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Nursing Care for patient undergoing TAHBSO for ovarian growth

Nursing Care for patient undergoing TAHBSO for ovarian growth

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Published by: sugarmontejo on Sep 07, 2009
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05/11/2014

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Pre Operative nursing careAssess patient. The health history and the physical and pelvic examinationsare completed and the laboratory tests are performed.Encourage patient to share details of her menstrual history, the date of her lastmenstrual period, the events leading up to admission and the current degree of vaginal blood loss or discharge.Assess client’s knowledge of her condition and the surgery.Perform skin operation: The lower half of the abdomen and the pubic and perineal area may be shaved and these areas may be cleaned with soap andwater.To prevent contamination and injury to the bladder or intestinal tract, the bladder and intestinal tract need to be empty before the patient is taken intothe OR.The patient who has previously been prescribed with oral contraceptive drugwill have to stop taking the drug 6 weeks prior to operation.Preoperative medications may be administered before surgery to help the patient relax.The patient must be allowed time to talk and ask questions.The nurse must know what information the physician has given the patientabout the surgery.Encourage patient to practice foot and leg exercises before operation tounderstand how to carry out the exercises while in bed after surgery.Let the patient will wear anti-embolism socks to prevent venous stasis duringthe operation.Provide education: Loss of fertility if ovaries are to be removed in conjunctionwith the operation. Discuss surgical menopause.
Discuss how sexual intercourse may change.
Client whose ovaries are removed may complain of a decrease in libido.
Tell the client that once healing has occurred, intercourse should be painfree.Let the patient relax on bed until she leaves the ward escorted by her nursewho completes a safe transfer to the operating theater staff.
 
Intra Operative Nursing CarePrepare and assist for anesthesia.Maintain homeostasis and asepsis.Assist the surgeon and the whole teamAssist in transferring the patient to the Operating table in a supine position.Ask patient to remove any jewelry or other objects that may interfere with the procedure.Ask patient to remove clothing and be given a gown to wear.Check for patency of the IV system.Monitor client’s HR, BP and breathing and report abnormalities.The skin over the surgical cite will be cleansed with an antiseptic solution
 
Post OpPerform usual post operative assessments.Evaluate psychological manifestationsMonitor proximity of the bladder to the reproductive organ.Monitor Foley catheter to prevent susceptibility to UTI and temporary urinaryretentionAssist GI functions by listening to bowel sounds. Note distention and palpate whether abdomen is soft or firmAssess abdominal incision for bleeding and intactness.Assess vaginal bleeding.There is no distinct diet. Simple, strong, distinct flavors rather than complicated andmulti-flavored dishes seem to be preferred with anything with smaller-than-usual portions. It’s best to avoid gassy foods like beans, broccoli and cabbage and/or foodsthat typically cause gas for you. Many suggest avoiding extra-spicy foods. Remember that all pos top surgical patients need protein to aid in healing. Include fiber in your  post op diet, drink lots of water, and consume caffeinated drinks sparingly.If pain is experienced during sexual intercourse let the patient manipulate the penetration.Avoid heavy lifting for about 6 weeks to prevent straining the abdominal muscles andsurgical sites.Avoid activities that increase pelvic congestion such as aerobics activity, horseback riding and prolonged standing.Report any fresh bleeding and any abnormal vaginal discharge to surgeon.Return for follow-up care as requested by the surgeon.Post op pain and discomfort are common, therefore the nurse should assess it’sintensity and administer analgesics as prescribed.If the patient has abdominal distention or flatus, rectal tube and application of heat tothe abdomen may be prescribedEncourage patient to contact nurse or surgeon when bleeding is excessive.Encourage early ambulation o facilitate the return of normal peristalsisMontior and manage potential complications such as:
Hemorrhage: Count perineal pads used, assess the extent of saturation with bloodand monitor vital signs. Guidelines for activity restriction are given above to promote healing and prevent post operative bleeding.

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