Question

. 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?

.

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Answer 1

Vaginal hysterectomy with bilateral salpingo-oophorectomy means a surgical method of removing the entire uterus with both fallopian tubes and both ovaries.

a)As a result of this surgery the patient can be saved from metastasis of the cancer cells to other parts.

There will be menopause, hormone related problems, infections, blood clots in legs and lungs,sterility, insomnia,mood changes,UTI, urinary incontinence, nerve damage, bowel obstruction, hernia scar tissue

Treatment:

Antibiotics for prescribed period as advised by surgeon

Analgesic to control pain

Hormonal therapy strictly as per the advice of doctor

b)The following nursing care has to be given as soon as she arrives to the medical surgical unit

• Monitoring vital signs
• Administration of medication as per order
• Keeping nil by mouth till bowel movements starts then to start clear liquid gradually increasing to solid diet
• Monitoring vaginal discharge
• Positioning
• Oxygen if needed via nasal cannula
• Mobilization of patient as per advice
• Psychological support
• Divertional therapy for pain
• Securing drain at right place

c)The following discharge information has to be given

• Can keep a care taker for a short time
• Follow up with doctor at 2 nd week and after 4-6 weeks
• Report any side effects
• No weight lifting
• Use sanitary napkins
• No tampoon or douching
• Resume shower however keep wound dry
• Maintain good personal hygiene
• Avoid strenuous exercise
• Minimal household chores can be done