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Unformatted text preview: Female Reproductive System
Female L Meneghini, RN, MSN, CEN Female Genitalia
Bartholins Gland Female Genitalia
Ovaries Developmental Considerations
At onset of puberty, estrogen stimulates cell
growth and secondary sex characteristics
Menarche during latter half of puberty; irregular
menses common in adolescence Pregnancy Signs on Exam
Pregnancy 1) Cervical softening= Goodell’s sign at 4-6
2) Vagina and cervix cyanosis=Chadwick’s
3) Uterine Isthmus softens = Hegars sign
Other changes in pregnancy: pH &
hormonal changes increase risk of yeast
infection in pregnancy; Mucus plug forms
in Developmental Considerations: Menopause
Age: usually 48 to 51 within wide possible age
range (35 to 60). Definition of menopause =
cessation of menses for 12 full months;
preceded by 1 to 2 yrs of irreg menses
Estrogen and progesterone production in
ovaries declines rapidly
Physical changes after menopause: Uterus
decreases in size; mucosa thin & fragile;
decreased vag secretions & pH changes = risk
for Subjective Data
Last menses: First day of LMP
First menses: age at menarche
Duration: How many days bleeding?
Usual amount: light, medium, heavy?
Pain or cramps? (Dysmenorrhea) Subjective Data
Gravida – number pregnancies
Para – number of births
Abortions – interrupted pregnancies including
elective abortions and spontaneous
miscarriages Subjective Data
Menopausal symptoms and related data:
Irregular menses, hot flashes, numbness, mood
swings, vaginal dryness, using hormonal
replacement therapy- if so, side effects?
Perceptions about menopause Subjective Data
How often do you have a gynecologic exam?
Last Pap Smear date and results
DES baby? Diethystilbestrol (Taking of
hormones by mother which may cause cervical
or vaginal abnormalities in the offspring)
or Subjective Data
Burning painful urination (dysuria)
Blood in urine (hematuria)
Color of urine
Difficulty with urination
Loss of urine with a sneeze, laugh, cough,
bearing Subjective Data
Character or color (white, green, yellow, clear)
When did it start ?
Is it associated with itching, rash, odor, pain with
intercourse? Partner having symptoms?
History of diabetes (increases glycogen content) Subjective Data
Menstrual cycle now?
Use of vaginal douche?
Treated for discharge? Subjective Data
Any problems such as sores, lesions
Past history or surgeries Subjective Data
Relationships: Partners (male and/or female);
number of partners (current and lifetime)
Age at first sexual activity
Satisfaction with sexual relationships with your
Satisfaction with ability to communicate with
your Subjective Data
Subjective Contraceptive use:
Do you use contraceptives? What type(s)
Currently planning a pregnancy?
Problems getting pregnant? STI’s: In past or recent exposure? how
treated? Current symptoms?
treated? STI risk reduction: Subjective Data
Additional history for infants/children:
Problem with genital area such as rash, itching
Screen for sexual abuse
Additional history for adolescents:
Ask age appropriate questions about periods,
development, body change, sex, sexual
behavior, protection, STD, sexual abuse
behavior, Subjective Data
Vaginal bleeding after menopause ?
Vaginal itching, discharge or dyspareunia (pain
with sexual intercourse)?
Feelings of pressure in genital area and/or loss
of urine with cough, sneeze?
Current sexual relationship? Satisfaction? ...
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- Fall '10