Doing physical examination

It is only necessary to do a physical examination in some contexts. If a young person comes to you for emergency contraception and cannot spend time with you, it is enough to briefly discuss sexual behaviour with her and then give her what she wants. Sometimes, it is only important to do a physical examination for diagnosing the health problem the young person has had. Doing some physical examinations may cause discomfort to the young people. For example, vaginal examination for a vaginal discharge may cause embarrassment in a young woman. Therefore, avoid doing vaginal examination unless there is a strong indication to perform it. For example, for a young woman in labour you should do a vaginal examination to assess the progress of labour.

You should never do a pelvic examination of a virgin as part of the physical examination. The following conditions are important aspects of physical examination in young people:

• Measuring temperature.
• Counting pulse rate.
• Checking for the presence of anaemia.
• Checking for the presence of under-nutrition.
• Examining for the presence of swelling or tenderness in the abdomen.

How to make the physical examination less stressful to a young person

The following are important points in making examinations less stressful to the young people

• Keep physical as well as auditory privacy of the young people.
• Explain each step of the examination what you are going to do before you begin.
• Allow them to keep their clothes on except for what must be removed. Make sure to cover the parts of the body that are exposed. Never leave any part of the body exposed when not being examined.
• Reassure the client that any results of the examination will remain confidential.
• Establish trust; a good relationship between you and the young person is essential.
• Provide reassurance throughout the examination.
• Give constant feedback in a non-judgmental manner, "I see you have a small sore here, does it hurt you?".

Based on what you get from the history taking and physical examination, you should counsel and provide services for each particular problem the young person has had. The way how to manage and give appropriate services depends on the specific presenting condition of the young people. Therefore, for pregnancy, childbirth and postpartum, STIs, HIV/AIDS, unsafe abortions, contraception, emergency contraception, sexual abuse and substance abuse see the respective sessions in this module on how to respond to the specific needs of the young person.