COLPOSCOPY – Purposes, Indications, Client Preparations, Procedure, Post-Procedural Care, Factors Affecting Diagnostic Results and Client Teaching (MATERNAL AND CHILD HEALTH NURSING)
Colposcopy is the examination of the vagina and cervix using a binocular instrument (colposcopy) that has a magnifying lens and a light. This test is for identifying precautions lesions of the cervix and can be performed in the gynecologist’s office or in the hospital. After a positive papanicolaou (pap) smear or a suspicious cervical lesion, colposcopy is indicated for examining the vagina and cervix more thoroughly.
Atypical epithelium, leukoplakia vulvae, and irregular blood vessels can be notified with this procedure, a photographs and a biopsy specimen can be obtained. Since this test has become more popular, there has been a decreased need for conization (surgical removal of a cone of tissue from the cervical). Colposcopy is also useful for monitoring women whose mothers received diethylstilbestrol during pregnancy; these women are prone to develop. Colposcopy is used to monitor female patients who have had cervical lesions removed
PURPOSES
To identify precancerous lesion of the cervix
INDICATIONS
- Vaginal and cervical lesions
- Abnormal cervical tissue after a positive Pap smear
- Irregular blood vessels
- Leukoplakia vulvae
- Dysplasia
- Cervical lesions
- Vaginal and cervical tissue changes for women whose mother took diethylstilbestrol during pregnancy
CLIENT PREPARATIONS
- Explain the purpose and procedure to the client
- Encourage the client to ask questions and to express any concerns or fears. Reducing anxiety is important for the client and for the rest, remains with the client during the procedure
- Place the biopsy tissue into a bottle containing preservation and place the cells, if obtained, on a slide and spray them with a fixative solution
PROCEDURE
- A consent form should be signed
- Food and fluids are not restricted
- The client’s clothes should be removed, and the client should wear a gown and be properly draped
- The client assumes a lithotomy position (legs in stirrups). A specimen is inserted into the vagina, and a long, dry cotton swab applicator is used to clear away any cervical secretions. Another long cotton-swab applicator with saline may be used to swab the cervix for visualizing vascular patterns
- Acetic acid (3%) is applied to the vagina and cervix. This produces color changes in the cervical epithelium and helps in detecting abnormal changes a biopsy specimen of suspicious tissues and photographs may be taken. Pressure should be applied to control bleeding at the biopsy site, or cautery may be used
- A biopsy specimen of suspicious tissues and photographs may be taken. Pressure should be applied to control bleeding at biopsy site, or cautery may be used
- The test takes approximately 15-20 minutes
POST-PROCEDURAL CARE
- Inform the client that she may have some bleeding for a few hours because of the biopsy. Tell neither the client that she can use tempons and that if bleeding becomes heavy and it is nor her menstrual period, she should call the gynecologist
- Instruct the client not to have intercourse for a week until the biopsy side is healed or as ordered by the healthcare provider
- Inform the client that the doctor will notify her of the results, and tell her to call if she has not heard from the office in a week
FACTORS AFFECTING DIAGNOSTIC RESULTS
Mucous, cervical secretions, creams and medications can decrease visualization
CLIENT TEACHING
- Inform the client that she should not experience pain but that there may be some discomfort with the insertion of the speculum or when the biopsy specimen is taken
- Tell the client that the test takes 15-20 minutes
