Female catheterization with possible retained tampon

[heatherrn1234]

I have a few simple questions. If you had a pt POD 5 after a c-section on the med/surg unit with possible retained tampon (unknown length of tampon retention), would a lady partsl sweep by the rn be indicated prior to foley insertion. My critical nurse brain says that this action would help reduce the risk of possible infection. Is a "lady partsl sweep" considered a pelvic exam? Clean or sterile gloves for the sweep? Is this within the rn scope of practice?

[LessValuableNinja]

Depends on your state and facility.

In mine, RNs do cervical exams regularly, and that's more invasive than a sweep.

[xoemmylouox, ASN, RN]

Someone had a retained tampon after a c-section? How is that even possible? That thing had to be up there 5+ months. Wouldn't the smell have triggered an investigation by someone before that point?

[Double Dunker]

Some women still menstruate when pregnant. If it was a planned csection, she wouldn't have had any contractions to push it out. Or did she insert it after the csection d/t the bleeding?

[PCnurse88]

Uh, if you think your patient has a retained tampon, I would hope you'd be spreading her legs IMMEDIATELY to check and calling the doc ASAP as this could very quickly lead to TSS, sepsis, and/or death.

I'm not an OB nurse, but if she's POD 5, wouldn't she have had her cervix checked prior to csection? (Do they still check baby's position even in a planned csection?) I mean, I imagine SOMEONE would have checked her out down there in OB, whether it was position check or foley/straight cath due to anesthesia.

To answer your question as basic as possible, though - no, a foley insertion would not have anything to do with a lady partsl sweep, as the foley and a tampon go in two different places.

[NPOaftermidnight, MSN, RN, NP]

Double Dunker said:

Some women still menstruate when pregnant. If it was a planned csection, she wouldn't have had any contractions to push it out. Or did she insert it after the csection d/t the bleeding?

No. Women do NOT menstruate when pregnant (I can't believe I just typed out that sentence. On a nursing forum ). Can you have bleeding/spotting during pregnancy? Absolutely, but it is NOT menstruation and you should absolutely not be using a tampon.

I feel like there is some major information missing from this story. Why do you suspect a retained tampon? Why was the patient using tampons? Why are you inserting a foley on POD 5? Why is the pt even still in the hospital on POD 5 of a csection? Clearly something has gone wrong here. However, regardless of the answers to these questions, you need to call up that provider and have them come do a pelvic as soon as possible. If I could see a string I would remove it, but a "lady partsl sweep" is not something that I would feel comfortable with as an RN - just have the provider come do an exam with a speculum.

[Anna Flaxis, BSN, RN]

What did the OB-GYN have to say about this?

[Kooky Korky, BSN, RN]

NPOaftermidnight said:

No. Women do NOT menstruate when pregnant (I can't believe I just typed out that sentence. On a nursing forum ). Can you have bleeding/spotting during pregnancy? Absolutely, but it is NOT menstruation and you should absolutely not be using a tampon.

I feel like there is some major information missing from this story. Why do you suspect a retained tampon? Why was the patient using tampons? Why are you inserting a foley on POD 5? Why is the pt even still in the hospital on POD 5 of a csection? Clearly something has gone wrong here. However, regardless of the answers to these questions, you need to call up that provider and have them come do a pelvic as soon as possible. If I could see a string I would remove it, but a "lady partsl sweep" is not something that I would feel comfortable with as an RN - just have the provider come do an exam with a speculum.

I have heard of more than one woman who has menstruated even while pregnant. At least 1 had menstruation through her 6th month.