CABILDO, GRANDVILLE MIA M.

BSN 4-B
Role: Scrub Nurse

MAY 26, 2022| 7-11 PM SHIFT

CASE STUDY ON TOTAL ABDOMINAL HYSTERECTOMY WITH BILATERAL

SALPINGO-OOPHORECTOMY
DATA
Name: LT
Age: 41
Sex: Female
Civil status: Married
Religion: Jehovah’s witnesses
Date of Admission: 5/25/2022; 9:51 AM
Admission compliant: Prolonged and heavy menstrual bleeding
Obstetric history: G1PI
Clinical Impression: Prolapse Submucous Myoma; Severe Anemia 2

PROCEDURE
Hysterectomy is a surgery to remove the uterus and cervix. “Abdominal” was the surgical technique
used which means the surgery was done through an incision in the abdomen. A bilateral salpingo-
oophorectomy is surgery to remove both of the ovaries and Fallopian tubes. The hysterectomy and
bilateral salpingo-oophorectomy is both be done during one procedure. This surgery removed the uterus,
cervix, bilateral ovaries, and bilateral Fallopian tubes of the patient. After a hysterectomy the patient
will no longer have periods or be able to become pregnant.
In addition, the patient was placed on NPO before and was catheterized during the procedure.

NURSING RESPONSIBILITIES
 PRE-OP
1. Assure patient’s safety
2. Identify patient correctly
3. Give medications pre-op as ordered
4. Patient must be NPO as ordered
5. Check for allergies
6. Remove jewelry and other objects
7. Obtain informed consent

 INTRA-OP

1. Ensures quality of care through proper use of instruments, equipment and supplies.

2. Observes proper positioning of the patient and maintaining the dignity of the patient.
3. Keeps the operation sterile.

4. Identifies, prepares and send specimen obtained during operation for examination.

 POST-OP

1. Check and record vital signs.

2. Observes keenly the patient who might undergo post-operative complication.

3. Notifies the anesthesiologist/ AMD immediately for any unusual symptoms manifested by
the patient.
4. Maintain safety of the patient.

DRUG STUDY
CONTRA-
MECHANISM SIDE NURSING
MEDICATION INDICATION INDICATIO
OF ACTION EFFECTS IMPLICATIONS
NS
Generic This medicine Following  muscle  Hyperse Assessment &
Name: is used to treat intravenous cramps nsitivity Drug Effects
Iron sucrose "iron-poor" administration,  nausea  Anemia  Withhold drug
blood (anemia) iron sucrose is  vomiting not and notify
Brand Name: in people with dissociated into  stomach caused physician
Venofer long-term iron and pain by iron when serum
kidney sucrose and the  diarrhea deficien ferritin level
Classification disease. You iron is  constipat cy equals or
s: Anti- may need transported as a ion  Iron exceeds
anaemic extra iron complex with  headach overload established
preparation, because of transferrin to e guidelines.
iron, blood loss target cells  cough  Stop infusion
parenteral during kidney including and notify
 sore
preparation dialysis. Your erythroid physician for
throat
body may also precursor cells. S&S
 sinus
Dosage: 100 need more iron The iron is then overdosage or
pain
mg if you use the incorporated infusing too
 congesti
drug into rapidly:
on
Route: erythropoietin hemoglobin as hypotension,
 back
intravenous to help make the cells mature edema;
pain
new red blood into red blood headache,
 joint
Frequency: cells. cells. dizziness,
pain
Twice-a-day nausea,
 dizzines
(Q12h) vomiting,
s
abdominal
 weaknes
pain, joint or
s
muscle pain,
 tired
and
feeling
paresthesia.
 anxiety
 Lab tests:
Periodic
serum ferritin,
transferrin
saturation,
Hct, and Hgb.
 Monitor
patient
carefully
during the
first 30 min
after initiation
of IV therapy
for signs of
hypersensitivit
y and
anaphylactoid
reaction

Patient & Family

Education
 Report any of
the following
promptly:
Itching, rash,
chest pain,
headache,
dizziness,
nausea,
vomiting,
abdominal
pain, joint or
muscle pain,
and numbness
and tingling.
 Do not breast
feed while
 taking this
drug without
consulting
physician.

INTERPRETATION OF LABORATORY TEST

1. CBC The hemoglobin, hematrocit,

mean cell volume, mean
corpuscular Hgb and mean
corpuscular width of the patient
is low compared to its normal
level. On the other hand, the
patient’s RBC distribution width
and monocytes are high. This
indicates that the patient has an
anemia. This maybe due to
profuse and heavy bleeding that
the patient experienced.

2. Urinalysis There is 6-8 level of WBC in

the urine of the patient. In
addition the urine color is dark
yellow and the transparency is
slightly turbid. This may
indicate infection, inflammation
or contamination.
3. Blood typing The patient has a O+ blood type.

4. Blood chemistry The patient has a high level of

liver enzyme which may
indicate that she has a liver
disease or irritation.
 5. Hematology Test The patient has normal PTT
blood test which indicate that
she does not have bleeding
disorder and blood cloting
problem.

DIAGNOSTIC TESTS AND RELEVANCE

1. Ultrasound This test is use to assess and evaluate
organs in the abdomen. This was
relevant to the patient to rule out he
cause of heavy bleeding.

2. Covid-19 Antigen test This test is part of the institution’s

protocol during the pandemic. The
patient must have a negative result of
SARS-CoV antigen test before
admission and surgery.
3. Chest X-ray Chest --ray shows medical problems
such as enlarged heart, CHF or fluid
around the lungs which could mean that
the operation should be delay or
cancelled. Since the patient has a
normal result, the operation was pushed
through.