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Female system gu
This document provides information on assessing the female genitourinary system, including: - The structures that make up the system and their functions - How to take a history, examine patients, and identify normal vs abnormal findings - Cultural and developmental variations - A case study of a patient complaining of scant midcycle bleeding, and the relevant history, exam findings, and potential nursing diagnoses for this patient
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Female system gu
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- 2. Outcomes Identify pertinent genitourinary historyquestions. Obtain a female genitourinary history. Perform a female genitourinary physical assessment. (Continued)
- 3. Outcomes Document pertinent genitourinary assessmentfindings. Identify actual/potential health problems stated as nursing diagnosis. Differentiate between normal and abnormal findings.
- 4. Structures Mons pubis Labiamajora & minora Clitoris Urinary meatus Perineum Bartholin’s glands Anus Cervix Uterus Fallopian tubes Ovaries Kidneys Urethra Bladder Vagina Skene’s gland
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- 6. Functions What are thefunctions of… Mons pubis: Subcutaneous pad over symphysis pubis for protection Labia majora/minora: Folds of adipose and connective tissue that protect and lubricate external genitalia (Continued)
- 7. Functions What are thefunctions of… Clitoris: Erectile tissue for sexual stimulation Urinary meatus: Opening to urethra Skene’s glands: Lubricate and protect (Continued)
- 8. Functions What are thefunctions of… Vaginal introitus: Opening of the vagina Vagina: Muscular tube for copulation, birth canal, and menses Bartholin’s glands: Secretes alkaline mucus that improves viability & motility of sperm (Continued)
- 9. Functions What are thefunctions of… Cervix: End of the uterus into vagina Uterus: Hollow, muscular organ; site for fertilized egg implantation; protects fetus (Continued)
- 10. Functions What are thefunctions of… Tubes: Passage for ovum to uterus, site of fertilization Ovaries: Produce ova, estrogen and progesterone Kidneys: Filter and excrete wastes (Continued)
- 11. Functions What are thefunctions of… Ureter: Connects kidneys to bladder Bladder: Hollow muscular structure; holds urine Urethra: Connects bladder to urinary meatus opening
- 12. Relationship to Other Systems Whatis the relationship of the female genitourinary system to other systems? Integumentary Gastrointestinal Lymphatic Musculoskeletal Cardiovascular Respiratory Endocrine Neurological
- 14. Developmental Variations Children—next quarter Pregnant clients—nextquarter Older Women Reproductive ability peaks in late 20’s Estrogen levels begin to decline, and between 46 & 55 menstrual periods become shorter, less frequent, & cease Increased risk of infection (decreased vaginal secretions)
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- 16. Case Study Mrs. James,29-year- old, married, mother of 4-year-old daughter, housewife C/O scant midcycle vaginal bleeding for past 2 months Annual PAP test and gynecologic exam
- 17. Symptoms What symptoms wouldsignal a problem with the female genitourinary system? Vaginal discharge Lesions Vaginal bleeding, pain Amenorrhea Urinary symptoms
- 18. Pertinent History Findings Midcycle vaginalbleeding Taking BCP, occasional ASA + History of rheumatic fever Gravida 1/para 1; menarche 12; LMP 21 days ago, cycle every 21-23 days, menses 5 days, moderate-to-light flow. Sexually active in monogamous, heterosexual relationship, satisfied with sexual performance
- 19. Physical Assessment Anatomical landmarks: external--note positionof structures; internal--visualize underlying structures Approach: inspection, palpation Position: lithotomy Tools: gloves, speculum, lubricant, light, slides and swabs for specimen collection General survey and head-to-toe scan
- 20. Inspection External genitalia: color,hair distribution, condition of skin, lesions, discharge, odor, pubic pediculosis, prolapse Rectal area: condition of skin, lesions, discharge, bleeding, hemorrhoids, fissures (Continued)
- 21. Inspection Pelvic exam: color,lesions of vaginal walls; color, lesions, discharge, position, size, shape, and patency of cervical os (obtain specimens)
- 22. Palpation Skene’s and Bartholin’sglands: masses, swelling, discharge, tenderness Vaginal wall: texture, swelling, lesions, tenderness Cervix: size, shape, consistency, position, mobility, tenderness Uterus: size, shape, symmetry, position, masses, tenderness
- 23. Palpation Ovaries: size, shape,symmetry, tenderness Anus and Rectum: sphincter tone, tenderness, lesions, masses, hemorrhoids, polyps; test any stool for occult blood
- 26. Pertinent Physical FindingsExternal genitalia pink,moist, intact; small amount of white, ordorless discharge; no lesions Vaginal walls and cervix pink, moist, intact; no lesions Uterus anteverted, no masses, non-tender Ovaries and tubes non-palpable No rectal masses; hematest negative
- 27. Nursing Diagnosis What actual or potential problemscan you identify for Mrs.James?