PAP SMEAR

WHAT IS PAP SMEAR TEST??

Is obtaining sample of exfoliated cell (dead cells that are shed) @ simple test to look at cervical cells

The specimen should be obtained 2 weeks after the first day of LMP taken by brushing or scraping.

PURPOSE

To detect early cancer of the cervix

To determine estrogen activity related to menopause or endocrine abnormalities.

WHEN TO DO PAP SMEAR?

All women have initial pap smear test no later than 21 years old

3 years after onset of sexual intercourse

After initial test, have annually or biannually

After age 30, because screened for 2-3 years unless has high factor developing cervical cancer

EQUIPMENT FOR VE PAP SMEAR

Vulva swabbing set •Container Vaginal speculum - Mask Receiver -Vaginal speculum Savlon -Torch light Perianal drapes -Cytobrush,Thin

prep Sterile glove -Incopad KY jelly -Swab sticks for

HVS Specimen Form

Vagina speculum

Cytobrush,Ayre’s spatula and thin prep

Thin prepAyer’s spatula

KY jelly Swab stick for HVS

PREPARATION BEFORE :

Nurse should advise patient to make an appointment other than during menstruation

Before appoiment : 1.Avoid intercourse for 2 days 2.Refrain from douching for 1 day 3.Cease the use of vaginal medication

for at least 48 hours.

PRE-PROCEDURE

1. Inform and explain the procedure to patient

2. Advice patient to void.3. Provide privacy.4. Assistant position Lithotomy to her on

examining table5. Drape patient permit minimal

exposure.

DURING PROCEDURE1. Explaining the procedure as

needed.2. Encourage patient to take deep

breaths- help the pelvic muscles relax.

3. Give support to the patient.4. Assist Dr in doing pap smear.5. Help to open the set.6. Help to focus the torch light to

perinea area of patient.

Insertion of speculum

POST-PROCEDURE1. Observed any discharge from the

vagina.2. Perineal care as needed.3. Assist patient from the dorsal

recumbent /Lithotomy position to supine position.

4. Documentation.5. Sent the specimen to Laboratory

with the form.

Normal: negative means there is no identifiable infection.

ASCUS :presence of a high-risk infection with HPV. Low-Grade changes: frequently due to infection

with HPV, which in some instances can be a risk for cervical cancer.

High-Grade changes: very atypical cells that may result in cancer

Squamous cell carcinoma or adenocarcinoma: cancer is evident and requires immediate attention.

HEALTH EDUCATION

1.Tell patient to inform any excessive bleeding after procedure(a little bid bleeding is normal.)

2.Instruct patient to follow up the procedure at least annually or biannually.(Depend on results)