Cupids Health

Medical Surgical Women's Health: Hysterectomy



Hello Everyone, here is a women’s health lecture on hysterectomy made easy to understand to help aide in your study sessions. I have gathered all of the important information from my Med- Surg Book (Brunners and Suddarth 12th edition) and NCLEX review (Saunders 6th edition) that will prepare you for your nursing test whether it is for school or NCLEX.

Here are some Extra information that may help and guide you…

Relieving Pain:

Postoperative pain and discomfort are common. Therefore,
the nurse assesses the intensity of the patient’s pain and assists the patient with analgesia as prescribed. Excision of a large tumor could cause edema because of the sudden release of pressure. In the postoperative period, fluids and food may be restricted for 1 or 2 days. If the patient has abdominal distention or flatus, a rectal tube and application of heat to the abdomen may be prescribed. When abdominal auscultation reveals return of bowel sounds and peristalsis, additional fluids and a soft diet are permitted. Early ambulation facilitates the return of normal peristalsis (Bohnenkamp, et al., 2007b).

Monitoring and Managing Potential Complications:

HEMORRHAGE. Vaginal bleeding and hemorrhage may occur after hysterectomy. To detect these complications early, the nurse counts the perineal pads used, assesses the extent of saturation with blood, and monitors vital signs. Abdominal dressings are monitored for drainage if an abdominal surgical approach was used. In preparation for hospital discharge, the nurse gives prescribed guidelines for activity restrictions to promote healing and to prevent postoperative bleeding. Because many women may go home the day of surgery or within a day or two, they are instructed to contact the nurse or surgeon if bleeding is excessive.

DEEP VEIN THROMBOSIS. Because of positioning during
surgery, postoperative edema, and decreased activity postoperatively,
the patient is at risk for DVT and pulmonary embolism (PE). To minimize the risk, anti-embolism stockings are applied. In addition, the patient is encouraged and assisted to change positions frequently, although pressure under the knees is avoided, and to exercise her legs and feet while in bed. The nurse helps the patient ambulate early in the postoperative period. In addition, the nurse assesses for DVT or phlebitis (leg pain, redness, warmth, edema) and PE (chest pain, tachycardia, dyspnea). If the patient is being discharged home soon after surgery, she is instructed to avoid prolonged sitting in a chair with pressure at the knees, sitting with crossed legs, and inactivity. Furthermore, she is instructed to contact her health care provider if symptoms of DVT or PE occur.

BLADDER DYSFUNCTION. Because of possible difficulty in voiding postoperatively, occasionally an indwelling catheter may be inserted before or during surgery and is left in place in the immediate postoperative period. If a catheter is in place, it is usually removed shortly after the patient begins to ambulate. After the catheter is removed, urinary output is monitored; additionally, the abdomen is assessed for distention. If the patient does not void within a prescribed time, measures are initiated to encourage voiding (eg, assisting the patient to the bathroom, pouring warm water over the perineum). If the patient cannot void, catheterization may be necessary. On rare occasions, the patient may be discharged home with the catheter in place and is instructed in its management.

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