Question

Procedure Name: Hysterectomy Description of Procedure Pevien Modele Chapter 29 Indications CONSIDERATIONS Nursing luterventions (pre, intra post Outcomes/Evaluation Client Education Nursing Interventions Potential Complications
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Answer 1

Hysterectomy

Description of procedure

Hysterectomy is the surgical procedure to remove all of or part of the uterus.

Indications

* Cancer of the uterus

* Menorrhagia( excessive uterine bleeding) due to Uterine fibroids , infections

* Uterine prolapse

* Endometriosis

* Adenomyosis( tissue that lines the uterus grows inside the walls of the uterus causes severe pain)

Nursing interventions

Pre operative:

-Assess the patient's understanding regarding hysterectomy

- Reassure the patient, provide explanation and emotional support

- Clean abdominal and perineal area

- administer medications as per Doctor's order( pre operative medications)

Intra operative:

- Monitor the vital signs of the patient

- Monitor pulse oxymetry

-(Count all swabs, sponges and sterile instruments( scrub nurse)

- Arrange sterile instruments in expected order( scrub nurse))

Post operative:

- Inspect dressings and perineal pads for heavy bleeding( to identify post operative haemorrhage)

- Monitor urinary output and voiding pattern ( to identify urinary retention)

- Provide good catheter care encourage perineal cleansing( to prevent urinary tract infection)

- Avoid high Fowler's position( to prevent pelvic congestion)

- listen to fears and concerns of patient

Outcomes

* Patient will have a clear understanding regarding the procedure.

* Patient will have a reduced level ofvanxiety over the surgical procedure

* Patient will remain free from infection throughout hospitalization

* Patient will empty the bladder regularly

* Patient will be free from oedema, signs of thrombosis

* Patient will verbalize concerns and indicate healthy ways of dealing with them

Client education

Client education should be regarding on

-deep breathing exercise

- importance of early ambulation

-Increase fluid intake

- restriction of physical activity for one month

- stair climbing, douching, sexual intercourse and heavy lifting should be avoided for 6 weeks

- Proper rest as she may feel tired for several days

- risk of loss of appetite and constipation

Potential complications

* Infection

* urinary incontinence

* vaginal prolapse and vaginal fistula

* ileus( disruption of the normal propulsive ability of GI tract)

* haemorrhage and shock

* Pulmonary embolism or thrombosis

* thrombophlebitis

Nursing interventions

- Maintain aseptic conditions during the procedures like dressing the wound, catheterization

- Identify the early signs of infection and other complications

- Notify the physician in case of any signs of complication

- Monitor vital signs in frequent interval

- Client education regarding the restrictions of physical activity, proper rest and food and follow up.