S24 Module 8 Assessment of Breast, External Genitalia & Perianal Area PDF

4/4/2024 Sabine Dunbar, DNP, NMW, RN, CNE Adapted from Lecture by Michelle Ballou MS, CNS, RN Describe inspection and palpation of the breasts and axillae. Identify normal and abnormal findings in the assessment of the breasts. Describe anatomy of the female and male genitalia. Identify positioning...

4/4/2024 Sabine Dunbar, DNP, NMW, RN, CNE Adapted from Lecture by Michelle Ballou MS, CNS, RN Describe inspection and palpation of the breasts and axillae. Identify normal and abnormal findings in the assessment of the breasts. Describe anatomy of the female and male genitalia. Identify positioning of the female and male patient for examination of the genitalia. Describe inspection and palpation of the female and male genitalia. Identify normal and abnormal findings in the assessment of female and male genitalia. Describe the appropriate nursing actions for any abnormal findings. Breast Assessment Female Genitalia Assessment Male Genitalia Assessment Perianal Assessment 1 4/4/2024 General appearance Skin Lymphatic drainage areas Nipple Screen for retraction 2 4/4/2024 Examine axillae while woman is sitting Inspect skin Reach fingers high into axillae to palpate Supine position Systematic pattern Gentle but firm pressure Rotate fingers at each palpation point Light, medium, and deep palpation Note Characteristics: Location Size Shape Consistency Movable Distinctness Nipple Note skin over lump Tenderness Lymphadenopathy 3 4/4/2024 Examination of male breast can be abbreviated, but do not omit it Normal finding is a flat disk of undeveloped breast tissue below nipple 4 4/4/2024 5 4/4/2024 Risk Factors That Cannot be Changed Female gender Age ≥ 55 yo Personal history of breast or ovarian cancer First-degree relative with breast cancer (mother, sister, daughter) Gene changes High breast tissue density Certain benign breast conditions High-dose radiation to chest Early menarche (55 years) Lifestyle-Related Risk Factors Alcohol intake Overweight/obesity Physical inactivity Nulliparity or first child after age 30 years Never breastfed a child Hormonal birth control Menopausal hormone therapy 6 4/4/2024 Ask patient to empty bladder Ensure privacy Female chaperone present Maintain eye contact Position & drape appropriately Explain each step in examination prior to carrying it out Gentle, firm touch, and gradual movements Communicate throughout examination Skin color Hair distribution Labia majora Presence of lesions With gloved hand, separate labia majora to inspect: Clitoris Labia minora Urethral opening Vaginal opening Perineum Anus 7 4/4/2024 Cystocele Uterine prolapse Rectocele 8 4/4/2024 Position client in standing or supine position Provide appropriate draping Your demeanor should be confident and relaxed Use a firm deliberate touch; do not use a soft or stroking touch Skin Dorsal vein Glans Retract foreskin Be sure to replace after examination Urethral meatus Shaft of penis Scrotal size Asymmetry is normal Left scrotal half usually lower than right Rugae Lift sac to inspect posterior surface Gently palpate each scrotal half between your thumb and first two fingers Palpate each spermatic cord between your thumb and forefinger Undescended testicle – cryptorchidism Family history Personal history of testicular cancer HIV/AIDS Age - age 20 to 34 (~50% cases) White male 9 4/4/2024 Painless Firm, solitary nodule or harder than normal section of testicle Enlargement or swelling of testis Sensation of heaviness or aching in lower abdomen or scrotum Genital Herpes Human Papilloma Virus Syphilitic Chancre 10 4/4/2024 Spread buttocks wide apart Anus normally looks moist and hairless, with coarse folded skin more pigmented than perianal skin Anal opening tightly closed No lesions should be present 11 4/4/2024 12 4/4/2024 Final Exam: Monday 6/3/24 @ 0900-1100, Room B135 Cumulative 65 MC questions Focus on Modules 6-8 30% of course grade Review vocabulary document on Canvas Mandatory Open Lab with faculty Friday 5/17/2024 @ 1200-1400 – attend for 1 hour of additional practice with input from faculty Independent practice hours due at time of completion of head to toe assessment (resubmit under same assignment on Canvas and total hours at bottom of document) 13