vaginal or uterine bleeding PA

[oracle389]

hello. umm, hope to get your insights on what i should be focusing in getting physical assessment for a patient who has uterine bleeding...

thanks

[BoonersmomRN]

Well I have a uterine bleed problem ( menorrhagia) and have been seen for almost a yr b/c of it ( I have had 1 D+C so far- didn't work)....

...I can tell you that the things they assessed for are pain, "feel the uterus( should be soft)", signs of hypothyroidism + anemia, ...my BP was taken- watching for drops in BP, CBC, hmmm..questions about start of problem, amount of flow + color of the blood, clot size, questions were "are you pregnant or is there a chance of pregnancy?" " any miscarriages/abortions?" , " past menstrual irregularities"

HTH a little:)

[VickyRN, MSN, DNP, RN]

Also find out what medications the patient is taking... any oral contraceptives, hormone replacement therapy? Is the patient premenopausal or postmenopausal (painless postmenopausal bleeding is very serious, often indicating uterine [endometrial] cancer). Is there any pain with bleeding? How much bleeding (saturating a pad in less than 1 hour - patient at immediate risk for hemorrhage).

[Daytonite, BSN, RN]

The physical assessment of a patient with uterine bleeding includes the following:

Before starting

: assess for pregnancy if age appropriate, presence of any fever (indicates infection), recent lady partsl trauma

Ask the patient about

:

amount and frequency of bleeding

length of time of bleeding (days)

the bleeding cycle (days of bleeding, days of no bleeding), look for a pattern and/or relationship to the menstrual cycle

any pain with or without the bleeding

Physical assessment would include

:

abdominal palpation and auscultation

symmetry and appearance of the abdomen

presence and description of any lady partsl drainage/bleeding (amount and color)

inspection of the perineal area

[VickyRN, MSN, DNP, RN]

Also assess client's weight, BMI (overweight, underweight?). Being overweight can contribute to estrogen imbalance and dysfunctional uterine bleeding. Nutritional status, usual diet? Any other medical conditions (such as diabetes)? Sexually active? Possibility of sexual abuse? Good link:

http://www.aafp.org/afp/20040415/1915.html (see Table 2, for lab and other tests frequently performed)

[oracle389]

thanks!

can i also ask about the nusrsing interventions? um, the usual independent interventions that is... and nursing responsibilities... thanks again:p

[MIA-RN1, RN]

had an elderly pt the other night w/ bleeding; our dx was risk for impaired skin integrity.