abuse in front of her parents.
      • B is incorrect as the mother may inhibit the pt or prevent her from reporting
      • C. is incorrect as you shouldn’t perform an internal exam but report your finding to the primary HCP
      • D. Trust yourself, you saw what you saw.