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NURS 306 Health Assessment Final:
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NURS 306 Health Assessment Final:3 hours for exam – have VSIM and PrepU done by Wednesday
Reproductive System
- Female System:
- Lymphatics of Female:
o Vulva to lower vagina – drain into inguinal nodes
o Internal genitalia – drains into pelvic/abdominal nodes (not palpable)
- Reproductive History:
o Menstrual
▪ Menarche: age at onset of menses
, ▪ Menopause: absence of menses for 12 consecutive months (48-
55 years)
▪ Postmenopausal bleeding: occurring 6 months or more after cessation
of menses
▪ Amenorrhea: absence of menses
▪ Dysmenorrhea: pain with menses
▪ Polymenorrhea – menses occurs every fewer than 21 days
▪ Oligomenorrhea – infrequent bleeding – skip some months – see
in athletes
▪ Menorrhagia – excessive bleeding lasting longer than 7 days
▪ Metrorahhgia – intramenstrual bleeding – bleed between periods
▪ Poccoital – bleeding after intercourse
▪ Premenstrual Syndrome (PMS): cluster of emotional, behavioral and
physical symptoms occurring 5 days before menses for 3
consecutive cycles
▪ Frequency – every 24-32 days (average 28 days)
▪ Duration – 3-7 days
▪ Men should be involved – especially with ovulation:
• Mid-term – 10-16 days into cycle (with 28 day cycle)
• How do you tell? – Some people feel it, temperature goes up
o Obstetric
▪ Pregnancy:
• Gravida (G): total number of pregnancies
• Para (P): outcomes of pregnancies
o F: full-term
o P: premature
o A: abortion – induced or spontaneous
o L: living child
• Ask about contraception – kind? Satisfied?
▪ Vulvovaginal symptoms – discharge/itching
• Do COLDSPA – color, lumps, pain?
o Sexual
▪ Sexual preference and response:
• Relationship status
• Explain why you are asking
• Affirm conversation is confidential
▪ Sexual contacts? History of STD’s? Safe Sex?
- Health Promotion for Women:
o Note normal signs of aging – dryness, decreased estrogen, ovulation
stops, thinning/graying of pubic hair, skin is less elastic
o Changes in anatomy from puberty to menopause, cervical cancer
screening (PAP), early prenatal care, family planning, STD’s/HIV
, ▪ Cervical cancer: screen with PAP and HPV infection
• Risk factors –viral/behavioral, high-risk strains
• Other – early sexual activity, multiple partners, history of STD’s
• HPV vaccine – 11-26 years old – preventative, does not treat
▪ STD’s and HIV:
• Chlamydia trachomatis – most commonly reported
• Infection rates higher in women (15-19 years old)
o Untreated – PID, infertile
o Transmission in women – heterosexual
• Gonorrhea – also common
• Syphilis – less common
- Male System:
, - Lymphatics of Male:
o Penile and scrotal surfaces – drain into inguinal nodes
o Testes – drain into abdomen
- Health History:
o Common/concerning symptoms
▪ Scrotal pain, swelling, lesions
• Do COLDSPA – onset, painless?
• Self-testicular examination
▪ Penile discharge or lesions
• Leaking, dripping?
• Had symptoms before?
▪ Problems with urination
• BPH or cancer – men over 70 at risk
• Weak flow? Starting or stopping issue?
• Blood in urine? Discomfort or heaviness?
• Day or night? How often?
▪ Inguinal pain/swelling
• Point to area, may indicate hernia, unilateral/bilateral
• When does it hurt? When lifting, standing, bending?
▪ Sexual preference/response
• Assess libido/arousal phase – orgasm/ejaculation –
absent, premature, early, out of control?
• Sexual activity and history of STD’s
o Aging – not what is normal/educate patient
▪ Fewer viable sperm, decrease in testosterone levels, erections
less firm, increase in prostate gland size, testes less firm/smaller
- Physical Exam:
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