The most important thing to do to ensure proper visualization of a woman’s cervix is to make certain her buttocks are just over the edge of the exam table. However, it is impossible for a woman to scoot down far enough while sitting up. You must ask the patient to remain supine with her legs bent at the knees and move down toward the end of the table.
It helps if you put your hand at the edge of the table and ask her to keep moving downward until she feels her buttocks bump your hand. Rest assured, she will then shift slightly back toward the head of the table. Once you are seated in position to perform the exam, ask the patient to come “one more scoot” toward you. Getting the buttocks slightly off the edge of the table allows the cervix to be visualized with very little effort. — Judy Winter, WHCNP, RN-C, Alice, Tex., submitted via the web (165-6)
These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it, here.