Holistic Health Final Exam with correct \| \| \| \| \| \|
answers
Structure-cervix - CORRECT ANSWERS ✔✔§ Nulliparous-no pregnancy
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§ Multiparous-previous pregnancies
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Subjective-Breast - CORRECT ANSWERS ✔✔§ Breast pain (mastalgia)-
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location, timing (menses), provocative (exercise, intercourse, bra)
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§ Swelling- with menses, pregnancy, breast feeding
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§ Trauma
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§ Lump- location, first noticed, related to menses, change to overlying skin
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§ Nipple discharge-how long, colour (blood tinged), consistency, odour
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Ø Galactorrhea milky- white discharge from breasts
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§ Self-care
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Ø Screening/exams??? Know their breasts (shower/supine)
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Ø Mammogram
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Subjective- Menstrual - CORRECT ANSWERS ✔✔§ date of last menstrual
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period (LMP) \|
§ age at the time of your first period (Menarche)
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§ how often
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§ how long
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,§ usual flow: light, medium, heavy? Pads/ tampons do you use each day or
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hour?
§ any clotting- indicates heavy flow/ vaginal pooling
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§ Pain/cramps before or during/spotting between
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Ø treat it? interfere with activities? Associated- bloating, breast tenderness,
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moodiness?
Subjective- Obstetrical - CORRECT ANSWERS ✔✔G- gravida number of
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pregnancies (twins = once) \| \| \|
T- term deliveries at term
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P- premature
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A- abortions (not vile - before 20 weeks - non threatened)
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L- living children (people with twins would have an L of 2)
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Any complications during pregnancy/delivery
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Subjective-Menopause/Urinary - CORRECT ANSWERS ✔✔Menopause \| \| \| \|
§ change in periods
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§ associated symptoms- next slide
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§ Treatments for symptoms
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§ Hormone replacement
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Urinary symptoms \|
§ Frequency, burning, nocturia, hematuria, cloudy, foul smelling,
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incontinence-stress
,Subjective-Vaginal Discharge - CORRECT ANSWERS ✔✔§ Amount, how long \| \| \| \| \| \| \| \|
§ Character-colour (white, yellow-green, grey, "cottage cheese like"), odour,
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itching, rash, pain during intercourse (dyspareunia)
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§ Selfcare
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Ø Douche (alters flora)
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Ø Talcum powder (ovarian cancer)
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Ø Panty hose/nylon underwear (local irritation)
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Ø Last Papanicolaou (PAP) & results
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Subjective-Sexual practices - CORRECT ANSWERS ✔✔§ Intercourse in last 6 \| \| \| \| \| \| \| \| \| \|
months
§ Number of partners
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§ Do you use contraceptives (intercourse/oral sex)
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§ History of sexually transmitted infections (STI)
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§ Lifestyle
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Objective- Breast - CORRECT ANSWERS ✔✔• normal slight asymmetry- left
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breast slightly larger
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• upper outer quadrant is the site of most breast tumours
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• nipples usually protrude, can be flat or inverted- note change/discharge
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• supernumerary nipple normal and common
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• Different positions-retraction (hands above head, on hips, palms together,
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lean forward (large breasts)
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, Objective- lymph nodes - CORRECT ANSWERS ✔✔• examine
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axillae- rash/infection
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• palpate axilla-tenderness/lymph nodes Reach your fingers high into the
\| \| \| \| \| \| \| \| \| \|
axilla
• Palpate breast- supine, arm overhead, pad under side (flattens breast &
\| \| \| \| \| \| \| \| \| \| \| \|
displaces)
• Large breast can use bimanual
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• If discharge reported- press nipple
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Objective: Physical Exam - Preparation (female health) - CORRECT
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ANSWERS ✔✔• Preparation \| \|
Ø Lithotomy position and draping
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Ø Measures to enhance comfort during exam
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Ø Mirror pelvic examination
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Development-Breast - CORRECT ANSWERS ✔✔• Full development average \| \| \| \| \| \| \| \|
of 3 years-range is 1.5 to 6 years
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• Breasts of nonpregnant women change with hormones during menses
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Developmental-Pregnancy (female health) - CORRECT ANSWERS ✔✔Breasts \| \| \| \| \| \|
• changes start during the second month
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• expansion of the ductal system and fatty tissue
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• development of true secretory alveoli
\| \| \| \| \|
• breasts enlarge/ more nodular
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answers
Structure-cervix - CORRECT ANSWERS ✔✔§ Nulliparous-no pregnancy
\| \| \| \| \| \|
§ Multiparous-previous pregnancies
\| \|
Subjective-Breast - CORRECT ANSWERS ✔✔§ Breast pain (mastalgia)-
\| \| \| \| \| \| \| \|
location, timing (menses), provocative (exercise, intercourse, bra)
\| \| \| \| \| \|
§ Swelling- with menses, pregnancy, breast feeding
\| \| \| \| \| \|
§ Trauma
\|
§ Lump- location, first noticed, related to menses, change to overlying skin
\| \| \| \| \| \| \| \| \| \| \|
§ Nipple discharge-how long, colour (blood tinged), consistency, odour
\| \| \| \| \| \| \| \|
Ø Galactorrhea milky- white discharge from breasts
\| \| \| \| \| \|
§ Self-care
\|
Ø Screening/exams??? Know their breasts (shower/supine)
\| \| \| \| \|
Ø Mammogram
\|
Subjective- Menstrual - CORRECT ANSWERS ✔✔§ date of last menstrual
\| \| \| \| \| \| \| \| \| \|
period (LMP) \|
§ age at the time of your first period (Menarche)
\| \| \| \| \| \| \| \| \|
§ how often
\| \|
§ how long
\| \|
,§ usual flow: light, medium, heavy? Pads/ tampons do you use each day or
\| \| \| \| \| \| \| \| \| \| \| \| \| \|
hour?
§ any clotting- indicates heavy flow/ vaginal pooling
\| \| \| \| \| \| \|
§ Pain/cramps before or during/spotting between
\| \| \| \| \|
Ø treat it? interfere with activities? Associated- bloating, breast tenderness,
\| \| \| \| \| \| \| \| \| \|
moodiness?
Subjective- Obstetrical - CORRECT ANSWERS ✔✔G- gravida number of
\| \| \| \| \| \| \| \| \|
pregnancies (twins = once) \| \| \|
T- term deliveries at term
\| \| \| \|
P- premature
\|
A- abortions (not vile - before 20 weeks - non threatened)
\| \| \| \| \| \| \| \| \| \|
L- living children (people with twins would have an L of 2)
\| \| \| \| \| \| \| \| \| \| \|
Any complications during pregnancy/delivery
\| \| \|
Subjective-Menopause/Urinary - CORRECT ANSWERS ✔✔Menopause \| \| \| \|
§ change in periods
\| \| \|
§ associated symptoms- next slide
\| \| \| \|
§ Treatments for symptoms
\| \| \|
§ Hormone replacement
\| \|
Urinary symptoms \|
§ Frequency, burning, nocturia, hematuria, cloudy, foul smelling,
\| \| \| \| \| \| \| \|
incontinence-stress
,Subjective-Vaginal Discharge - CORRECT ANSWERS ✔✔§ Amount, how long \| \| \| \| \| \| \| \|
§ Character-colour (white, yellow-green, grey, "cottage cheese like"), odour,
\| \| \| \| \| \| \| \| \|
itching, rash, pain during intercourse (dyspareunia)
\| \| \| \| \|
§ Selfcare
\|
Ø Douche (alters flora)
\| \| \|
Ø Talcum powder (ovarian cancer)
\| \| \| \|
Ø Panty hose/nylon underwear (local irritation)
\| \| \| \| \|
Ø Last Papanicolaou (PAP) & results
\| \| \| \| \|
Subjective-Sexual practices - CORRECT ANSWERS ✔✔§ Intercourse in last 6 \| \| \| \| \| \| \| \| \| \|
months
§ Number of partners
\| \| \|
§ Do you use contraceptives (intercourse/oral sex)
\| \| \| \| \| \|
§ History of sexually transmitted infections (STI)
\| \| \| \| \| \|
§ Lifestyle
\|
Objective- Breast - CORRECT ANSWERS ✔✔• normal slight asymmetry- left
\| \| \| \| \| \| \| \| \| \|
breast slightly larger
\| \|
• upper outer quadrant is the site of most breast tumours
\| \| \| \| \| \| \| \| \| \|
• nipples usually protrude, can be flat or inverted- note change/discharge
\| \| \| \| \| \| \| \| \| \|
• supernumerary nipple normal and common
\| \| \| \| \|
• Different positions-retraction (hands above head, on hips, palms together,
\| \| \| \| \| \| \| \| \| \|
lean forward (large breasts)
\| \| \|
, Objective- lymph nodes - CORRECT ANSWERS ✔✔• examine
\| \| \| \| \| \| \| \|
axillae- rash/infection
\|
• palpate axilla-tenderness/lymph nodes Reach your fingers high into the
\| \| \| \| \| \| \| \| \| \|
axilla
• Palpate breast- supine, arm overhead, pad under side (flattens breast &
\| \| \| \| \| \| \| \| \| \| \| \|
displaces)
• Large breast can use bimanual
\| \| \| \| \|
• If discharge reported- press nipple
\| \| \| \| \|
Objective: Physical Exam - Preparation (female health) - CORRECT
\| \| \| \| \| \| \| \| \|
ANSWERS ✔✔• Preparation \| \|
Ø Lithotomy position and draping
\| \| \| \|
Ø Measures to enhance comfort during exam
\| \| \| \| \| \|
Ø Mirror pelvic examination
\| \| \|
Development-Breast - CORRECT ANSWERS ✔✔• Full development average \| \| \| \| \| \| \| \|
of 3 years-range is 1.5 to 6 years
\| \| \| \| \| \| \|
• Breasts of nonpregnant women change with hormones during menses
\| \| \| \| \| \| \| \| \|
Developmental-Pregnancy (female health) - CORRECT ANSWERS ✔✔Breasts \| \| \| \| \| \|
• changes start during the second month
\| \| \| \| \| \|
• expansion of the ductal system and fatty tissue
\| \| \| \| \| \| \| \|
• development of true secretory alveoli
\| \| \| \| \|
• breasts enlarge/ more nodular
\| \| \| \|
