Question

ll 80% 7:46 X 976 Copy of CS_CH_57 F R... View only Case Study, Chapter 57, Management of Patients With Female Reproductive Disorders 1. June Brite, 35 years of age, is admitted to the medical-surgical unit after a vaginal hysterectomy with bilateral salpingo-oophorectomy for the treatment of uterine cancer. (Learning Objective 7) a. What will occur as a result of this type of surgery and what are the treatment options? b. What nursing care should be provided for the patient as she arrives on the medical-surgical unit? c. What discharge instructions should the nurse provide the patient? 2. The Health Promotion nurse at a state university plans a series of educational programs focusing on female reproductive health issues for incoming first-year female students. Because cervical cancer is the third most common female reproductive cancer and affects over 10,000 women annually in the United States, the nurse has planned the first session to focus on cervical cancer screening and prevention. (Learning

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Answer 1

Case study

1. Vaginal hysterectomy is a surgical procedure in which the uterus is removed through the vagina. Bilateral salpingo-oophorectomy is performed in order to remove both the ovaries and fallopian tubes.

a. This surgery is done to treat problems related to uterus, ovaries, and fallopian tubes. In this case, it is used for treatment of uterine cancer. As a result of removing these organs, the patient can be saved from the risk of cancer cells metastasizing to other parts of the body. The problems and discomfort associated with uterine cancer like excessive bleeding and pain will be gone once the surgery is done.

This type of surgery can result in hormonal effects causing immediate menopause. As a result of this, in the long run, the patient is likely to develop osteoporosis, bone fractures, cardiovascular diseases, dementia, impaired sexual function, etc. The best way to combat these ill effects is to undergo hormone replacement therapy. It involves taking progesterone and estrogen medications.

b. The patient may need to stay in the hospital for 2 to 3 days after the surgery.

Nursing care provided for the patient when she arrives on the medical-surgical unit include:

• Intravenous fluid is administered on the first day, especially if the patient is nauseous or is vomiting.
• Pain medicine must be given orally or intravenously.
• Vaginal packing that is used to reduce bleeding is removed the next day after the surgery.
• Catheter is also removed the next day and urine output must be monitored.
• Nutritious food and a diet containing high fiber must be given in order to improve bowel function.
• Should help the patient to perform routine activities initially.
• Patient must be encouraged to remain active by doing small activities like moving leg and foot, sitting on the bed side, taking a short walk, getting up, etc. She should resume daily activities as soon as possible.
• Instruct the patient to perform deep breathing exercise and coughing to prevent lung congestion.

c. Discharge instructions provided to the patient.

Instruct the patient regarding the things to be taken care of while at home.

• Bleeding or spotting is common and for this, sanitary pads must be used. (Not tampons)
• Do not douche.
• Avoid sexual intercourse for 4 to 6 weeks.
• Do not lift heavy weight for 4 to 6 weeks.
• Try increasing activities slowly.
• Daily activities like walking must be performed regularly.
• Patient may experience emotional stress. In such cases, she should get help from the doctor.
• Take the prescribed medications on time and pain medication must be taken as needed.
• Educate the patient regarding life after hysterectomy. She will not experience monthly periods from now on and will not get pregnant.
• Hormone replacement therapy must be continued with the assistance of the doctor.
• Get immediate help if there are any signs of infection, fever, uneasiness, less urine output, excessive pain, etc.