MEDICAL PROCEDURES

Are procedures performed to asses the problem occurring in the body which give
a reliable data on the conditions of reproductive system.
Types
1. Urine studies
2. Blood studies
3. Cytology studies
4. Fertility studies
5. Syphilis studies
6. Radiological studies

Urine studies: This has to do with the analysis of urine using physical,
chemical microscopic test to determine the proportion of its normal
constituent and detect any abnormality.
There are two types of urine studies that are carried out to asses disorders
of reproductive system
(a) Pregnancy Test
(b) Testosterone and FSH test

PREGNANCY TEST: This is the method that is used to detect wether a

woman is pregnant or not by detection of the presence of a hormone
called HCG which is produce by the trophoblast. Production of HCG
begins on the day of implantation and can be detected in the urine
within 10 to 26days after conception.
Testestorone level test: This test can be done when there is tumours and
developmental abnormalities of the testes while
FSH test: is used to detect gonadal failure when there is pituitary dysfunction

BLOOD STUDIES
SERUM HCG: In this test the hormone is detected to ascertain the wether a
woman is pregnant and the hormone can be detected 6days after conception.
SERUM ANDROGEN & TESTESTERONE TEST
This test is being done to ascertain the increase in androgen level wether is due to
adrenal or ovarian dysfunction while serum Testestorone level is used to asses
the cause of ammenorrhrea
SERUM FSH: This test is used to validate menopause in female and production of
sperm in male
CYTOLOGIC STUDIES
Is the study of the structure and function of cell and these are obtain by scraping
an organ and most of the times the cell are cancerous. There are to major
cytology used in the disorder of reproductive system.These are
(i) Pap smear
(ii) Nipple discharge test

Pap smear: In this test pre-malignant and malignant cells from the female
genital tract are scrapped from the endothelialium and are examine
microscopically to detect vaginal and cervical carcinoma

Nipple discharge test: This is done to ascertain the spontaneous escape of fluid
from the nipple and this also help or enable to know if the woman is breast
feeding or has any history of amenorrhea discharge and the discharge from
the nipple is then examine for fat, globulins to detect if breast milk is found or
not.
When the discharge is green it indicates serious infection and can be treated,
when it is brown or red in colour it indicates serious problem/ but when the
discharge is clear there is no problem
 FERTILITY STUDIES: It is the study used to know the capacity or ability to
reproduce offsprings.Female fertility depend on ovulation and easy passage of
egg in to fallopian tubes towards the uterus. Women become fertile at puberty
and remain so until menopause, men remain until 70years. while male fertility
depend on so many factors such as healthy sperm, ability to retain and create
and retained.
Test used in fertility studies include
(i) Semen analysis: These analysis is done incase of infertility.The semen is
assesses for volume, (2-5mls), Viscousity, , Sperm cells less than
20million, sperm motility and percentage of abnormal sperm. Structure
(ii) Sim's hulliner test: In this test sample of mucus from the cervix is is
examine for 2-8hrs after intercourse to determine wether the cervical
mucus is hostile to the sperm that passes from the vagina to the uterus
SPHYLLIS STUDIES: Is a study that is used to detect chronically sexually
transmitted disease caused by bacteria and treponoma palliduma
RADIOLOGICAL STUDIES: This involves the study of the radiographs & other
imaging techniques such as ultrasound and mammograph to diagnose or treat
disease

SURGICAL PROCEDURES

 Dilation and curettage (D&C) – A D&C involves the removal of tissue from
inside the uterus in order to diagnose and treat certain uterine conditions
(e.g., heavy bleeding) or to clear the uterine lining following a miscarriage
or abortion.
  Hysterectomy – This refers to an operation to remove the uterus. In some
cases, it may also involve the removal of other surrounding structures, such
as the cervix, ovaries, or Fallopian tubes.
 Laparoscopy – This operation is performed for diagnostic purposes or
therapeutic intervention with a few small cuts in the abdomen and the use
of camera called a laparoscope.
 Pelvic floor repair – This is minimally invasive surgical technique used to
correct pelvic prolapse, a condition in which the pelvic muscles can no
longer support organs (uterus, vagina, bladder and/or rectum) in the pelvic
area, resulting in symptoms such as urinary leakage, constipation, or
difficulty with intercourse.
 Myomectomy – This procedure removes uterine fibroids, noncancerous
growths in the uterus that produce heavy bleeding and pelvic pressure.
 Ovarian cystectomy – This surgery is designed to remove a cyst from
an ovary using a minimally invasive laparoscopic technique with only a few
small incisions in the lower abdomen.
 Cesarean section – This refers to the surgical delivery of a baby through an
incision in the mother’s abdomen and uterus.
 Cerclage – The purpose of this procedure is to help prevent premature
birth by closing the cervix during pregnancy using strong sutures (stitches).
The stitches are removed during the final month of pregnancy
 AUGMENTATION MAMMOPLASTY: Is an Implantation of breast
prostheses for the purpose of enlarging the breast. This procedure is
performed for micromastia, postpartum involution of the breast, and post
surgical deformity. The silicon rubber prostheses can be filled with gel,
inflatable, or filled with gel

REVIEW OF ASEPTIC TECHNIQUE

PRINCIPLES AND PRACTICE OF ASEPTIC TECHNIQUE

INTRODUCTION
The aseptic technique is a method of preventing the transmission of infection to
the patient during the performance of various clinical procedures. The correct
practice of this technique requires the understanding of some principles and
facts.
DEFINATION:
Aseptic Technique: Is the method of carrying out a procedure with minimum risk
of introducing infection. The aim is to avoid introduction of micro-organism in to
vulnerable tissues of the body.
Sources of infection in the ward
 The patient's skin
 The air
 The contaminated surfaces
 Contaminated instrument
 Human nasal and throat cavities
 Nasal carriers
 Skin carriers
Ways of preventing cross infection in the ward
1.Adequate bed spacing
2.Sterilization and disinfection of equipments
3.Isolation or barrier nursing when necessary
4.Proper ward hygiene E.g. Dump Dusting, sweeping etc.
5.Nurses and doctors personal hygiene E.g. hand washing before and after
attending to each patient
6.Patient's personal hygiene E.g. covering mouth when sneezing
7.Provission of air conditioner instead of Fan
8.Proper disposal of hospital waste
Principles of Aseptic Techniques
1. The tray or trolley to be used must be carbolised
2. All equipments used must be sterile
3. Unsterile article should not cross over a sterile field
4. Minimal movement during the procedure
5. Talking is minimize or not done at all
6. Use of the mask to avoid breathing on the vulnerable tissue or sterile article
7. Any sterile article that falls on the ground is regarded as unsterile even if not
used
8. Gloves are worn before the procedure
9. Only sterile items are used within the sterile field
10. Microorganisms must be kept to an irreducible minimum

Isolation Techniques
1. Utensils and equipments are kept and used solely for individual patient there
2. Gowns are kept outside or by the door side for attendants
3. Mask, gloves and disposable towels are supplied for used
4. Gown is worn and remove before washing hands
5. Soiled bed and patient linen are put in disinfectant solution for 2 hours before
they are sent to the laundry
6. Feeding utensils are washed in the patient room or separate bowl outside
7. Food left over by patient are disposed
8. The relatives is educated and ensure compliance on aseptic Technique
what is suturing?
Suturing is the application of a stich or series of stiches made to secure
apposition of the edges of a surgical or traumatic wound.

GOALS OF SUTURING
1. Maintain hemostasis.
2. Aid in wound healing.
3. Supporting and strengthening the wounds until healing occurs
4. Minimizing the risk of bleeding and infection
5. Reducing the skin edges for a cosmetically appealing outcome
 6. Closing dead space

BASIC PRINCIPLES OF SUTURING

1. Non touch technique

2. Fewer numbers of sutures are not possible
3. From mobile to fixed tissue
4. 3-5mm from margin and needle should enter at right angle to the
mucosa
5. Avoid over tightening
6. Avoid overlapping the wound
7. Undermine the incision to facilitates insertion of the needle and
decrease tension
8. Sutures should be remove after 5-7 days

Complication

o Poor apposition of wound edges

o Stitch Marks
o Stitch Abscess
o Infection
o Dehiscence
o Skin necrosis

INCISSION &DRAINING

 Abscesses are localized infections of tissue

marked by a collection of pus surrounded by
inflamed tissue.

Indication
 Skin and soft tissue infection

Abscesses may be found in any area of the body,

but most abscesses presenting for urgent
attention are found on the extremities, buttocks,
breast, perianal area, or from a hair follicle.
Abscesses begin when the normal skin barrier is
breached, and microorganisms invade the
underlying tissues.
Causative organisms commonly include
Streptococcus, Staphylococcus, enteric bacteria
(perianal abscesses), or a combination of
anaerobic and gram-negative organisms

Materials

1. Universal precautions materials

2. 1 or 2 lidocaine WITH epinephrine for local

anesthesia, 10 cc syringe and 25 gauge needle for
infiltration

3. Skin prep solution

4. 11 scalpel blade with handle

5. Draping

6. Gauze

7. Hemostat, scissors, packing (plain or

iodoform, 1/2)

8. Tape

9. Culture swab
procedure

1.Explain the procedure and  Obtain informed consent

2. Wash and dries hand

3.wear gloves

5. Maintain aseptic technique

6. Cleanse site over abscess with skin prep

7. Drape to create a sterile field

8. Infiltrate local anesthetic, allow 2-3 minutes

for anesthetic to take effect

9. Incise widely over abscess with the 11 blade,

cutting through the skin into the abscess cavity.
Follow skin fold lines whenever able while making
the incision

10. Allow the pus to drain, using the gauzes to

soak up drainage and blood. Use culture swab to
take culture of abscess contents, swabbing inside
the abscess cavity

11. Use the hemostat to gently explore the abscess

cavity to break up any locations within the
abscess

12. Using the packing strip, pack the abscess

cavity

SETTING OF I.V LINE

I.V infusion: Is the administration of a prescribed electrolyte, food or drug

in solution through a vein.

1.Receiver with a 10mls syringe

2.Sterile giving set

3.Solution to be infused,

4.2 pairs of gloves

15.Mask

6.Fluid balance chart

7.Tourniquet

8.Drip stand

9.Screen

10.Plaster

11.Sterile cotton swab

12.Reciever for used swab

13.Methylated spirit

.When Rapid and prolonged action is required in an emergency condition

2.When internal intake of food is not possible e.g. unconscious state

3.To counteract shock

4.To correct fluid and electrolyte imbalance

5.when a large dose of drug I required

Procedure for setting I.v line

1.Explain procedure to the patient

2.Gather all requirements at once

3.Bring Trolley to the patient's bed side

4.Screen bed and close nearby windows

5.place patient in convinient position and expose chosen site

6.place drip stand by the patient bedside

7.protect bedlinen under site with dressing

8.put tourniquet or sphygmomanometer in position but do not tie

9.Scrub hand and dry

10. Assemble apparatus, flush fluid through tube to expel air and drip left
ready on drip stand

11.Assitant pours antiseptic lotio in to gallipot

12. Instruct assistant ties tourniquet and patient instructed to open and
close first several times

13.Clean site with antiseptic lotio

14.Insert needle in to vein

15.Release and remove tourniquet to flow at required rate

16.Release clamp to allow fluid flow at required rate

17.Secure needle with a loop of tubing with adhesive plaster where

necessary

18.Immoblize limb with splint and bandage not too tightly

19.Observe site of infusion for any swelling

20.Leave patient compostable

21.Remove screen and open windows

22.Discard trolley

23.Document the procedure

Complication

1.Thombus

2.Embolism

3.Thromboplebitis

4.Pain

5.Swelling

6.Infection