Question

Part 3

T.A. is a 20-year-old female nursing student who is being seen in the OB-GYN clinic for a yearly physical.

Subjective Data
The patient asks about birth control options
States she feels fine physically, no complaints at this time
Enrolled in college for nursing
Has steady boyfriend, 1-year relationship
Sexually active
Lives on campus
Nonsmoker
Exercises 3 times a week

Objective Data
Vital signs: T 37 P64 R 12 BP 104/64
Weight: 135 lbs.
HT: 5 feet, 3 inches
Last menstrual cycle = 10 days ago
Current birth control method = condoms

Questions:

1. What patient care equipment does the nurse need for this visit?
2. What personal protective equipment does the nurse or provider need to prepare for this visit?
3. Describe proper hand hygiene.
4. What other information needs to be gathered for this patient?
5. What techniques of physical assessment might be used in this visit?
6. What teaching should the nurse consider from the information gathered?

Answer 1

ANSWERS

It is a challenging step to perform the physical examination and very crucial to develop a trustworthy relationship before proceeding. Always begin by explaining the procedure and article and their use. Ask the patient to ask the doubt freely.

1. Patient care equipment needed for the visit includes Lubricant, vaginal speculum, cervicovaginal swab, Stethoscope or doppler transducer, Blood pressure monitor, ultrasound gel, screen to cover the patient, minimum exposure of parts, gauze pads

2. The nurse should wear gloves, gowns, and surgical masks before preparing for the visits.

3.Hand hygiene should be performed before and after patient contact , contact with infectious materials. Hand hygiene should include the use of 60-90% alcohol or washing hand water and soap for 20sec.

4.Assesment includes the following steps:

• History
• Physical examination
• Genital examination
• Pressure and touch sensitivity
• Mechanical pain threshold
• Quantitative sensory testing for assessment of myelinated A BETA FIBERS
• Bulbocavernoses reflex testing to check the conduction time to pelvic floor muscles
• Current and past sex practice
• Menstrual history
• Abdominal or pelvic pain - Onset, Site, Character, Radiation, Time course
• current or past contraceptive methods
• history of postcoital Vaginal bleeding
• Breast examination - check for any abnormalities

5.The nurse should provide the following teaching in detail

1. she should explain the safe contraceptive methods other than condoms
2. Teaching proper techniques of breast self examination
3. Ask the patient to observe the bleeding for frequency and amount
4. Note the date of the menstrual cycle
5. wether the patient is fit or not