Running head: COMMUNITY PROJECT

Community Project
Erin H. Chun
KCC 320 Nursing

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For my community resource project, I visited Pali Womens Health Center in Kailua.
This center is composed of three medical doctors, one physician assistant, one mid-wife, clinical
assistants, and receptionists, whom are all women. Along with a friendly and welcoming smile
they specialize in womens health and maternity care. They specialize in a wide variety of care
which include the following: pap smears, breast exams, osteoporosis prevention, contraceptive
counseling and family planning, menopause management and hormone replacement therapy.
They also provide treatment for gynecologic problems such as: abnormal pap smears,
endometriosis, polycystic ovarian syndrome, abnormal menstrual bleeding, uterine fibroids,
urinary leakage and incontinence, pelvic pain, vaginal infections, and urinary tract infections.
Maternity care include: prenatal care and education, pregnancy testing, fetal
assessment and monitoring, management of multiple births, gestational diabetes,
delivery options, cord-blood banking, post-partum care, family planning, and birth
control options. As you can see, this facility caters to teenagers to eighty-ninety
year-old women.
When I arrived, I spoke with Malia, who was a medical assistant. She
answered most of my questions, gave me a short tour, and a plethora of handouts.
We focused on two interesting topics which were abnormal pap smears and urinary
incontinence.

Pap smears are not diagnostic test but are screening tools used to

detect any abnormal cells in the cervix. This procedure is done to detect early
signs of cancer so that, if any are found, it can be treated before the disease
actually develops. An abnormal pap smear may indicate the following: infection,
inflammation, Herpes, Trichomoniasis, recent sexual activity, Human Papilloma
Virus, or dysplasia. If one is to have an abnormal pap smear, the second step
would be to get a colposcopy. During the exam, a colposcope is used to magnify

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the cervix, which will allow the health care provider to exam any signs of problems,
such as genital warts or abnormal cells.

If there are any abnormal areas on the

cervix, a tiny sample of tissue may be taken and sent to the lab for a closer look.
The third step if the results are abnormal is to have a special procedure called Loop
Electrosurgical Excision. LEEP is used to remove the area containing abnormal cells
from the cervix. This procedure uses a thin wire loop that acts like a scalpel. An
electric current is passes through the loop, which cuts away a thin layer of the
cervix.
Urinary incontinence is another topic I find interesting. It simply means
uncontrolled leakage of urine and is not only directed toward the older population.
Stress urinary incontinence, which is a type of urinary incontinence, is when a
woman leaks urine when she coughs, laughs, or sneezes.

Stress urinary

incontinence may be caused by a weakening of the sphincter muscle that controls

the urethra, which may occur from pregnancy, childbirth, or aging. Pelvic support
problems also cause stress urinary incontinence.

To test for stress incontinence,

they go through a procedure called urodynamic, which will then figure out if she will
be a good candidate for sling surgery. She is asked to drink a lot of fluid and when
she can no longer hold her urine, she releases her urine into a measuring cup. The
measuring cup interprets the following: volume, duration, and characteristics.

It

simply tells us what happened from the start of the stream to the end. When the
bladder is completely empty, the second part of the procedure begins. A catheter
is inserted into the urethra