Female Genitourinary System (NURS 313)

Female Genitourinary System (NURS 313)

• Objectives:
  • Identify external female genitalia structures.
  • Describe internal female genitalia structures.
  • Outline changes during puberty.
  • Document pregnancy-related changes.
  • Detail perimenopausal changes.
  • Incorporate health promotion concepts into assessments.

External Genitalia (Vulva)

• Structures:
  • Mons pubis
  • Labia majora
  • Labia minora
  • Clitoris
  • Urethral meatus
  • Skene glands
  • Vaginal orifice
  • Hymen
  • Bartholin glands
  • Vestibule
  • Perineum
• Functions:
  • Lubrication during intercourse is secreted by Bartholin glands

Internal Genitalia

• Structures:
  • Vagina
  • Cervix
  • Squamocolumnar junction
  • Anterior fornix
  • Posterior fornix
  • Uterus
  • Fallopian tubes
  • Ovaries

Developmental Considerations

• Infants:
  • External genitalia engorged due to maternal hormones
• Adolescents:
  • Puberty markers: breast development, pubic hair growth
  • Average menarche age: 12.25 years
  • Tanner staging
• Pregnant Females:
  • Uterine expansion to accommodate fetus
• Aging Females:
  • Menopause (48-51 years): decline in function, vaginal dryness, dyspareunia
  • Increased risk of vaginal, urinary tract issues
  • Muscle weakness/loss of elasticity

Cultural Considerations and Sexual Identity

• Exposure of genitalia: ensure privacy
• Menarche: beginning of menstruation
• Pubertal rites: cultural practices
• Transgender care: providing support

IDD Care

• Relationships, intimacy, and sexuality: often overlooked
• Assessment: inquiry about intimacy, relationships, appropriate education/counseling
• Pregnancy: increased risk of DVT, preeclampsia
• Risk Factors: obesity, epilepsy, polypharmacy, mental health issues, poverty
• Menopause: can start earlier

Subjective Data

• Biographical data
• Chief complaint (followed by hip pain, pain with urination)
• Past history: menstrual cycle, obstetrics events
• Family history: menopause
• Functional Assessment, lifestyle/health
• GYN papsmear appt dates
• Sexual history
• STIs
• HPV vaccine

Subjective Data (Aging Adults)

• Postmenopausal bleeding: higher risk of cancer
• Uterine prolapse
• Sexual satisfaction (dryness, itching)

Objective Data

• Explain exam purpose (in sensitive manner)
• Prepare client (empty bladder, gown, privacy, chaperone)
• Equipment: stool, light, speculum, lubricant, swabs, specimen containers, pH paper, mirror, gloves
• Physical Exam:
  • Inspect External Genitalia: skin color, hair distribution, labia, clitoris, urethral/vaginal opening, perineum, anus, lesions, discharge
  • Palpate External Genitalia: Skene & Bartholin glands, pelvic musculature support
• Older Adult Considerations:
  • Pubic graying/thinning, paler cervix, decreased lubrication (painful sex)