IAN PEATE is a Visiting Professor at Northumbria University and Buckinghamshire New University and a Senior Clinical Fellow at the University of Hertfordshire. He is also the Editor-in-Chief of the British Journal of Nursing, and Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 The Anatomy and Physiology of the Female Reproductive System 1Introduction 1The Female Reproductive System 3The Ovaries 3Oogenesis and Follicular Development 4Corpus Luteum 6Role of Female Sex Hormones 6The Internal Organs 8The External Genitalia 13The Breasts 14The Menstrual Cycle 15Conclusion 16Glossary of Terms 17Multiple Choice Questions 18References 192 Engaging with Patients and Assessing the Female Reproductive System Introduction 21Language and Its Impact on Female Reproductive Health 21Promoting Patient-centred Communication 23Valuing the Patient's Experience 25Collaborative Relationships 27Cultural Sensitivity 28Health Literacy 29 Assessing the Female Reproductive System 31The Patient History 33Physical Examination 39Tests and Investigations 44Vital Signs and Other Observations 45Clinical Judgement and Communication 45Documentation and Interpretation of Findings 46Conclusion 46Glossary of Terms 47Multiple Choice Questions 48References 493 Health Promotion Introduction 51Health Promotion 52Biopsychosocial Model and Reproductive Health 54Inclusive and Culturally Safe Practice 59Public Health Approaches 60Common Female Reproductive Health Conditions 63Primary, Secondary and Tertiary Prevention 64The Role of Those Providing Care and Support 66Supporting Behaviour Change in Reproductive Health 68Digital Health 69Conclusion 70Glossary of Terms 71Multiple Choice Questions 72References 734 Planning Care: Cervical Cancer Introduction 76Cervical Cancer 76Prevalence and Demographics 79Types of Cervical Cancer 80Pathophysiology of Cervical Cancer 81Patterns of Spread 82Clinical Staging 82Overview of Cervical Cancer 83Cervical Cancer and Systemic Illness 84Signs and Symptoms of Cervical Cancer 86Diagnosing Cervical Cancer 89Communicating the Diagnosis 90Planning Individualised Care 91Digital Tools 93Management of Cervical Cancer 93Care Considerations 95Side Effects and Late Effects 96Psychosocial Support 96End-of-life Care Planning 96Survivorship Care and Secondary Prevention 97Promoting Equality 97Conclusion 97Glossary of Terms 98Multiple Choice Questions 99References 1005 Vital Signs Introduction 102Vital Signs in Context 102Clinical Decision-making in Practice 104Clinical Reasoning Cycle 104Core Vital Signs 106Hormonal and Endocrine Dynamics 107Vital Signs Across Life Stages 110Menopause 112Transgender and Non-binary People 112Clinical Considerations 113Chronic Reproductive Conditions 113Long-term Contraceptive Use 114Technology and Future Directions 115Conclusion 116Glossary of Terms 116Multiple Choice Questions 117References 1196 Cervical Screening Introduction 121Cervical Screening 121Obtaining Informed Consent 124The Procedure 129Communication 133Interpretation of Results 134Post-procedure Care 136Conclusion 163Responding to Concerns 137Conclusion 138Glossary of Terms 138Multiple Choice Questions 139References 1417 Female Genital Examination 143Introduction 143Gender-affirming Care 144Genital Examinations and Role Development 145Rationale for Performing Genital Examinations 146Professional Issues 146Patient Autonomy and Advocacy 147Confidentiality and Privacy 147Chaperones 148Infection Prevention and Control 149Professional Communication 149The Care Environment 150The Procedures 152External Genital (Vulval) Examination 154Speculum Examination 154Bimanual Vaginal Examination 156Transvaginal Ultrasound 160Transvaginal Ultrasound for Patients Without a History of Penetrative Sex 160Female Genital Mutilation and Genital Examinations 162Glossary of Terms 163Multiple Choice Questions 165References 1668 Specimen Collection 168Introduction 168Principles of Safe and Effective Specimen Collection 168Communicating Effectively 172Vaginal Specimen Collection 174Key Notes 174Cervical Screening 174Uterine and Endometrial Specimen Collection 174Risks and Contraindications 176Urine and Non-invasive Specimens 177Vulval and External Genital Specimens 179Documentation, Transport and Chain of Custody 180Ethical and Legal Considerations 181Conclusion 182Glossary of Terms 183Multiple Choice Questions 184References 185MCQ Answers 188Index 189

IAN PEATE is a Visiting Professor at Northumbria University and Buckinghamshire New University and a Senior Clinical Fellow at the University of Hertfordshire. He is also the Editor-in-Chief of the British Journal of Nursing, and Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 The Anatomy and Physiology of the Female Reproductive System 1Introduction 1The Female Reproductive System 3The Ovaries 3Oogenesis and Follicular Development 4Corpus Luteum 6Role of Female Sex Hormones 6The Internal Organs 8The External Genitalia 13The Breasts 14The Menstrual Cycle 15Conclusion 16Glossary of Terms 17Multiple Choice Questions 18References 192 Engaging with Patients and Assessing the Female Reproductive System Introduction 21Language and Its Impact on Female Reproductive Health 21Promoting Patient-centred Communication 23Valuing the Patient's Experience 25Collaborative Relationships 27Cultural Sensitivity 28Health Literacy 29 Assessing the Female Reproductive System 31The Patient History 33Physical Examination 39Tests and Investigations 44Vital Signs and Other Observations 45Clinical Judgement and Communication 45Documentation and Interpretation of Findings 46Conclusion 46Glossary of Terms 47Multiple Choice Questions 48References 493 Health Promotion Introduction 51Health Promotion 52Biopsychosocial Model and Reproductive Health 54Inclusive and Culturally Safe Practice 59Public Health Approaches 60Common Female Reproductive Health Conditions 63Primary, Secondary and Tertiary Prevention 64The Role of Those Providing Care and Support 66Supporting Behaviour Change in Reproductive Health 68Digital Health 69Conclusion 70Glossary of Terms 71Multiple Choice Questions 72References 734 Planning Care: Cervical Cancer Introduction 76Cervical Cancer 76Prevalence and Demographics 79Types of Cervical Cancer 80Pathophysiology of Cervical Cancer 81Patterns of Spread 82Clinical Staging 82Overview of Cervical Cancer 83Cervical Cancer and Systemic Illness 84Signs and Symptoms of Cervical Cancer 86Diagnosing Cervical Cancer 89Communicating the Diagnosis 90Planning Individualised Care 91Digital Tools 93Management of Cervical Cancer 93Care Considerations 95Side Effects and Late Effects 96Psychosocial Support 96End-of-life Care Planning 96Survivorship Care and Secondary Prevention 97Promoting Equality 97Conclusion 97Glossary of Terms 98Multiple Choice Questions 99References 1005 Vital Signs Introduction 102Vital Signs in Context 102Clinical Decision-making in Practice 104Clinical Reasoning Cycle 104Core Vital Signs 106Hormonal and Endocrine Dynamics 107Vital Signs Across Life Stages 110Menopause 112Transgender and Non-binary People 112Clinical Considerations 113Chronic Reproductive Conditions 113Long-term Contraceptive Use 114Technology and Future Directions 115Conclusion 116Glossary of Terms 116Multiple Choice Questions 117References 1196 Cervical Screening Introduction 121Cervical Screening 121Obtaining Informed Consent 124The Procedure 129Communication 133Interpretation of Results 134Post-procedure Care 136Conclusion 163Responding to Concerns 137Conclusion 138Glossary of Terms 138Multiple Choice Questions 139References 1417 Female Genital Examination 143Introduction 143Gender-affirming Care 144Genital Examinations and Role Development 145Rationale for Performing Genital Examinations 146Professional Issues 146Patient Autonomy and Advocacy 147Confidentiality and Privacy 147Chaperones 148Infection Prevention and Control 149Professional Communication 149The Care Environment 150The Procedures 152External Genital (Vulval) Examination 154Speculum Examination 154Bimanual Vaginal Examination 156Transvaginal Ultrasound 160Transvaginal Ultrasound for Patients Without a History of Penetrative Sex 160Female Genital Mutilation and Genital Examinations 162Glossary of Terms 163Multiple Choice Questions 165References 1668 Specimen Collection 168Introduction 168Principles of Safe and Effective Specimen Collection 168Communicating Effectively 172Vaginal Specimen Collection 174Key Notes 174Cervical Screening 174Uterine and Endometrial Specimen Collection 174Risks and Contraindications 176Urine and Non-invasive Specimens 177Vulval and External Genital Specimens 179Documentation, Transport and Chain of Custody 180Ethical and Legal Considerations 181Conclusion 182Glossary of Terms 183Multiple Choice Questions 184References 185MCQ Answers 188Index 189

IAN PEATE is a Visiting Professor at Northumbria University and Buckinghamshire New University and a Senior Clinical Fellow at the University of Hertfordshire. He is also the Editor-in-Chief of the British Journal of Nursing, and Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 The Anatomy and Physiology of the Female Reproductive System 1Introduction 1The Female Reproductive System 3The Ovaries 3Oogenesis and Follicular Development 4Corpus Luteum 6Role of Female Sex Hormones 6The Internal Organs 8The External Genitalia 13The Breasts 14The Menstrual Cycle 15Conclusion 16Glossary of Terms 17Multiple Choice Questions 18References 192 Engaging with Patients and Assessing the Female Reproductive System Introduction 21Language and Its Impact on Female Reproductive Health 21Promoting Patient-centred Communication 23Valuing the Patient's Experience 25Collaborative Relationships 27Cultural Sensitivity 28Health Literacy 29 Assessing the Female Reproductive System 31The Patient History 33Physical Examination 39Tests and Investigations 44Vital Signs and Other Observations 45Clinical Judgement and Communication 45Documentation and Interpretation of Findings 46Conclusion 46Glossary of Terms 47Multiple Choice Questions 48References 493 Health Promotion Introduction 51Health Promotion 52Biopsychosocial Model and Reproductive Health 54Inclusive and Culturally Safe Practice 59Public Health Approaches 60Common Female Reproductive Health Conditions 63Primary, Secondary and Tertiary Prevention 64The Role of Those Providing Care and Support 66Supporting Behaviour Change in Reproductive Health 68Digital Health 69Conclusion 70Glossary of Terms 71Multiple Choice Questions 72References 734 Planning Care: Cervical Cancer Introduction 76Cervical Cancer 76Prevalence and Demographics 79Types of Cervical Cancer 80Pathophysiology of Cervical Cancer 81Patterns of Spread 82Clinical Staging 82Overview of Cervical Cancer 83Cervical Cancer and Systemic Illness 84Signs and Symptoms of Cervical Cancer 86Diagnosing Cervical Cancer 89Communicating the Diagnosis 90Planning Individualised Care 91Digital Tools 93Management of Cervical Cancer 93Care Considerations 95Side Effects and Late Effects 96Psychosocial Support 96End-of-life Care Planning 96Survivorship Care and Secondary Prevention 97Promoting Equality 97Conclusion 97Glossary of Terms 98Multiple Choice Questions 99References 1005 Vital Signs Introduction 102Vital Signs in Context 102Clinical Decision-making in Practice 104Clinical Reasoning Cycle 104Core Vital Signs 106Hormonal and Endocrine Dynamics 107Vital Signs Across Life Stages 110Menopause 112Transgender and Non-binary People 112Clinical Considerations 113Chronic Reproductive Conditions 113Long-term Contraceptive Use 114Technology and Future Directions 115Conclusion 116Glossary of Terms 116Multiple Choice Questions 117References 1196 Cervical Screening Introduction 121Cervical Screening 121Obtaining Informed Consent 124The Procedure 129Communication 133Interpretation of Results 134Post-procedure Care 136Conclusion 163Responding to Concerns 137Conclusion 138Glossary of Terms 138Multiple Choice Questions 139References 1417 Female Genital Examination 143Introduction 143Gender-affirming Care 144Genital Examinations and Role Development 145Rationale for Performing Genital Examinations 146Professional Issues 146Patient Autonomy and Advocacy 147Confidentiality and Privacy 147Chaperones 148Infection Prevention and Control 149Professional Communication 149The Care Environment 150The Procedures 152External Genital (Vulval) Examination 154Speculum Examination 154Bimanual Vaginal Examination 156Transvaginal Ultrasound 160Transvaginal Ultrasound for Patients Without a History of Penetrative Sex 160Female Genital Mutilation and Genital Examinations 162Glossary of Terms 163Multiple Choice Questions 165References 1668 Specimen Collection 168Introduction 168Principles of Safe and Effective Specimen Collection 168Communicating Effectively 172Vaginal Specimen Collection 174Key Notes 174Cervical Screening 174Uterine and Endometrial Specimen Collection 174Risks and Contraindications 176Urine and Non-invasive Specimens 177Vulval and External Genital Specimens 179Documentation, Transport and Chain of Custody 180Ethical and Legal Considerations 181Conclusion 182Glossary of Terms 183Multiple Choice Questions 184References 185MCQ Answers 188Index 189