NUR-418M6DStudentsPost.docx

 

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

Genitalia

Angela Thompson

St. Thomas University

NUR-418-AP2

Professor Rojas

September 29, 2022

Appropriate patient position can facilitate proper physiologic function during pathophysiologic processes and facilitate access to certain anatomical locations during surgical procedures. Multiple factors should be considered when choosing the patient's position (Armstrong & Moore, 2022). Positioning for examinations or surgeries is important to properly perform any routine assessment. There are many positions within the medical field and a few different positions used in order rot complete a pelvic examination. Sims is a position used to inspect a woman’s rectum and vagina. Flexion of the hip and knee allows for the patient’s rectum to be examined fully. The knee to the chest also known as genupectoral position is also a position that will allow the provider to examine the rectum. Examination of the genitalia should include the clitoris, urethra, labia majora, labia minora, peri hymenal tissues, hymen, posterior fourchette, and perineal body.

Frequent intercourse, vulvovaginal atrophy, change of the local bacterial flora, history of UTIs during premenopausal or in childhood, family history, and a non-secretor blood type are substantiated risk factors for recurrent uncomplicated UTIs (Storme, et al., 2019). A woman’s genitalia is located internally and externally, whereas men’s genitalia is located externally. Because of a woman’s anatomy, the likelihood of developing a UTI is much higher than that of a man. Proper hygiene practices, safe sex practices, and a proper balance of vaginal bacteria all help to reduce a urinary tract infection from occurring. Direct effects of aging on the bladder influence the risk of UTIs, and include decreased capacity, reduced contractility, increased hyperactivity, and increased residual urine (Storme, et al., 2019).

Newborn circumcision is a decision all new mothers must discuss after the birth of their son. Certain cultures and religious beliefs all support one’s decision to circumcise their child. Others tend to believe it is more sanitary to circumcise their sons. Pros include less risk of UTIs, a decrease in penile cancer, and a reduced risk of contracting an STD or HIV. There is also a reduction of foreskin complications that include balanitis and is much easier to keep clean. Cons of this procedure include infection, pain during the procedure, excessive bleeding, and potential damage to the penis and foreskin.

Goodell sign is described as the softening of the Cervix. Hegar’s sign is the softening of the lower uterine segment. McDonald’s sign is fundal height and measures the size of the uterus and is used to assess fetal growth. Chadwick sign is a blueish color of the Cervix and vagina. All these signs are used during a woman’s pregnancy and delivery.

Hernias all share the same symptoms which include pain. Indirect inguinal hernias are caused by continuous opening that does not close after pregnancy, abdominal content such as fat or bowel pushes down causing excessive pain or pressure in the abdomen. Direct inguinal is typically caused by age-related stress and weakness of the muscles within the inguinal canal. The only solution and repair for these types of hernias is surgery. Femoral hernias are less common than inguinal hernias so identifying the type of hernia is important for proper diagnosis. Recognition of a femoral hernia is an important factor in the workup and evaluation of a patient who presents with a groin bulge as the options and urgency of repair may differ from that of a more common inguinal hernia (Goethals, Azmat & Adams, 2022). To ensure a successful examination and diagnosis, it is important to properly assess and examine all areas of the pelvic and abdominal regions.

References

     Armstrong, M., & Moore, R. (2022). Anatomy, Patient Positioning. Retrieved 28 September 2022, from  https://www.ncbi.nlm.nih.gov/books/NBK513320/ Links to an external site.

    Goethals, A., Azmat, C., & Adams, C. (2022). Femoral Hernia. Retrieved 28 September 2022, from  https://www.ncbi.nlm.nih.gov/books/NBK535449/ Links to an external site.

    Storme, O., Tirán Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. (2019). Risk factors and predisposing conditions for urinary tract infection.  Therapeutic Advances In Urology, 11, 175628721881438. doi: 10.1177/1756287218814382

Genitalia 

Eugene Kerline

St Thomas University

NUR-418-AP2

Professor Rafeal 

September 29, 2022

Positions other than the Lithotomy in which a Pelvic Examination can be Performed

A pelvic exam may be conducted while standing in the Knee-Chest Position, one of the available positions. The lady sleeps on her side in this position, with her knees bent and her leg near her breast for support. Lie down on your back with your legs bent and feet flat on the table, contacting the table surface. Another option is the Obstetric Stirrups Position, which is similar to the previous one. While lying down on her back, the pregnant woman should wear obstetric stirrups to keep her legs elevated. The M-Shaped Position is still another option to consider. She will lie on her stomach on the examination table, with her knees bent and her legs wide apart, to undergo the examination (Bibbins-Domingo et al., 2017). The V-shaped Position is the apex of the quarterback's playing field, where he should be. The lady is sprawled out on the floor in the back of the room, her unbent legs being split in two by the table.

Why are Women at a Higher Risk of UTI than Males?

Women are at greater risk of UTIs than males for various reasons, including feminine anatomy, which has a shorter urethra than men. As a result of the shorter length of the female urethra, the germs must travel a shorter distance to reach the bladder, increasing the likelihood of UTIs in women. Women may also wind up with numerous sex partners due to their stronger sexual urge than males, which raises their risk of UTIs. Another risk factor is the onset of menopause. When a woman goes through menopause, the estrogen she produces causes changes in her urinary tract system, increasing her susceptibility to infection.

What would you Educate to Decrease the Risk Of UTI?

I would educate them on the need to drink enough water and empty themselves frequently to reduce the risk of UTI infection. Drinking plenty of water and emptying oneself can help to wash the bacteria out of the urinary system and the blander before it becomes established. In addition, I would educate them on the need to urinate after and before intercourse. This would aid in the removal of germs from the gastrointestinal tract. In addition, I would emphasize the need to limit the use of douching, powders, and sprays in the genital area, as doing so increases the likelihood of infection in that area. Also, I would emphasize the importance of wiping from the front to the rear since bacteria like to hang around after a bowel movement, preventing it from being pushed into the urethra.

Pros and Cons of Newborn Circumcision.

The pros of circumcision are that it lowers the risk of tract infections, lowers the risk of getting STDs, and makes genital hygiene easier. Also, circumcision prevents foreskin infection as well as penile cancer. The cons of circumcision in babies are that it causes bleeding or even injury of testicles or penis.  

           Goodell Signs

If Goodell's illness is a telltale sign of pregnancy, she may get pregnant. As a result of increased vascularization, the cervix's vaginal area becomes significantly softer than it was previously. Because of uterine hypertrophy and engorgement, which increases the size of the arteries underneath the uterus, this vascularization can develop during pregnancy. Around the fourth week of pregnancy, this symptom begins to appear.

Hegar's Signs

The Hegar's sign does not reliably predict women's pregnancy, but the lack of the sign does not rule out the possibility of pregnancy. It is primarily concerned with the features of the cervix and the uterine isthmus. This sickness manifests itself in the form of your uterus becoming fragile and seeming to be split in two if you have it .

Mcdonald's Signs

When determining fetal growth and development throughout pregnancy, doctors employ the McDonald's rule. The McDonald's rule is a method of determining the size of the uterus. The mother's pubic symphysis and the top of her uterus are measured to acquire the measurement. 

Chadwick Sign's

As a result of pregnancy, various bodily changes occur, with the formation of Chadwick's sign being one of them. Any time you see something like this, you can be sure that someone is expecting a kid. Whenever the amount of venous blood flowing through the vaginal tissue, vulva, or cervix increases, the color of the blood changes to dark blue or purple.

Indirect Inguinal

One of the most common types of groin hernia is known as an indirect inguinal hernia. An indirect inguinal hernia is a condition in which fat or bowel from the belly protrudes into the inguinal canal without being pushed back into the abdomen (Kelahan et al., 2021). The scrotum is a tube that links the vas deferens and testicular veins to the uterus in males.

Direct Inguinal

Unlike indirect hernias, which migrate via the inguinal ring and into the scrotum, direct hernias do not travel in this manner. A straight hernia is a hernia that develops on only one side of the groin. A bulging indirect hernia that extends into the inguinal ring has the potential to block the intestines. 

Femoral

A femoral hernia is caused by a weakness in the groin or inner thigh muscular wall, allowing the tissue to press through and cause discomfort. A femoral hernia is characterized by a bulge or discomfort in the groin or inner thigh area (Kelahan et al., 2021). Nausea, vomiting, and stomach pain are all possible in severe cases of food poisoning.

References

Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Barry, M. J., Davidson, K. W., Doubeni, C. A., ... & US Preventive Services Task Force. (2017). Screening for gynecologic conditions with pelvic examination: US Preventive Services Task Force recommendation statement.  Jama, 317(9), 947-953.

Kelahan, L., Menias, C. O., & Chow, L. (2021). A review of internal hernias related to congenital peritoneal fossae and apertures.  Abdominal Radiology, 46(5), 1825- 1836.