Question

What are five nursing interventions for the post TAH/BSO patient (put in order of priority; think “ABCs”) and What are three complications post TAH/BSO?

Answer 1

Total abdominal hysterectomy (TAH) is a surgical procedure that   removes the entire uterus along with cervix through an abdominal incision.    Bilateral salpingo-oophorectomy(BSO) is a procedure in which both the ovaries and fallopian tubes are removed.

Five post operative nursing interventions for a patient after total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH/BSO ) are given below

Serial No.	Nursing interventions	Rationale
1	Monitor · pain level · bowel sounds · abdominal distension	Bowel injury can cause paralytic ileus causing gaseous abdominal distension which will result in increased pain.
2	Assess for bleeding (especially for first 8 hrs).Report if a vaginal pad is saturated every hour.	One of the most dangerous postoperative problems with hysterectomy is haemorrhage .
3	Palpate urinary bladder for distension	Bladder atony (loss of strength) can cause voiding problems.
4	Monitor urinary output. Report if it is less than 30ml/ hour	Decreased urinary output may occur due to oedema, nerve trauma and ligation of ureter during surgery.
5.	Change position and encourage early ambulation	It promotes venous return and prevents deep venous thrombosis

Three complications after total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH/BSO ) are

1. Haemorrhage: it begins from lateral vaginal angles in most cases.

2. Infection : Pelvic cellulitis and urinary tract infection

3. Injury to surrounding organs, including bladder, bowel, and ureters