الأربعاء، 29 أغسطس 2018

323-Oophorectomy

About
Surgical removal of ovary( s).
Assess
Bleeding, incision, vital signs, lung sounds, bowel sounds, knowledge related to procedure and post-operative care
Complications
Post-operative complications including atelectasis, pneumonia, DVT, PE, infection, hemorrhage, paralytic ileus, bowel obstruction.
Onset of surgical menopause
Diagnosis
  • Sexual dysfunction related to perceived body changes
  • Knowledge deficit related to possible surgical intervention
  • Acute pain related to surgical procedure
  • Constipation related to anesthesia, pain medications
  • Ineffective health maintenance related to care after surgery
  • Sexual dysfunction related to perceived body changes
Goals
  • The client will understand pre-, intra-, and post-operative instructions.
  • The client will be free from infection.
  • The client will be able to normally eliminate urine and have positive bowel sounds.
  • The client will demonstrate effective coughing and deep breathing and incentive spirometry post-operatively.
  • The client will ambulate at least three times daily after post-op day 1.
  • The client will identify signs and symptoms that require follow-up or indicate infection.
  • The client will have a pain of less than 4 on a VAS 0-10 pain scale.
  • The client will verbalize concerns and fears related to change in body image and sexual functioning.
Interventions
  • Teach client what to expect prior to, during, and after procedures.
  • Teach client coughing and deep breathing exercises to minimize risk of pneumonia.
  • Post-operatively, monitor VS every 15 minutes X 2, every 30 Minutes X 2, every 1 hour X 2, than every 4 hours ( may have different guidelines for each clinical agency).
  • Monitor voiding amount, color and clarity.
  • Monitor vaginal bleeding, notify physician if bleeding increases.
  • Notify physician if unable to void greater than 6 hours after removing indwelling catheter.
  • Provide proper catheter care; monitor for s/s of infection.
  • Initiate early ambulation to minimize risks of complications.
  • Administer medicines ( analgesics, stool softeners, hormone replacement, etc.) as ordered.
  • Perform assessments every 4-8 hours to monitor for complications ( circulation, oxygenation, auscultation, etc).
  • Monitor for signs/ symptoms of complications.
  • Encourage client to discuss feelings associated with changes in body image and sexual function.

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