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Examining female patients

Discussion in 'Step II' started by Pox in a box, Feb 27, 2007.

  1. Pox in a box

    Pox in a box 1K Member
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    Let me get this straight...when you want to do a pulmonary or cardiovascular exam on a female, you ask for permission to untie her gown and then pull her gown down to expose the chest/back. At this point, she's going to be exposing her entire upper torso but she'll be wearing a sports bra of some sort...is this correct or is this like a red flag for indecent exposure?

    Also, one of the first things you should do is "inspect." How do you comment on this? "Ms. Johnson, your chest looks very symmetrical." I can't think of any non-threatening comments to make to let the SP know I'm "inspecting" without being creepy. How akward can it get? Then, "Now I'm going to press on your chest."
     
  2. Villin

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    okay, now. i think you're a little neurotic about this CS exam. you've been asking a ton of questions recently. have you picked up the FA book? most of the questions are addressed there.

    cover ANY area not being examined...period! ask for permission, say you're inspecting for any asymmetry, etc.

    you need to relax about this exam...when do you take it?
     
  3. OP
    OP
    Pox in a box

    Pox in a box 1K Member
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    Hey, thanks. I'm just covering all the bases. The First Aid book is pretty good but doesn't cover everything regarding actual physical exam tactics. I just realized that my med school did a horrible job at actually instructing us on whether we were doing each skill correctly. It's true that they just had a checklist (listened to my chest...well, yeah...check....felt my tummy...well, yeah...check) and anything remotely near what was on the list they gave credit. Hey, a little neuroticism is okay...I'll chill with the posts. Somebody busted my chops when I started asking minutiae on the Step 2 CK forum and lo and behold, I had 3 questions that were verbatim on that topic ("minutiae"). :thumbup:
     
  4. Villin

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    i had no idea your school didn't give you much feedback. Now, i understand your neuroticism. ;) Good luck on the exam and give them hell. (but only in a very nice way!)
     
  5. Critical Mass

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    They wouldn't make you do a breast exam, would they?
     
  6. Tired

    Tired Fading away
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    No breast exam, pelvic exam, or corneal reflex testing. If this is indicated, tell the patient you would recommend doing it, and put it in your "plan" section of the writeup.

    Always ask for permission before you do an exam, always warm the patient what you're about to do.

    For the OP, if your school hasn't prepared you, also try to remember to use appropriate "draping". ie - when you do an abdominal exam, first drape a sheet over the patient from the waist down, then pull the gown up to expose the abdomen in order to maintain the patient's modesty.

    And absolutely absolutely wash your hands every time before you touch a patient.
     
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  7. Villin

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    unnecessary...i didn't for 4 of my patients.;) listen to Tired. wash your hands.
     
  8. HannahDH

    HannahDH Immunologist
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    I always wash my hands before I touch my patients. It's important and I recommend all doctors do that.

    As for what to do, remember to ask for permission before you do an exam, and always let the patient know what you are about to do before you do it.
     
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  9. Villin

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    :rolleyes: good for you! :thumbup: (do you also use alcohol wipes for your stethoscopes in between patients? because if you don't, i would recommend you do that, too.)
     

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