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EXAMINATION AND DIAGNOSIS PROCEDURES OF REPRODUCTIVE SYSTEM (PAP SMEAR…
EXAMINATION AND DIAGNOSIS PROCEDURES OF REPRODUCTIVE SYSTEM
GENERAL EXAMINATION
conjunctiva and the tongue for psllor in cases of anemia
the thyroid gland for hyper which could be present with menstrual abnprmalities
the breast to exclude it movement
the skin for cyanosis in cases of poor circulation
distribution of the hair
lower extremities for oedema
ABDOMEN AND PELVIS EXAMINATION
Inspection
observing the abdomen and assessing the vulva, the vagina, the inner aspect of the thighs
noting the size and shape of the abdomen
observing the condition of the skin for rashes, scars from previous surgery
noting the distribution of body and pubic hair
inspecting the labia majora and minora and separating these to expose the clitoris
inspecting all structures including the perineum and anal region for colour and warts
the vaginal introitus may be closed depending on parity
vaginal speculum may be used to further expose the inside of the vagina and access vaginal discharge for inspection
trauma or weakness of the anterior vaginal wall may manifest with cystocele
palpation
position the patient comfortable on her back
the nurse should make their hands warm
the nurse should use the palm of the hand rather than the tips of the finger
to assist relaxation the patient should be asked to take deep breath
if a mass is discovered it position, size, shape should be noted
the nurse should be able to feel the presence of free fluid in the peritoneum through palpation
VAGINAL EXAMINATION
ensure that the consent is obtained
the patient assumes adorsal lithotomy position with legs on stirrups
two fingers are introduced to the vagina in upward and backward direction to reach the opening of the cervix
vaginal and cervical ulceration, tears, polyps If present may be palpated
PAP SMEAR
wear well-fitting gloves for protection against body fluids and to prevent cross infection
moisten the vaginal speculum with sterile water and gently introduce this into the vagina
do not use the lubricant as this may contaminate the specimen
insert a cotton wool swab applicator and gently remove cervical secretions from the cervical os
transfer the secretions onto a glass slide and fix by spraying with fixative or place the swab in a tight sterile glass tube
it should be accompanied by a laboratory test requisition form with patient details
transport to laboratory immediately
CERVIX EXAMINATION
for right handed people the middle and fouth fingers of the right hand are placed in vagina
the palm of the hand are place din the vagina while the palm of the hand is placed in the abdomen between the umbilicus and symphysis pubis
this manoeuvre causes the body of the uterus to descend and become freely movable between the abdominal examining hand that are touching the vagina
percussion
enables the identification of fluid pr masses in the pelvic cavity
it is used to locate pain
auscultation
use stethoscope to listen to foetal heart sounds
RECTAL EXAMINATION
the patient lies in a lateral position with the knees flexed and pulled up to the abdomen
a gloved and lubricated index finger is gently inserted through the anus and moved around to feel weakeness on the wall
explain the examination to gain cooperation
ENDOSCOPIC EXAMINATION
colposcopy
visualisation of the cervix under a low-powered microscope
a sample of the suspicious cells id obtained either by a swab applicator a curettage
laparoscopy
it involves insertion of a laparoscope into peritoneal cavity
it Is done to introduce contrast media for visualisation of pelvic structures
hysteroscopy
it is useful in obtaining uterine polys and fibroids