TABLE OF CONTENTS

Introduction………………………………………………………………………………………2

General Objectives……………………………………………………………………………...3

Nursing History…………………………………………………………………………………..4

Biographical Data……………………………………………………………………….4

Reasons for Seeking Health Care…………………………………………………….4

History of Present Health Concern……………………………………………………4

Past Health History……………………………………………………………………..5

Lifestyle and Health Practices…………………………………………………………5

Physical Assessment…………………………………………………………………………...6

Anatomy & Physiology………………………………………………………………………….9

Pathophysiology……………………………………………………………………………….10

Laboratory Results & Findings……………………………………………………………….13

Drug Study……………………………………………………………………………………...18

Nursing Care Plan……………………………………………………………………………..44

Health Teaching………………………………………………………………………………..52
 INTRODUCTION

Adenocarcinoma is a type of cancer. It begins to form in organs or other internal

structures. Your glands aid in the proper functioning of your body and the preservation
of organ moisture. Tumors can form when glandular cells start growing out of control as
a result of mutations in the body's DNA replication process. Some glandular cell tumors
aren't cancerous. They're known as adenomas. Adenocarcinomas are malignant tumors
that take over healthy tissue inside an organ and can spread to other parts of the body.
According to the National Cancer Institute, adenocarcinomas are typically identified as a
thickened, plaque-like white mucous membrane. They frequently spread quickly through
the soft tissue in which they appear.

Endometrial adenocarcinoma is the third most common female genital tract

cancer, occurring most frequently in postmenopausal women. High tumor grade,
advanced surgical stage, and lymphovascular space invasion have all been linked to a
poor prognosis for disease spread. Endometrial cancer (also known as endometrial
carcinoma) begins in the cells of the uterine inner lining (the endometrium). This is the
most common type of uterine cancer. The majority of endometrial cancers are
adenocarcinomas, and endometrioid cancer is by far the most common type of
adenocarcinoma. Endometrioid cancers begin in gland cells and resemble the normal
uterine lining (endometrium). Some of these cancers contain squamous cells (flat, thin
cells) as well as glandular cells.

Endometrial cancer is unknown to doctors. What is known is that something

causes changes (mutations) in the DNA of cells in the endometrium — the uterine
lining. The mutation causes normal, healthy cells to become abnormal. Healthy cells
grow and multiply at a predictable rate before dying at a predictable time. Abnormal
cells grow and multiply uncontrollably, and they do not die at a predictable time. The
abnormal cells that are accumulating form a mass (tumor). Cancer cells invade nearby
tissues and can spread from an initial tumor to other parts of the body (metastasize).

2
 GENERAL OBJECTIVES

1. To define Endometrial Carcinoma.

2. To understand the disease process the patient is undergoing.

3. Describe the diagnostic tests and analyze the results.

4. Understand the anatomy and pathophysiology of Endometrial Adenocarcinoma.

5. Review etiological factors related to Endometrial Adenocarcinoma.

6. To discuss the nursing care plan management for Endometrial Adenocarcinoma.

7. To improve the patient’s wellness by applying the nursing interventions and

providing appropriate health teachings including discharge plan.

3
 NURSING HISTORY

BIOGRAPHICAL DATA

Name: C., R. A.
Address: Laguna
Age: 56
Gender: Female
Civil Status: Married
Source of Information: Patient, medical files
Race or Ethnic background: Filipino
Educational Level: College Undergraduate
Occupation: Unemployed - Former Real Estate Worker
Significant Others or Support Persons: Children

REASONS OF SEEKING HEALTHCARE:

Abdominal Mass

HISTORY OF PRESENT HEALTH CONCERN:

1 year prior to consultation, the patient has an abdominal enlargement of 42 inches with
no associated symptoms. After 9 months, patient consulted in a clinic wherein
ultrasound and CT scan was done revealing a consideration of endometrial malignancy
with ovarian new growth probably malignant. 1 week prior to consult, the patient had
vaginal bleeding at Global center Canlubang and was advised to transfer to Rizal
Medical Center. Patient was admitted to the PhilHealth Ward on September 27, 2022
and on October 1, 2022 , Client had a procedure of Exploratory Laparotomy +
Extrafascial Hysterectomy with Bilateral Salpingooophorectomy + Bilateral Lymphnode
Dissection + Infracolic Omentectomy under Combined Epidural and General
Endotracheal Anesthesia. The patient returned to PhilHealth Ward for post-operative
care.

4
PAST HEALTH HISTORY
Problems at Birth: none
Childhood illnesses: none
Immunizations to date:
Adult Illnesses: Hypertension
Surgeries: Bilateral Tubal Ligation (1989, Calamba Laguna Clinic)
Total Thyroidectomy (1995, San Fernando Provincial Hospital)
Accidents: none
Allergies: none

LIFESTYLE AND HEALTH PRACTICES

Typical day description (AM to PM): A housewife, taking care of their house (includes
cooking and cleaning)
24-hour dietary intake (foods and fluids): Soft diet
Who purchases and prepares meal: self/ child
Activities on a typical day: Exercising, Cooking and cleaning the house
Exercise habits and patterns: none
Sleep and rest habits and patterns: normal (8-10 hrs)
Use of medication and or substances: Has a maintenance of 5mg Amlodipine for her
hypertension. Non-smoker and Non-Alcoholic
Self-concept
Self-care responsibilities: normal
Social activities for fun and relaxation:
Social activities related to society: none
Relationships with family: lives with her one child
Values, religious affiliation, spirituality:
Type of work, job satisfaction, work stressors: none
Finances: Children
Stressors in life, coping strategies used: no stressors specified.
Residency, type of environment, neighborhood: low risk
Environmental risk: none detected

5
 PHYSICAL ASSESSMENT

GENERAL SURVEY:
Appears stated age: Patient seems appropriate for stated age.
Level of consciousness: Patient is alert and oriented x3
Skin color: Pinkish and warm, appropriate appearance for stated age and ethnicity
Nutritional status: Stated dietary intake is adequate, patient seems well nourished.
Posture and position: Upright, erect posture. No abnormalities detected.
Obvious physical deformities: No obvious physical deformities seen.
Mobility: arrived in wheelchair
Facial expression: No signs of distress, pain, or anxiety. Face symmetrical.
Mood and affect: Patient is content and displays a normal affect.
Speech: Patient’s speech is appropriate and understandable.
Hearing: Patient does not state to have any issues hearing.
Personal hygiene: Patient is well groomed and appropriately dressed.

MEASUREMENT AND VITAL SIGNS

Weight: 55 kg
Height: 162.5cm
Body mass index: 21.5 kg/m2
Pulse rate: 115, strong pulse
Respiration rate: 21, Normal work of breathing
Blood pressure: 130/80 mm/Hg
Temperature: 36.2 °C
Pain assessment: 2/10

GLASGOW COMA SCALE: 15

Eye Opening - Spontaneous (4)
Verbal Response - Oriented (5)

6
Motor Response - Follows command (6)
R upper extremity (+) L upper extremity (+)
R lower extremity (+) L lower extremity (+)
Sensory Response - R upper extremity (+) L upper extremity (+)
R lower extremity (+) L lower extremity (+)
Pulse - R upper extremity (+) L upper extremity (+)
R lower extremity (+) L lower extremity (+)

SKIN
Color and pigmentation: pale, even pigmentation, no lesions noted.
Temperature: Warm
Moisture: Dry
Texture: Smooth
Turgor: Good turgor
Any lesions: No notable lesions
Capillary refill: <2 secs

HEAD AND FACE

Scalp, hair, cranium: Normocephalic, normal hair distribution, no lesions or
deformities.
Skin Pinkish, warm, and dry.
Face (cranial nerve VII): Patient facial expressions symmetrical, no deficit noted.
EYES
Pupillary light reflex: PERRLA
Pupils: 3mm, equal bilaterally.

EARS
No significant findings

NOSE AND SINUSES

No significant findings

7
NECK
No significant findings

BREAST AND AXILLAE

No significant findings

CHEST, HEART, AND LUNGS

Clear airway
Breathing: Normal rhythm, normal depth, normal quality, no dyspnea, no cyanosis
Spine: Intact
Breath Sounds: Equal
No cough
Heart Sounds: Normal
Cardiac Rhythm: Regular
No chest pain

ABDOMEN
Globular Abdomen
Abdominal circumference: 115cm

MUSCULO-SKELETAL SYSTEM
No bone deformities
Muscle Strength: Strong grip bilaterally, Legs strong bilaterally
Ambulation: Independent
Range of motion: Full

GENITOURINARY
Vaginal walls smooth
active Vaginal bleeding
Normal urination
Voiding freely
Yellow color of urine

RECTUM AND ANUS

No significant findings

8
 ANATOMY & PHYSIOLOGY
The Uterus

The uterus is an organ in the female reproductive system, widely known as “the
womb”. It is a hollow pear-shaped organ that holds multiple functions. It is located in the
middle of the pelvis, behind the bladder and above the rectum. It is made up of three (3)
layers of tissue:

● Endometrium - the innermost layer where implantation occurs

● Myometrium - the thickest muscular layer of the uterus which consists of smooth
muscles and is responsible for the contraction in labor.

● Perimetrium - the outermost membrane that envelopes and provides support to

the uterus

In nulliparous women, this organ is about the size of a pear which measures to
approximately 7.5cm long and 5cm wide and is located in the pelvis between the urinary
bladder and rectum. However, in pregnant women, the uterus undergoes progressive
changes in its shape, size, and position in the abdominopelvic cavity.

The uterus performs multiple functions but the major role of it is to hold the fetus
and nourish it until childbirth. The uterus is also a secondary sex organ for females. as it
is required for uterine orgasm to occur. Blood flow is directed to the pelvis, ovaries as
well as the external genitalia such as the vagina, labia, and the clitoris by the blood
vessels and nerves of the uterus. The uterus plays a major role in sexual response.

9
SCHEMATIC DIAGRAM OF PATHOPHYSIOLOGY

10
11
12
 LAB RESULTS AND FINDINGS

Name: R.A.C Date: September 29, 2022

Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

Sodium 139.00 mmol/L 136 - 145

Potassium 4.21 mmol/L 3.5 - 5.1
Chloride 100.00 mmol/L 98 - 107
Total Calcium L 2.00 mmol/L 2.12 - 2.52

Name: R.A.C Date: September 29, 2022

Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

CA 19-9 8.91 U/ml 0 - 37

13
 URINALYSIS RESULT
(Automated)

I. PHYSICAL EXAMINATION III. MICROSCOPIC EXAMINATION REFERENCE

VALUE
Color Dark Yellow Cells
Transparency SLIGHTLY TURBID WBC (Microscopic) 25 /hpf 0-3
pH 6.50 109.65 /ul 0 - 17
Specific Gravity 1.024
RBC 63 /hpf 0-2
276.32/ul 0-2

II. CHEMICAL EXAMINATION

Blood 3+
Bilirubin Negative Epithelial Cells
Urobilinogen NORMAL Squamous Epithelial
Ketone Trace Cells RARE
Protein 1+ Crystals
Nitrite Negative Calcium Oxalate MODERATE
Glucose Negative Others
Leukocyte 2+ Bacteria FEW
Mucus Threads MODERATE

14
Name: R.A.C Date: October 01, 2022
Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

PRO-BNP H 1016.00 pg/ml <300

Name: R.A.C Date: October 01, 2022

Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

Procalcitonin H 24.39 ng/ml <0.10

Name: R.A.C Date: October 01, 2022

Age: 56Y Sex: FEMALE
ARTERIAL BLOOD GAS RESULT FORM

ENTERED DATA: REF. RANGE BLOOD GAS: REF. RANGE

Temperature 36.10 deg C pH: 7.32 L (7.350 - 7.450)

FI02 IN % 36.00 % pCO2: 41.60 (35.0 - 45.0 mmHg)
PO2: 37.10 L (80 - 105 mmHg)

DERIVED PARAMETERS: REF. RANGE TEMP CORRECTED: REF. RANGE

15
HCO3: 21.00 L (22 - 26 mmol/L) pH: 7.33 L (7.350 - 7.450)
BE(B): -4.80 L (-2 to +3 mmol/L) pCO2: 40.00 (35.0 - 45.0 mmHg)
SO2c: 56.20 L (95 - 98 %) pO2: 34.80 (80 - 105 mmHg)

Name: R.A.C Date: October 01, 2022

Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

Total Protein L 46.90 G/L 64 - 82

Albumin L 17.40 G/L 34 - 50
Globulin 29.5 G/L 23 - 35
A/G Ratio L 0.59 1.0 - 2.5

Name: R.A.C Date: October 02, 2022

Age: 256Y Sex: FEMALE

HEMATOLOGY

TEST RESULT UNIT REFERENCE RANGE

Complete Blood Count

Hemoglobin L 109 g/L 120 - 160
Hematocrit L 0.34 0.370 - 0.40

16
Erythrocytes Count 3.96 x10^12/L 3.50 - 5.00
MCV 85 fL 80 - 100
MCH 28 pg 27 - 32
MCHC 322 g/L 320 - 360
Leukocytes Count 8.39 x10^9/L 4.00 - 1.00

Differential Count
Neutrophil H 0.88 0.35 - 0.650
Lymphocytes L 0.06 0.200 - 0.400
Monocytes 0.05 0.030 - 0.100
Eosinophil 0.01 0.000 - 0.050
Platelet Count 174 x10^9/L 150 - 450
MPV 9.50 fL 6.5 - 12.0

Name: R.A.C Date: October 02, 2022

Age: 56Y Sex: FEMALE
CLINICAL CHEMICAL RESULT FORM

TEST NAME RESULT UNIT REFERENCE RANGE

Total Protein L 45.60 G/L 64 - 82

Albumin L 15.90 G/L 34 - 50
Globulin 29.7 G/L 23 - 35
A/G Ratio 0.54 1.0 - 2.

17
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

Medication Classification Why is your Mechanism of Action Side Effects/Adverse Nursing

(Generic/Rou patient taking this Effects Implications/Responsi
te/Dosage) drug? bilities

I. Brand Pharmacologic Prevent Chemical: a Common Side Effects: Check the doctor's
Name: : post-operational second-generation order to avoid mistakes.
Ceftin Cephalosporin infections cephalosporin that binds to ● Nausea ➢ Consider 10
(2nd gen.) bacterial cell membranes ● vomiting rights
Generic and inhibits cell wall ● diarrhea ➢ Assess for
Name: Therapeutic: synthesis. ● strange taste in the hitstory: hepatic
Cefuroxime Antibiotic mouth and renal
Therapeutic: Bactericidal: ● stomach pain impairment,
Route: PO inhibits synthesis of lactation,
bacterial cell wall, causing Adverse Side Effects: pregnancy.
Dosage: cell death. ➢ Culture injection
500 mg CNS: headaches, dizziness, site, and
lethargy, paresthesias arrange for
Time: 1 sensitivity tests
tab Q12 x GI: anorexia, abdominal before and
7 days pain, flatulence, during therapy if
hepatotoxicity expected
response is not
GU: nephrotoxicity seen.
➢ Take the pt’s BP
Hematologic: bone marrow ➢ Instruct patients
depression (Decreased to avoid alcohol
WBC, platelets, Hct) while taking this
drug and for 3

18
Hypersensitivity: ranging days after
from rash to fever to because severe
anaphylaxis; serum sickness reactions often
reaction occur.
➢ Discontinue if
Local: pain, abscess at hypersensitivity
injection site, phlebitis, reaction occurs.
inflammation at IV site After:
➢ Take note of
Other: superinfections, side effects:
disulfiram-like reaction with stomach upset
alcohol. or diarrhea
➢ Take patient’s
v/s
➢ Evaluate
therapeutic
effects and
document
findings.

19
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

Medication Classification Why is your Mechanism of Action Side Effects/Adverse Nursing

(Generic/Rout patient taking this Effects Implications/Responsibil
e/Dosage) drug? ities

II. Brand Drug Class: It works by works by stimulating Common side effects: Assessment and Drug
Name: a member of increasing the enteric neurons to cause ● Vomiting Effects:
Dulcolax the movement of the peristalsis, i.e., colonic ● Abdominal
diphenylmethan intestines, helping contractions. It is also a Cramping ➢ Evaluate
Generic e family and is the stool to come contact laxative; it ● Electrolyte and periodically
Name: considered to out. increases fluid and salt fluid imbalance patient's need for
Bisacodyl be a stimulant secretion. The action of ● Excessive continued use of
laxative. bisacodyl on the small diarrhea drug; bisacodyl
Route: PO intestine is negligible; ● Nausea usually produces 1
stimulant laxatives mainly ● Rectal Burning or 2 soft formed
Dosage: 15 promote evacuation of ● Spinning stools daily.
mg the colon Sensation ➢ Monitor patients
(vertigo) receiving
Time: 1 tab at ● Stomach/Abdomi concomitant
8pm nal Pain anticoagulants.
● Weakness Indiscriminate use
Serious Side Effects: of laxatives results
● Persistent in decreased
nausea/vomiting/
diarrhea

20
● Muscle absorption of
cramps/weakness vitamin K.
● Irregular
heartbeat Patient and Family
● Dizziness Education:
● Fainting
● Decreased ➢ Add high-fiber
Urination foods slowly to a
● Mental/mood regular diet to
changes (such as avoid gas and
confusion) diarrhea.
Adequate fluid
intake includes at
least 6–8
glasses/d.
➢ Do not breast feed
while taking this
drug without
consulting a
physician.

21
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

Medication Classificatio Why is your Mechanism of Action Side Effects/Adverse Nursing

(Generic/Rout n patient taking this Effects Implications/Responsibi
e/Dosage) drug? lities

III. Brand Pharmaceuti Relieve and Analgesic and CNS: headache, dizziness, Before:
Name: cal: alleviate acute pain anti-inflammatory activities somnolence, insomnia, ➢ Check the
Celebrex related to inhibition of the fatigue, tiredness, tinnitus, doctor's order to
Specific COX-2 enzyme, which is ophthalmologic effects. avoid mistakes.
Generic COX-2 activated in inflammation to ➢ Consider 10
Name: enzyme cause the signs and Dermatologic: rash, rights
Celecoxib inhibitor symptoms associated with pruritus, sweating, dry ➢ Assess and
inflammation. mucous membranes, accurately record
Route: PO Therapeutic: stomatitis. vital signs for
baseline data.
Non Opioid GI: nausea, abdominal ➢ Wash hands
analgesic pain, dyspepsia, flatulence, before
GI bleeding. administration
➢ Explain about the
Hematologic: neutropenia, importance and
eosinophilia, leukopenia, purpose of the
pancytopenia, drug to patient
thrombocytopenia, bone ➢ Assess skin color
marrow, depression, and lesions,
menorrhagia. reflexes,
sensations,
Other: Peripheral edema, edema, serum
anaphylactoid, reactions to electrolyte.
anaphylactic shock.

22
During:
➢ Establish safety
measures if CNS
or visual
disturbances
occur.
➢ Arrange for
periodic
ophthalmologic
examination
during long-term
therapy
➢ take note of side
effects.

After:
➢ Document and
record.
➢ Provide
positioning and
environmental
control to reduce
pain
➢ Monitor patient’s
V/S

23
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

Medication Classification Why is your Mechanism of Action Side Effects/Adverse Nursing

(Generic/Route/ patient taking Effects Implications/Respons
Dosage) this drug? ibilities

I. Brand Name: Pharmacologic: To treat and Acts to normalize RBC CNS: Drowsiness, fever, ➢ Check the
Feratab, Iron Preparation prevent iron production by binding with headache, paresthesia, doctor's order
Fer-In-Sol, deficiency anemia hemoglobin or by being syncope to avoid
Slow Fe, Therapeutic: oxidized and stored as mistakes.
Feosol, Iron Preparation hemosiderin in EENT: Metallic taste, tooth ➢ Consider 10
reticuloendothelial cells of discoloration rights
Generic Name: the bone marrow, liver, ➢ Assess V/S
Ferrous and spleen. Iron is an CV: Chest pain, including Pain
Sulfate essential component of hypertension, level
hemoglobin, myoglobin, hypotension, tachycardia ➢ Assess history
Route: PO and several enzymes, of allergies
including catalase, GI: Abdominal cramps, ➢ Give drug with
Dosage: cytochromes and constipation, epigastric food, milk or
peroxidase. Iron is needed pain, nausea, stool antacids
Time: for catecholamine discoloration, vomiting ➢ Do not
metabolism and normal increase or
neutrophil function. RESP: Dyspnea, double dose;
Wheezing follow exactly
as prescribed
SKIN: Diaphoresis, and indicated.
flushing, pruritus, rash, ➢ Discontinue
urticaria drug promptly
if diarrhea,

24
Other: injection-site dark stools, or
discoloration rash occur
➢ Document
accordingly
➢ Monitor for
adverse effect
➢ Instruct
discontinuation
of medication if
adverse
effects occur.

25
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATION WHY DOES THE MECHANISM OF SIDE EFFECT/ NURSING

(GENERIC/ROUTE/ PATIENT TAKE ACTION ADVERSE EFFECT IMPLICATIONS/
DOSAGE) THIS DRUG? RESPONSIBILITIES

I. Brand in a class of It lowers blood Inhibits the transport CNS: Headache, Before:
Name: medications called pressure by of calcium into fatigue, dizziness 1. Monitor blood
Norvasc calcium channel relaxing the blood myocardial and pressure and
blockers. vessels so the vascular smooth CV: peripheral edema, pulse before
Generic heart does not muscle cells, angina, bradycardia, therapy, dose
Name: have to pump as resulting in inhibition hypotension, titration, and
Amlodipine hard. of palpitations periodically during
excitation-contraction therapy.
Route: PO coupling and GI: Gingival 2. Monitor intake and
subsequent Hyperplasia, Nausea output ratios and
Dosage: 50 contraction. daily weight.
mg Derma: Flushing Assess for signs
Therapeutic Effects: of CHF (peripheral
Systemic vasodilation edema, rales or
resulting in crackles,
decreased blood dyspnea, weight
pressure. Coronary gain, jugular
vasodilation resulting venous
in decreased distention).
frequency and During:
severity of angina 1. Ensure to observe
attacks. the following
rights of the

26
 patient.
After:
1. Caution patient to
continue taking
drug, even when
feeling better.
2. Tell patient S.L
nitroglycerin may
be taken as
needed when
angina symptoms
are acute. If
patient continues
nitrate therapy
during adjustment
of amlodipine
dosage, urge
continued
compliance.
3. Instruct patient to
notify prescriber if
any unusual
symptoms and
toxicity occur.

27
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATI WHY DOES THE MECHANISM OF ACTION SIDE EFFECT/ADVERSE NURSING
(GENERIC/ROUT ON PATIENT TAKE THIS EFFECT IMPLICATIONS/RESPONSIB
E/DOSAGE) DRUG? ILITIES

Brand Pharmacologi Treatment of Tranexamic acid CNS: Dizziness Before:

Name: c: excessive bleeding competitively inhibits ➢ Check the doctor's
Cyklokapron, Anti fibrinolytic resulting from activation of EENT:Visual order to avoid
Cyklo-F, systemic or local plasminogen (via abnormalities mistakes.
Menstralite Therapeutic: hyperfibrinolysis. binding to the kringle ➢ Consider 10 rights
Hemostatic domain). Thereby CV: Hypotension, ➢ Do skin testing
Generic Name: Agent reducing conversion of thrombosis ➢ Tell the patient to
Tranexamic Acid plasminogen to plasmin inform the
(fibrinolysin) an enzyme GI:Diarrhea, nausea, healthcare
Route: IV that degrades fibrin vomiting provider if they are
clots, fibrinogen, and color blind, have a
Dosage: 500 mg other plasma proteins, history of stroke,
including the and blood clot, or
Time: procoagulant factors (V bleeding in your
Q8 x 24 and VIII) brain.

During:
➢ Check the patency
of the IV site and
IV line,
➢ Do not use this
medication without

28
 telling your doctor
if you are
breastfeeding a
baby.

After:
➢ Unusual change in
bleeding pattern
should be reported
to the physician.

29
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATION WHY DOES THE MECHANISM OF SIDE EFFECT/ NURSING IMPLICATIONS/
(GENERIC/ROUTE/ PATIENT TAKE THIS ACTION ADVERSE EFFECT RESPONSIBILITIES
DOSAGE) DRUG?

I. Brand Name: Pharmacotherapeutic: Used to treat a wide Disrupts DNA, inhibiting Side Effects: Baseline Assessment:
Acea, Anabact, Nitroimidazole variety of infections. It nucleic acid synthesis. ● Question for history of
Flagyl, Metrogel, derivative. works by stopping the Frequent: Systemic: hypersensitivity to
Metrosa, growth of certain bacteria Therapeutic Effect: Anorexia, nausea, dry metronidazole, other
Rosiced, Rozex, Clinical: and parasites. Produces bactericidal, mouth, metallic taste. nitroimidazole
Vaginyl, Zidoval, Antibacterial, antiprotozoal, derivatives (and
Zyomet. antiprotozoal. amebicidal, Vaginal: Symptomatic parabens with topical).
trichomonacidal effects. cervicitis/vaginitis, abdominal ● Obtain specimens for
Generic Name: Produces anti- cramps, diagnostic tests,
Metronidazole inflammatory, uterine pain. cultures before giving
immunosuppressive first dose (therapy
Route: PO effects when applied Occasional may begin before
topically. Systemic: Diarrhea, results are known)
Dosage: 500 mg constipation, vomiting,
dizziness, erythematous Intervention/Evaluation:
Time: Q12 x 7 rash, urticaria, reddish- ● Monitor daily pattern
brown urine. of bowel activity,stool
consistency.
Topical: Transient ● Monitor I&O, assess
erythema, mild dryness, for urinary problems.
burning, irritation, ● Be alert to neurologic
stinging, tearing when symptoms (dizziness,
applied too close to eyes. paresthesia of
extremities)
Vaginal: Vaginal, ● Assess for rash,
perineal, vulvar itching; urticaria.
vulvar swelling. ● Monitor for onset of
superinfection

30
Rare: Mild, transient
leukopenia;
thrombophlebitis with IV
therapy.
Adverse Effects:
Oral therapy may result
in furry tongue, glossitis,
cystitis, dysuria,
pancreatitis.
Peripheral neuropathy
(manifested as
numbness, tingling of
hands/feet) usually
is reversible if treatment
is stopped immediately
upon appearance of
neurologic symptoms.
Seizures occur
occasionally.
(ulceration/ change of
oral mucosa, furry
tongue, vaginal
discharge, genital/anal
pruritus).
Patient/Family Teaching:
● Urine may be
red-brown or dark.
● Avoid alcohol,
alcohol-containing
preparations (cough
syrups, elixirs) for at
least 48 hrs after last
dose.
● Avoid tasks that
require alertness,
motor skills until
response to drug is
established.
● If taking
metronidazole for
trichomoniasis, refrain
from sexual
intercourse until full
treatment is
completed.
● For amebiasis,
frequent stool
specimen checks will
be necessary.
Topical: Avoid contact with
eyes.
● May apply cosmetics
after application.
● Metronidazole acts on
erythema, papules,
pustules
but has no effect on
rhinophyma
(hypertrophy of
nose), telangiectasia,
ocular problems
(conjunctivitis,
keratitis, blepharitis).
● Other
recommendations for
rosacea include
31
avoidance of hot/spicy
foods, alcohol,
extremes of hot/cold
temperatures,
excessive sunlight

32
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFIC WHY DOES THE MECHANISM OF SIDE EFFECT/ADVERSE NURSING

(GENERIC/ROUT ATION PATIENT TAKE ACTION EFFECT IMPLICATIONS/RESPONSIBILIT
E/DOSAGE) THIS DRUG? IES

I. Brand Name: Pharmaco Relief of - Binds to mu-opioid Common Side Effects: ➢ Check the doctor's
Ultram logic: moderate to receptors. order to avoid
Opioid moderately - Inhibits reuptake of ● sleepiness. mistakes.
Generic analgesic severe pain. serotonin and ● headache. ➢ Consider 10 rights
Name: norepinephrine in the ● nervousness. ➢ Assess and accurately
Tramadol Therapeut CNS. ● uncontrollable record vital signs for
ic: shaking of a part of baseline data.
Route: I.V Centrally - Therapeutic Effects: the body. ➢ Assess BP & RR
acting ● muscle tightness. before and periodically
Dosage: 50 g analgesic. Decreased pain. ● changes in mood. during administration.
● heartburn or Respiratory
Time: slow IV indigestion. depression has not
push Q8 PRN ● dry mouth. occured with
recommended doses.
Adverse Effect: ➢ Assess bowel function
● CNS: Seizures, routinely. Prevention
dizziness, headache, of constipation should
somnolence, anxiety, be instituted with
confusion, increased intake of
coordination fluids and bulk and
disturbance, malaise, laxatives to minimize
nervousness, sleep constipating effects.

33
 disorder, weakness ➢ Assess previous
● CV: vasodilation analgesic history.
Tramadol is not
● EENT: visual recommended for
disturbances patients dependent on
● GI: constipation, opioids or who have
nausea, abdominal previously received
pain,anorexia, opioids for more than
diarrhea,dry mouth, 1 week may cause
dyspepsia, opioid withdrawal
flatulence, vomiting symptoms.
● GU: menopausal ➢ Assess the client’s
symptoms, urinary history of allergy to the
retention/frequency drug to avoid
● Skin: pruritus, complications.
sweating ➢ Assess type,
● Neuro: hypertonia location,and intensity
of pain before and
2-3hr. (peak) after
administration.
➢ Assess previous
analgesic history.
Tramadol is not
recommended for
patients dependent on
opioids or who have
previously received
opioids for more than
1 week; may cause
opioid withdrawal
symptoms.
➢ Encourage clients to
report severe pain for
prompt intervention.
➢ Evaluate therapeutic
effects and document
findings.

34
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATI WHY DOES THE MECHANISM OF SIDE EFFECT/ADVERSE NURSING

(GENERIC/ROU ON PATIENT TAKE ACTION EFFECT IMPLICATIONS/RESPONSIBILITIES
TE/DOSAGE) THIS DRUG?

I. Brand Pharmaceuti Prophylaxis of Binds to bacterial Frequent: Mild ➢ Check the doctor's order to
Name: cal: surgical cell membranes, diarrhea, mild abdominal avoid mistakes.
Kefzol, Ancef First infections inhibits cell wall cramping, vaginal ➢ Consider 10 rights
generation synthesis. candidiasis. ➢ Assess and accurately
Generic cephalospori record vital signs for baseline
Name: n Therapeutic Occasional: Nausea, data.
Cefazolin Effect: serum sickness-like ➢ Assess the client’s history of
Clinical: Bactericidal reaction (fever, joint pain; allergy, particularly
Route: I.V Antibiotic usually occurs after cephalosporins, penicillins.
second course of therapy Persons with a negative
Dosage: 2 g and resolves after drug is history of penicillin sensitivity
discontinued). may still have an allergic
Time: Q8 X response.
24 Adverse Effects: ➢ Observe patients for signs
and symptoms of
CNS: Seizures (high anaphylaxis (rash, pruritus,
doses) laryngeal edema, wheezing).
Discontinue drugs and notify
GI: Diarrhea, nausea, health care professionals
vomiting, cramps immediately if these
problems occur.
GU: Interstitial Nephritis ➢ Keep epinephrine, an

35
 antihistamine, and
Skin: Rash resuscitation equipment
close by in case of an
anaphylactic reaction.
➢ Be alert for superinfection:
fever, vomiting, diarrhea, oral
mucosal changes
(ulceration, pain, and
erythema).
➢ Instruct patients to report
adverse reactions promptly.
➢ Tell the patient to report
discomfort at the IV injection
site.
➢ Evaluate therapeutic effects
and document findings.

36
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATION WHY DOES THE MECHANISM OF SIDE NURSING

(GENERIC/ROUTE PATIENT TAKE THIS ACTION EFFECT/ADVERSE IMPLICATIONS/RESPONSIBILITI
/DOSAGE) DRUG? EFFECT ES

I. Brand Drug to treat certain Gastric acid ● headache ➢ Caution patient to

Name: Classification: conditions where pump inhibitor: ● abdominal pain swallow capsules whole
Prilosec proton pump there is too much Suppresses ● diarrhea - not to open, chew or
inhibitors (PPI) acid in the gastric acid ● nausea crush them.
Generic stomach. secretion by ● vomiting ➢ Advise patient to avoid
Name: specific inhibition ● gas alcohol and foods that
Omepraz of the hydrogen (flatulence) may cause an increase
ole potassium ATP ● dizziness in GI irritation.
as enzyme ● Upper ➢ Instruct patient to report
Route: IV system at the respiratory bothersome or
secretary surface infection prolonged side effects,
Dosage: of the gastric ● acid reflux including skin problems
40 mg parietal cells; ● constipation (itching, rash) or GI
blocks the final ● rash effects (nausea,
step of acid ● cough diarrhea, vomiting,
production. constipation, heartburn,
Potentially Fatal: flatulence, abdominal
Anaphylaxis pain).

37
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

Medication Classification Why is your Mechanism of Side Effects/Adverse Nursing

(Generic/Route/Dos patient taking this Action Effects Implications/Responsib
age) drug? ilities

I. Brand Therapeutic Used to reduce Pain relief may result Common Side Effects: Before:
Name: Class: fever and relieve from inhibition of
Tylenol, Nyquil, minor pain prostaglandin ● Nausea ➢ Consider 10
Dayquil, Percocet, Analgesics synthesis and other ● Stomach pain rights
and Vicodin (pain relievers) substances in CNS, ● Loss of appetite ➢ Assess vital
and with subsequent ● itching signs for
Generic Name: Antipyretics blockage of pain ● rash baseline data.
acetaminophen (fever impulses. Drug may ● headache ➢ Ensure clean
reducers) relieve fever from ● dark urine hands before
Route: I.V and PO vasodilation and ● clay-colored drug preparation
Pharmacologi increase peripheral stools, and and
Dosage: 500 mg/tab c Class: blood flow in the ● yellowing of skin or administration.
hypothalamus, which eyes (jaundice) ➢ Ensure that the
Time: Para-aminophe dissipates heat and drug is in a good
Q6 x 4 doses for IV; nol derivative lower body Serious Side Effects: condition (not
Q6 x 3 days for PO temperature. expired,
after IV. ● rash tampered, etc).
● itching or swelling ➢ Maybe taken
Duration: (especially of the with or without
while symptoms last; face, tongue, or food.
not used for more throat),
than 10 days unless ● severe dizziness During:
and ➢ Watch out for

38
directed by a doctor. ● trouble breathing possible adverse
reactions.
Adverse Effect:
After:
● CNS: agitation, ➢ Reassess pain
anxiety, dizziness, and refer to AP if
insomnia, pain worsen /
headaches, Reassess body
pyrexia, fatigue. temperature and
● CV: hypotension, vs.
peripheral edema, ➢ Evaluate
periorbital edema, therapeutic
tachycardia effects and
● GI: Abdominal document
pain, nausea, findings.
vomiting, diarrhea,
dyspnea, hypoxia,
atelectasis, pleural
effusion
● Hematologic:
Thrombocytopenia
, hemolytic
anemia,
neutropenia,
leukopenia,
pancytopenia
● Hepatic: Jaundice,
hepatotoxicity
● Metabolic:
Hypoalbuminemia,
hypoglycaemia,
hypokalemia,
hypervolemia,
hypomagnesemia,
hypophosphatemia
● Musculoskeletal:
muscle spasms,
extremity pain
● Skin: rash,

39
 urticarial
● Other:
hypersensitivity
reactions(such as
fever)

40
 Philippine Women’s University
SCHOOL OF NURSING
Drug Study

Name of Student: Group D - PhilHealth Name of Patient: C., R.A

Clinical Instructor: Prof. Zenaida Quilaquil Allergies: No known allergies

MEDICATION CLASSIFICATION WHY DOES THE MECHANISM OF SIDE EFFECT/ADVERSE NURSING

(GENERIC/ROUTE/ PATIENT TAKE ACTION EFFECT IMPLICATIONS/RESPONSIBILITIES
DOSAGE) THIS DRUG?

I. Brand Name: Drug Class: Used to treat - Inhibits Common Side Effects: ➢ Check the doctor's order to
Toradol Nonsteroidal moderate to prostaglandin ● Headache avoid mistakes.
anti-inflammatory severe pain synthesis, ● Drowsiness ➢ Consider 10 rights
Generic Name: agents. producing ● Indigestion ➢ Assess and accurately record
Ketorolac mediated vital signs for baseline data. (If
analgesia. ● Stomach or abdominal BP is <90/80 never
Route: I.V pain administered. Refer to the
-Antipyretic and ● Nausea doctor.
Dosage: 30 mg anti-inflammatory ➢ Assess the client’s history of
(reduce ● Diarrhea allergy to the drug to avoid
Time: inflammation) ● Dizziness complications.
Q8 x 48 properties. ➢ Be aware that patients may be
● Itching at increased risk for CV events,
Duration: Therapeutic ● Swelling (edema) GI bleeding, renal toxicity
Ketorolac Effect: monitor accordingly
administration Decreased pain ● Increased blood urea ➢ Assess pain (note type,
should not be nitrogen (BUN) location,and intensity) prior to
for longer and 1-2hr following
● Constipation
than five days administration.
unless ➢ Inform the patient that the drug
directed by a is meant only for short-term pain
doctor. management.
➢ Encourage clients to report

41
● Purpura severe pain for prompt
intervention.
➢ Evaluate therapeutic effects and
document findings.

Adverse Side Effects:

● CNS: drowsiness,
headache,
dizziness,insomnia,
ophthalmologic effects
● CV: hypertension
● GI: nausea, vomiting,
diarrhea, constipation,
flatulence, dyspepsia,
epigastric pain,
stomatitis.
● Respiratory: dyspnea,
hemoptysis, pharyngitis,
bronchospasm, rhinitis
● Hematologic:
thrombocytopenia,
bleeding, anemia,
decreased Hgb or Hct,
bone marrow
depression
● Skin: rash, pruritus,
diaphoresis
● Other: excessive thirst,
edema, injection site pain

42
 Philippine Women’s University
OF NURSING
Nursing Care Plan (Hospital)

Name of Student: Group D - PhilHealth Date: October 29, 2022

Initials of Patient: C., R. A. Clinical Instructor: Prof. Zenaida Quilaquil
Diagnosis: Gravida 3 Para 3 (3003) Endometrial Adenocarcinoma - Endometrium, Ovarian growth, Laterally Undetermined probably
malignant Extension, Hypertension II, S/P Total thyroidectomy (1995, San Pedro Provincial Hospital), S/P Bilateral Tubal
Ligation (1989, Calamba Laguna Clinic)

Cues Rationale of the

Nursing
Subjective Objective Nursing Diagnosis Nursing Goals Nursing Evaluation
Intervention
Intervention

“Nasakit yung - Facial Acute pain related After 8 hours of Independent: After 8 hrs of
aking tahi Grimace to surgical trauma nursing - Ask the - To identify nursing
minsan” as - Discomfor as evidenced by interventions, the patient’s the intervention, the
verbalized by t verbal reports. patient should pain level intensity, patient was able
patient. (incisional pain) manifest a onset, to experience
decrease in the duration, lesser pain as
● Vital Signs: pain scale of 5/10 - Monitor V/S and quality manifested by
- BP: 130/80 to manageable regularly of the pain.
- PR: 115 level of 3 or below. - Pain scale
- RR: 21 - To observe of 4/10
- SpO2: 99% any - No facial
- Temp: 36. 2 changes in Grimace
- Encouraged the pt’s vs - Calm and
- Pain deep such as pr cooperativ
level: breathing and tempt. e.
8/10 and (V/S
relaxation changes
techniques.

43
 during
- Encourage onset).
having
adequate - To distract
rest attention
periods. and reduce
tension.
- Provide
emotional
support by
actively - To prevent
listening to fatigue.
the
patient's
concerns
and needs.
- To provide
- Instruct comfort to
patients to patient.
increase
fluid intake.

Dependent:

- Administer
medications
. - To promote
frequent
emptying
of the
bladder.

44
- To maintain
an
acceptable
level of
pain.

45
 Philippine Women’s University
SCHOOL OF NURSING
Nursing Care Plan (Hospital)

Name of Student: Group D - PhilHealth Date: October 29, 2022

Initials of Patient: C., R. A. Clinical Instructor: Prof. Zenaida Quilaquil
Diagnosis: Gravida 3 Para 3 (3003) Endometrial Adenocarcinoma - Endometrium, Ovarian growth, Laterally Undetermined probably
malignant Extension, Hypertension II, S/P Total thyroidectomy (1995, San Pedro Provincial Hospital), S/P Bilateral Tubal
Ligation (1989, Calamba Laguna Clinic)

Cues Rationale of the

Subjective Objective Nursing Diagnosis Nursing Goals Nursing Intervention Nursing Evaluation
Intervention
● Risk for fall ● After 8 hours of ● Assess the ● To determine the ● After 8 hours
● Vital Signs: related to nursing patient’s ability to patient’s rendering
- BP: 130/80 altered mobility intervention, the turn side to side. functional abilities proper nursing
- PR: 115 secondary to patient will be to plan the ways intervention,
- RR: 21 surgical free from any fall of improving the the patient will
- SpO2: 99% procedure during her problem areas. be free from
- Temp: 36. 2 hospitalization. fall during the
entire
● The patient will ● Provide and put a ● To help the hospitalization.
● Patient shows participate “Falls Risk” healthcare
decreased willingly in wristband to the provider to
strength in necessary patient. become aware of
lower actions/intervent implementation
extremities ions. of fall precaution
behaviors.
● Patient is
weak in
appearance.

46
● Keep the patient’s ● To reduce the risk
bed in the lowest of falls and
position with serious injury.
wheels locked at all
times.

● Keep the side rails ● To reduce the

up at all times. likelihood of falls
when one of the
side rails is left
unraised.

● Keep the patient’s ● To reduce fall

personal possibly caused
possessions within by reaching items
safe reach. that are too far
within the
patient’s reach.

● Instruct the patient ● To prevent

to call for patients from
assistance when slippering or from
doing full range accidentally
motions. falling.

47
 Philippine Women’s University
SCHOOL OF NURSING
Nursing Care Plan (Hospital)

Name of Student: Group D - PhilHealth Date: October 29, 2022

Initials of Patient: C., R. A. Clinical Instructor: Prof. Zenaida Quilaquil
Diagnosis: Gravida 3 Para 3 (3003) Endometrial Adenocarcinoma - Endometrium, Ovarian growth, Laterally Undetermined probably
malignant Extension, Hypertension II, S/P Total thyroidectomy (1995, San Pedro Provincial Hospital), S/P Bilateral Tubal
Ligation (1989, Calamba Laguna Clinic)

Cues Rationale of the

Subjective Objective Nursing Diagnosis Nursing Goals Nursing Intervention Nursing Evaluation
Intervention
● Dressing ● Risk for Infection ● Short-term: ● Monitor patient’s vital ● To establish ● Before
dry and related to signs. baseline data. discharge, the
intact postoperative After 8 hours of patient
trauma to the nursing ● Inspect the dressing ● Redness, displayed
● Vital Signs: abdominal wall interventions, the through observation of excessive understanding
- BP: 130/80 (incision at the patient will be able color, odor, drainage, and by restating the
- PR: 115 lower to understand the consistency, and foul-smelling causative
- RR: 21 abdomen). causative factors, degree of saturation of odor from the factors, signs
- SpO2: 99% identify signs and dressing. incision site can and symptoms
- Temp: 36. symptoms of be a sign of of infection and
2 infection, and infection. proper wound
report to the care of surgical
healthcare provider ● Demonstrate proper ● This will incision.
accordingly. wound care for decrease the
abdominal incision by likelihood of
emphasizing keeping surgical site
the dressing clean and infection.

48
 dry.

● Administer antibiotics ● Antibiotics have

as ordered by a bactericidal
physician. effect that
combats
pathogens.

● Educate the patient on

the signs and ● This will help the
● Long-term: symptoms of infection. patient on
identification of
After 5-7 days the signs and
patient will achieve symptoms of
timely wound infection and
healing, be free of become aware
purulent drainage when to seek
or erythema, be prompt
afebrile and will be treatment.
free of infection. ● Emphasize the
importance of taking a ● To prevent
complete course of premature
antibiotics (even after discontinuation
discharge) as directed of antibiotic
by physician. treatment after
discharge when
the patient feels
well. This could
lead to
reinfection and

49
 antibiotic
● Encourage the patient resistance.
to comply with the
follow up check up ● This will ensure
schedule as directed monitoring of
by the physician. the patient’s
health status and
proper wound
healing of
surgical incision
site.

50
 HEALTH TEACHINGS

IMMEDIATE CARE AFTER THE SURGERY:

The main objective of immediate post-anesthesia nursing care (phase 1) is:
● During surgery, fluids are lost by blood loss, hyperventilation, and exposed skin
surfaces. IV fluids can replenish volume, and excessive blood loss can be
replaced with blood, blood products, colloids, or crystalloids. Due to the activation
of antidiuretic hormone as part of the stress response and the effects of
anesthesia, the body naturally retains fluid for at least 24 to 48 hours following
surgery. Within 48 hours, fluid and electrolyte balance returns to normal as the
body stabilizes.
● Nausea and vomiting are frequent surgical complications that can lead to fluid
and electrolyte imbalances. General anesthesia, abdominal surgery, opiate
analgesics are common causes. Nausea and vomiting are most common in the
first 24 hours, with the largest frequency occurring in the first 2 hours. It can
lengthen recovery time, resulting in an unanticipated hospitalization for an
outpatient surgical patient.
● Pain is a regular occurrence following most surgical operations and is likely the
most severe postoperative concern in the patient's eyes. A vital nursing
intervention is prompt and appropriate pain management. Unresolved acute pain
has several unfavorable consequences, including increased complications,
longer hospital stays, increased disability, and the possibility of permanent pain.

The uterus is removed during a hysterectomy. Make certain that you:

➢ Learn what things you can and cannot undertake.
➢ Maintain your follow-up appointments.
➢ If you have any concerns or are worried about any difficulties or changes in your
mood, contact your healthcare practitioner.

51
ACTIVITY:

Some activities may be restricted for a length of time following surgery. You may
require additional rest during the day. However, try to get up and walk around as much
as possible.

MAKE SURE YOU ARE AWARE OF:

● When you have the option of taking the stairs. Slow down and pause
every few steps. For the first few days, have someone with you. Plan your
day so that you don't have to go up and down stairs continuously.
● When you are able to conduct housework or return to work.
● Whether or not you are able to carry heavy objects.
● When you will be able to start driving. If you are using prescription
painkillers or other drowsy medications, do not drive.
● How far should you walk? As you recuperate, talk to your doctor about
what kind of activity you should do.

THERE MAY BE A CHANGES IN YOUR BODY:

● For up to eight weeks, you may have vaginal discharge. (At first, this may
appear bloody, but it should progressively become lighter and thinner.)
● Some women have an increase in vaginal bleeding for 24 hours two
weeks following surgery. This is typical. Call your doctor if it persists or
gets really heavy.
● If both ovaries are removed, you may have menopausal symptoms such
as hot flashes, vaginal dryness, and night sweats. Hormone replacement
treatment may be an option for treating these symptoms and should be
addressed with your doctor before undergoing surgery.

52
DIET:

● Eat a well-balanced diet rich in protein, fruits, and vegetables to aid in

recovering after surgery.
● Drink 8-10 glasses of fluids every day (preferably water) to ensure that
you stay hydrated. If you have a heart condition, see your physician about
your fluid consumption.
● Increase your fiber consumption if you are prone to constipation. If you
need assistance with your nutrition, please contact a dietitian.

INCISION CARE:

● Maintain a clean and dry incision. Wash your incisions and intimate region
with warm water and a mild soap every day. Make care to completely rinse
and pat dry.
● Every day, examine the area of your incisions for redness, edema,
drainage, or wound opening.
● You will most likely leave with staples or steri-strips (thin, white
Band-Aids). They will aid in the healing of your wound. Staples are metal
clips that, in addition to sutures, are used to assist seal the wound.
● Wear loose-fitting clothes that will not irritate or rub the incision. To avoid
irritation from your clothing, place a clean patch of gauze over the wound.

● Nothing should be placed in your vagina. This involves using tampons,

douching, or engaging in sexual activity. When this region has healed
sufficiently, your doctor will notify you. This normally takes approximately
eight weeks.

● Avoid exposing the incision to direct sunlight. Also, unless otherwise told,
do not apply any creams and lotions or lotions directly to the incision.

53
 ● A tiny quantity of clear or light crimson fluid may flow from the incision or
stained your garment or clothing. If there is a lot of drainage (for instance,
the bandages get wet), please contact your surgeon very once.

IN TERMS OF SEXUAL INTERACTIONS:

● Discuss this with your surgeon at your first postoperative appointment,
although the normal guideline is no vaginal discharge for eight weeks.
(This includes using tampons, douche products, and engaging in sexual
activity.)

MEDICATION:

● When you go home, your doctor will write you a prescription for pain
relievers and an anti-inflammatory (Motrin). Discomfort and mild to
moderate pain are frequent after surgery. Take your pain reliever before
the agony gets unbearable. This will improve your pain management. It is
also beneficial to alternate pain relievers with anti-inflammatory
medications. If you notice that your suffering increases as your activity
level rises, consider taking your pain medication one-half hour before the
activity. If medicine does not relieve your discomfort, please contact your
doctor. Constipation may result from pain medication. To avoid
constipation when using pain medication, drink more water, eat more high
fiber meals, and take a stool softener and a laxative.

● Take all of the drugs you were taking before to the procedure, unless any
of them have been modified or discontinued. Please contact your surgeon
if you have any concerns about which medications to take or not take.
Another option for answering such issues is your primary care physician.

WHEN TO CONTACT YOU PRIMARY HEALTH PROVIDER:

54
● The temperature is higher than 100.5.
● Redness, swelling, soreness, and drainage from your wound or surgical
site.
● Heavy vaginal bleeding soaking a pad every hour
● Your pain medication is not relieving your agony.
● A nasty odor emanating from your vagina.
● Vomiting and/or nausea
● Prolonged constipation or diarrhea despite eating meals and taking
medicine to treat it. If you haven't had a bowel movement in 5 days,
contact your doctor.
● Urinary symptoms include frequent urination, discomfort, and difficulty to
pee.
● If you have chest discomfort, shortness of breath, palpitations, or leg pain,
you should go to the nearest emergency facility.

55