Abnormal findings are charted as a chain — finding, severity, comparison to baseline, the risk it creates, and the skilled action taken.
Any vaginal bleeding after menopause — treated as malignancy until excluded and requiring evaluation.
Severe pelvic pain, especially with fever — concerning for pelvic inflammatory disease, an abscess, or ovarian torsion.
Heavy vaginal bleeding with light-headedness, pallor, or hemodynamic change — an emergency.
Perineal or vulvar pain out of proportion to the exam with discoloration, crepitus, and systemic toxicity — concerning for a necrotizing perineal infection (route to External Genitalia).
A post-operative complication — significant bleeding, infection, or vaginal-cuff dehiscence after gynecologic surgery.
A pessary complication — erosion, an inability to remove it, or a foul discharge suggesting retention or infection.
Worsening prolapse with new voiding or bowel dysfunction — requiring management.
Abnormal vaginal discharge with infection signs — requiring evaluation.
