1. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Chapter 41 OB/GYN Examinations

2. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Gynecology Specialty that focuses on the diseases and disorders of the female reproductive system Many women prefer to see a gynecologist for this type of examination

3. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pap Test Developed by George Papanicolaou in 1883 Cytological screening – Used to detect cancer of the cervix – Used to screen for atypical cytology Requires patient education

4. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Patient Prep for Pap Test Avoid scheduling during menstrual period – Try to schedule at least 5 days after menstrual period 48 hours prior to test, avoid: – Tampons, birth control foams, jellies, or creams – Douching – Sexual intercourse

5. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Preparing the Room Exam table – Clean, with new paper – Set out a gown and drape for patient – Place light source near exam table

6. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Preparing the Room Prepare the Mayo tray – Include all instruments and supplies – Attach requisition form to ThinPrep bottle – Cover

7. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Preparing the Patient Provide instructions to collect a specimen, if applicable Make the patient feel comfortable Explain the procedure Instruct patient to undress and put on gown – Assist in gowning if needed – Assist onto exam table if needed

8. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Assisting with Exam Assist with breast exam, if applicable Provide patient education on BSE Help position patient into lithotomy position

9. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Assisting with Exam Assist provider as requested during pelvic exam and Pap test

10. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. After the Exam Help patient feel comfortable – Help patient off exam table – Offer tissues to wipe off excess lubricant – Ask patient to get dressed – Explain when to expect results or report Bethesda system is commonly used to report – Assist in scheduling a follow-up appointment

11. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. After the Exam Clean room Restock supplies Place labeled specimen with attached requisition form in appropriate area for pickup

12. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Other GYN Procedures Performed to make decisions about the condition of the uterus and cervix Instruments used: – Uterine sounds – Curettes – Biopsy forceps

13. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Obstetrics Providing direct care to women during pregnancy, childbirth, and immediately thereafter The MA’s role in obstetrics includes: – Document information completely – Stress compliance with checkups – Provide patient education and answer questions

14. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Confirming Pregnancy Provider performs: – Prenatal health assessment and history – Complete examination – Laboratory tests – Diagnostic tests

15. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Date of Delivery Normal pregnancy is 37-41 weeks – Infants born before 37 weeks are considered premature Naegele’s rule is a formula for estimating the date of delivery 1.Start with first day of last menstrual period 2.Subtract three months 3.Add seven days, plus one year

16. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Prenatal Visits Interview the patient – Determine any problems – Record remarks and symptoms Take vital signs and request a specimen, if applicable Check the chart – Ensure all lab reports are provided – Ensure all studies or referral letters are included

17. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Prenatal Visits Prepare patient for provider examination – Instruct patient to undress and gown – Assist patient onto exam table to sitting position – Drape patient’s legs – Notify provider patient is ready to be seen

18. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Prenatal Visits Assisting the provider during the exam – Assist the patient into exam positions – Provide assistance to the provider as appropriate

19. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Prenatal Visits Patient care after the exam – Assist patient to sitting position – Instruct the patient to dress – Answer any questions – Help make follow-up appointment Document in patient’s chart Clean room and restock supplies