All about foundations of nursing

1. Robert.K
GENERAL EXAMINATION

2. Vaginal examination
 This is the examination of the vaginal canal to assess
aspects of gynecological conditions
 Indications
1. Gynecological conditions
 Tumor- cervical/uterine cancers
 Displacement of the uterus
 Cysts
 Abortion
 Abnormal vaginal discharges
 To exclude extra uterine pregnancies e.g. ectopic, abdominal
 Septed vagina
 Trauma
 Before insertion of a coil
 Contra indications
 Excessive vaginal bleeding
 A patient admitted fro trial labor

3. Vaginal examination cont’d
 Requirements
 Tray:
 Sterile bowel for lotion
 Gauze swabs aor cotton wool balls
 Sterile vaginal speculum in a reciever
 Sanitary pads
 Recievers
 Lotion)normal saline or 1:100 savlon
 Sterile gloves
 Obstetric cream(lubricating cream)
 Mackintosh and towel
 Torch or angled lamp

4. Vaginal examination cont’d
 Procedure
 Explain the procedure to the patient
 The bed is screened
 Ensure that the patient empties her bladder before
examination
 Place the mackintosh and towel under patient’s buttocks
 Help the patient into dorsal position with knees apart
 Wash hands and put on sterile gloves
 Re; assure and encourage the patient to relax
 The vulva is inspected for any abnormality
 Swab the vulva using sterile swabs for each part doing
the swabbing in the following order
 Left labia major then right labia major
 Left labia minor then right labia minor
 The vaginal introitus
 Insert lubricated fingers(index & middle fingers of the
examining hand into the vagina

5. Vaginal examination cont’d
After completion of the examination give the patient
sanitary pads
Clear away used equipments
1. Observations to record
I. External genitalia
 Edema, varicose veins, warts, perineal scars
II. Condition of the vagina
 It should be warm and easily distended with fingers.
Hotness indicates infection
 A tight vagina indicates a tense patient
 Any vaginal discharge is noted

6. Rectal examination
 Indications
1. For diagnostic purposes
2. To exclude imperforate anus in new born, hemorrhage
from the lower bowel
3. Growth e.g. hemorrhoids, enlarged prostate gland
4. To evacuate the rectum incase of impacted feces
 Requirements
 Tray with;
 A receiver with gloves
 A receiver with a proctoscope
 Lubricant
 Spatula
 Mackintosh and small towel to place under the buttocks
 Swabs in a galipot
 Ant septic solution in a galipot

7. Rectal examination cont’d
 Bed side
 Screen
 Bed pan toilet tissue
 Apron
 Procedure
 Explain the procedure to the patient
 Screen the bed and close near by windows
 Ensure that the patients bladder is empty
 Place a mackintosh and towel in position
 Place the patient in left lateral position, the knees are flexed to
the chest and buttocks at the edge of the bed
 Lubricate a gloved fore finger & gently insert it into the rectum
 After examination discard the gloves in a receiver
 Clean off the lubricant
 Clear away and leave the patient comfortable
 Wash hands
 Report and record findings