Gynaectomy Case Studies

According to Franciscan Alliance’s internal policy (2016), “The registered nurse (RN) may independently enter an order into the medical record per policy/protocol to discontinue an indwelling urinary catheter” (p.2). The hospital policy for CAUTIs includes proper placement and removal of the catheter, as well as the protocol for when to remove an indwelling catheter. The specific guidelines in which a catheter should be maintained are in agreement with the CDC guidelines. Franciscan Alliance’s criteria to maintain an indwelling catheter include (2016):

When I started my placement , Mrs . X who was suffering from Parkinsonism and dementia was on Indwelling urinary catheter for the management of urinary incontinence. Adhering to the results from the literature review I planned for initiating several steps to control incontinence in Mrs. X. My mentor was always with me with full support and guidelines. Fluid management was the first step started. An input output chart was kept and well maintained. Then steps wre also taken to manage constipation. Exercises were the last method practiced and the final result was really appreciable as she got a great reduction in the incontinence rate.

Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)

Good Evening Barbara for getting back with me if it was not for Kim I really and few more employees at Penfed. Really I would had left and my father as when. Barbara with kim am trying to get loan which am going to reapply with my boyfriend, now the autoloan its crazy. Since day one.

The first step nurses can take to decrease the incidents of CAUTIs in older adults is avoiding unnecessary use of catheters altogether. Initially, this begins with nurses knowing both appropriate and inappropriate situations in which a catheter should be utilized. According to (Gould et al., 2017), an appropriate situation is one where a patient has acute urinary retention or bladder obstruction, whereas an inappropriate situation is one where a catheter is being used a means of obtaining urine for culture when the patient can voluntarily void. Nurses can also use basic techniques like palpation, percussion, and inspection to effectively assess urinary retention, which is the main reason for catheterization as mentioned earlier. When techniques like this do not achieve desired results,

According to a study conducted in 2011 by the government, approximately 80% of urinary tract infections associated with indwelling catheters, increase the hospital length of stay by one to three days, and according to the Centers for Medicare & Medicaid Services (CMS), have an annual cost of

After an initial search of scholarly databases, a total of fifteen articles was selected for their application to the PICO question. An appraisal of each article uses the following format:

The three questions addressed were: Who should receive urinary catheters, what are the best practices for those who require urinary catheters and for preventing CAUTI’s acquired from urinary obstruction. This updated guideline offers recommendations for the appropriate use of indwelling catheters utilizing appropriate indications for usage, proper techniques for insertion of indwelling catheters, proper techniques for indwelling catheter maintenance, quality improvement programs, administrative infrastructure and surveillance including identifying those at risk for CAUTI (Gould et al, 2009). The strengths of this guideline are that many questions and scenarios are examined in this document and answered in explicit detail. Any healthcare professional can refer to the document to answer most practice based questions that are posed to them regarding indwelling urinary catheters. One weakness identified is the lack of an alternative explored for the external catheterization for female patients, for example the Purewick solution. However, the Purewick was not released until January 2016 and this guideline was last updated in 2009. Integrative Review

Having a hysterectomy can be one of the most difficult decisions a woman ever has to make. It can threaten your identity, sexuality, and fertility, and lead to lingering feelings of grief, depression, and loss. But sometimes a hysterectomy is necessary in order to increase quality of life, reduce painful symptoms, or even save lives. If you are thinking about having a hysterectomy, it is important to weigh your decision carefully. This report is designed to give the reader some important background information on hysterectomy procedures and on how a hysterectomy might affect you or someone you love.

A hysterectomy can be a life-saving procedure for women who are having serious reproductive health issues. Dr. John Macey, MD performs this procedure and many others as part of his practice. If you live in Kentucky, Alabama, or the mid-central Tennessee area near Nashville, Dr. Macey encourages you to call his office for all of your OB/GYN needs. After a thorough examination, he’ll discuss any possible health issues  you may have and offer effective treatment options to help overcome them.

First my father had to go through Transurethral Surgery, to remove the primary tumor from his bladder. During this procedure a resectoscope is passed through the urethra and into the bladder. This instrument has a wire loop attached at the end of it, which is used to scrape the tumor off the wall of the bladder. The tumor is then sent to the lab to be tested for cancer. The patient of this surgery can be placed on either regional anesthesia (patient’s lower body is numbed) or general anesthesia (patient is completely asleep). Side effects to this surgery can include bleeding and pain when urinating. This procedure is very effective because the tumor is completely removed from the bladder and the site is burned to ensure the base of the tumor was removed. My father has had this surgery twice in the past two years where they have successfully removed all of his tumors. He does suffer side effects from the transurethral surgery, such as vomiting, difficulty urinating, and is in a lot of pain, but it prevents him from having to go through Chemotherapy (American Cancer

After completing my Master's in Biomedical Science at Barry University, I increased my work hours at Good Samaritan Medical Center from thirty hours a week to forty hours. This opportunity increased my clinical exposure allowing me to have more interactions with patients. In addition, I continued working on a research review article on the effects of anti-emetic drugs on postoperative gynecology procedure. I plan to continue working on writing review articles with Barry's Biomedical program Director Dr. Chandra, to sharpen my research skills and writing skills.

“Perimenopause is the period extending from the first signs of menopause- usually hot flashes, vaginal dryness, or irregular menses- to beyond the complete cessation of menses” (2014). There are two basic regimens for Hormone therapy, estrogen alone and estrogen plus progestin. “The purpose of estrogen in both regimens is to control menopausal symptoms by replacing estrogen that was lost owing to menopause. The progestin is present for one reason only; to counterbalance estrogen mediated stimulation of the endometrium, which can lead to endometrial hyperplasia and cancer” (2016). The estrogen/progestin regimen is used for women who still have a uterus while the estrogen only is used for women who have undergone a hysterectomy.

A small soft tube may be placed inside the ureter to ensure the free flow of urine while the edema goes down. The stent may remain in place for a few days, and may cause mild discomfort in the area of the kidney or bladder. Its removal may require a cystoscopy.

I was slightly familiar with the foley catheter, however, I need some slight guidance. I knew that I needed to drain the foley bag because it was slightly full, but I did not know where to unclamp to drain it. The nurse’s aid taught me how to unclamp the bag so I can drain the urine. I also learned that when moving the patient who has a foley bag, it was important to make sure that the patient is not going to get a UTI. UTI can be caused by holding the foley bag at a higher positon causing the urine to backtrack. It is important to keep that in mind as a healthcare worker. I have not been skill checked on foley catheters, however, I need to practice working around foley catheters to protect the patient. I could always go on youtube and search videos on foley catheters or I can use the perry and potter book to learn