NSG 6430 - Clinical Exam Notes. Complete Summary.

Performing a Pelvic Exam Preparation  First, elevate the head of the exam table to 30 to 45 degrees and assist the patient in placing her heels in the footrests, adjusting the angle and length as needed.  Carefully cover the patient's abdomen and legs down to her knees with a sheet.  Ask patient to slide down to the edge of the table and relax her knees outward just beyond the angle of the footrests. External inspection and palpation  Look for any redness, swelling, lesions or masses.  Inspect the labia, the folds between them, and the clitoris, paying attention to any redness, swelling, lesions, or discharge. Speculum exam  Use a warm and lubricated speculum for the examination. (There is some controversy about whether gelbased lubricants distort cytologic assessment. For this reason, the speculum is lubricated with warm tap water or a thin layer of gel lubricant, avoiding the tip of the speculum. You should know what is recommended by the laboratory in your area.)  Inform the patient that you are about to begin the speculum exam.  Expose the introitus by spreading the labia from below using the index and middle fingers of the nondominant hand (peace sign).