CHAPTER-7
Breast Self Examination
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Courtesy - American Cancer
Society
CHAPTER-7
Metal dilators. Sims Speculum
Uterine Sound Vulsellum Uterine Packing forceps
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Preparationof Patient :-
the o T
Receive the patient in
1
Explain the procedure and reassure.
Checkthe consent form and other necessary.
2
Be
sure about the cleanliness
of vulva and
perineum, Shaving is not always
patient about feed. of operation, if necessary.
4. Ask the No feed within 6 hours
anaesthesia. Otherwise may have light done under general
5
Premedication to be given as prescribed.
drinks.
6 Patient should empty the bladder prior to operation. Othewise catheterization to
7 Record vitalsigns. be done.
8
responsibilities during the procedure :-
Nurses
Place the patient in lithotomy position.
1.
Assist the doctor to clean the vulva, vagina and perineum with antiseptic lotion
Drapethe patient to maintain privacy. and swabs.
3. Assist to induce anaesthesia or to administer IN drugs.
Assist the doctor
during vaginal
4
5.
examination prior to operation.
Help in the operative procedure as required.
6 Preserve the curettings in the 10% formaline saline. (in case of
7.
formaline is not used)
suspected endometrial tuberculosis
Clean, dry, and comfort the patient after operation.
8 Observe for any abnormal bleeding and vital signs. Record the findings.
10.
Send the patient out of the O.T.
Record the operation.
11.
12.
Mash the articles and keep ready for sterilization,
Rndthe specimen for histological examination with filled form.
13. lain the discharge advice and follow up, specialy about rest,
a act. Patient can be discharged after ashort period of
analgesic, self perineal care and
observation for 3-4 hours and if the
patient's condition permit to go home.
remember :
Special points to
1
Strict asepsis to be maintained.
2 Itany vaginal pack is given, it should be removed before discharge.
Instruct the patient about the self perineal care in details.
Tie nrocedure is to be done by doctor. Nurse will assist throughout the
4 procedure.
neration can be done in the OPD setting, though usualy done in the O.T.
5.
DILATATION AND EVACUATION OPERATION
Dilatation and Evacuation (D & E) operation is a surgical procedure of dilating the cervical cannal and
evacuation of the products of conception from the uterine cavity.
Indications :
1 Incomplete abortion
2 Inevitable abortion.
3 Missed abortion.
4 Hydatidiform mole.
5 Medical Termination of pregnancy (6-8 weeks)
Articles Required :
Same as D &C operation.
Extra instruments needed for D &E operation
1 Ovum forceps-to remove the product of conception.
2 Flushing currette-to flush out and curette the uterine cavity.
3 Uterine dressing forceps-to clear out the uterine cavity.
4 Antiseptic lotion or Normai saline.
5 Laminaria tent can be used for slow dilatation of the cervical canal prior to evacuation.
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