Gynecological Trauma for Certified Emergency Nursing (CEN)

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Gynecological Trauma

Definition/ Etiology:

Gynecological trauma involves the external and internal female reproductive organs:

Vulva
Clitoris
Urethra
Vagina
Cervix
Perineum
Rectum

Any person who complains of pain, bleeding, or swelling of the vulva should be evaluated for further injury to the vagina as well. Internal injuries are much more difficult to assess.

History should be consistent with the injury. It may take time for the patient to become comfortable with providing history. Utilize SANE staff if available and appropriate.

Pathophysiology:

Vulvar injury mechanisms:

Usually, blunt trauma
Straddle injuries

Risk factors:

Girls and adolescents are more likely to have vulvar injuries. They may not have yet developed the fat pads of the labia majora which protect the vulva from injury.
Bicyclists
Motorcyclists
Gymnasts

Vulvar injury sequelae:

hematoma due to the rich vascular supply

Vaginal injury mechanisms:

nonconsensual or forceful consensual coitus
penetration by a foreign object
pelvic fracture
hydraulic or pneumatic forces (eg, water or air insufflation from jet ski accidents or water skiing)

Risk factors:

first coitus (usually associated with hymenal lacerations)
hypoestrogenic states (menopause, lactation, postpartum)
history of pelvic irradiation
anatomic abnormalities

Vaginal injury sequelae:

Fistulas

Differences in sex development, or DSD, is the term used to describe congenital abnormalities in reproductive organs. These patients may delay care due to concerns about compassion of healthcare workers. The same is true with the transgender community. It is important to address patients respectfully and be aware that gender expression may not match physical reproductive organs. Also, in some cultures, even in the US, female genital mutilation is common, and can have unintended outcomes such as difficulty urinating and menstruating, as well as pregnancy complications.

Gynecological Trauma for Certified Emergency Nursing (CEN)

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Outline

Gynecological Trauma

Definition/ Etiology:

Pathophysiology:

Clinical Presentation:

Collaborative Management:

Evaluation | Patient Monitoring | Education:

Linchpins (Key Points)

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For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD https://greatnurses.com/

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For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/