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Genitals and Inguinal

Assessment
Female Genitals and Inguinal Area
♂External Female
Genitals
 mons pubis
 prepuce
 clitoris
 labia majora
 labia minora
 urethra
 vagina
 vestibule
 perineum
Anatomy
♂ Internal Female
Genitals
 fallopian tube
 ovary
 uterus
 bladder
 urethra
 Bartholin’s gland
Five Stages of Pubic Hair
Development
 Stage 1

 Stage 2

 Stage 3

 Stage 4

 Stage 5
Assessment

♂ Genitals
 external genitals
 Internal genitals

♂ Reproductive Tract

♂ Inguinal Lymph Nodes


Assessment

♂ Equipment
 drape

 examination
gloves

 supplemental
lighting, if needed
Assessment
 Implementation
1.Explain the procedure to the client.

2. Wash hands, apply gloves and appropriate


infection control procedures.

3. Provide for client privacy.


Assessment
4. Inquire client’s history:
♂ age of onset of menstruation
♂ last menstrual period (LMP)
♂ regularity of cycle, duration, amount of
daily flow, and whether menstruation is
painful
♂ incidence of pain during intercourse
♂ vaginal discharge
♂ number of pregnancies
History
♂ 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
Assessment
5. Position the client
supine with feet
elevated on the
stirrups of an
examination table.
Alternately assist
the client into the
dorsal recumbent
position with knees
flexed and thighs
externally rotated.
Assessment
6. Inspect the distribution, amount, and
characteristics of pubic hair.
7. Inspect the skin of the pubic area for
parasites, inflammation, swelling and
lesions.
8. Inspect the clitoris, urethral orifice and
vaginal orifice when separating the labia
minora.
9. Palpate the lymph nodes.
10. Document findings.
Internal Genitals
 Involves the following
a. palpating Skene’s and Bartholin’s glands

c. asessing the pelvic musculature

e. inserting a vaginal speculum to inspect


the cervix and vagina

g. obtaining a Papanicolaou smear


Internal Genitals
♂ Nursing Responsibilities
2. Assembling the equipment
3. Preparing the client.
4. Supporting the client during the
procedure.
5. Monitoring and assisting the client
after the procedure.
6. Documenting the procedure.
Vaginal Speculum
Papanicolaou Smear

 Inserting a vaginal speculum and


obtaining a specimen
Normal Cervical Mucus
 wet, clear, slippery,  sticky, white, cloudy,
fertile mucus infertile mucus (on the
left)
Lifespan Considerations
♂ Infants
 Can be held in a supine position on the
mother’s lap with knees supported in a
flexed position and separated.

 The labia and clitoris may be edematous


and enlarged and there may be white
vaginal discharge
Lifespan Considerations
♂ Children
 Ensure that you have parent or guardian’s
approval to perform the examination and
tell the child what you are going to do.
 Assessment of adolescent girls is limited to
inspection of the external genital unless,
unless the girls is sexually active.
 The clitoris is a common site for syphilitic
chancres in younger females
Lifespan Considerations
♂ Elders
 Labia are atrophied and flatter
 The vulva, falllopian tubes and ovaries atrophy
 The clitoris is a common site for cancerous
lesions
 The vaginal environment becomes dier and
more alkaline
 The cervix and uterus decrease in size
 Ovulation and estrogen production cease
 Prolapse of the uterus