Question

A 59-year-old female patient who has generalized weakness in her extremities and is in a wheelchair has arrived at the office for her yearly physical. She is here for a pelvic exam, which will require her to be placed in lithotomy position. What would you say to the patient when you enter the room to prepare her for the examination?

Answer 1

I would say that during the annual physical exam, it would be necessary to place it in a certain position for better performing the procedure.

Step-by-step explanation:

During some examinations and / or treatments, the patient may be placed in a certain position to better perform the procedure. Each of these positions has a nomenclature and is used in academic and professional circles.

It is important that this need to place the patient in certain positions, which will not always be comfortable, be informed to the patient. In the case shown in the question above, the patient should be informed of the need to place him in the lithotomy position, which consists of positioning the patient with his back erect, his face up and his legs apart and suspended over his leggings. This position is generally used for internal and external genital examination. It is also used in urinary and genital tract surgery.

Answer 2

It is very important to always bear in mind that pelvic exams, in any woman, with or without any kind of additional difficulties, are pretty uncomfortable, especially because the person will have to take off her clothes and display one of her most private parts. This is why, regardless of if it is a woman with added situations, or not, the first thing to do is to greet her, use a very professional tone of voice and appropriate language, and explain what the exam is, what it will done for, and the steps that will take place.

In this particular case, given that there is an added situation of difficulty to maintain the lithotomy poistion, which is basically on an examination table, with legs spread out and slightly bent at the knees, because the woman has weakness in her extremeties, there will be an added need to explain to her that either the physician will have to touch her legs in order to help her maintain her position, or someone might have to help them out. Explaining this, and the why for the patient, is vital, as this type of examination causes, in and of itself, great stress, and having other people in, or having the doctor touch anything other than it is extremely necessary for the purpose of the exam, might cause serious problems.