Procedure: Mesh Hernioplasty Excision of Cord Lipoma

Classification: Major Surgery

Diagnosis: Indirect Inguinal Hernia Right Incarcerated Cord Lipoma

Signs & Symptoms:

The signs and symptoms of a hernia can range from noticing a painless lump
to the painful, tender, swollen protrusion of tissue that you are unable to
push back into the abdomen (an incarcerated strangulated hernia).

• Reducible hernia
o It may appear as a new lump in the groin or other abdominal
area.
o It may ache but is not tender when touched.
o Sometimes pain precedes the discovery of the lump.
o The lump increases in size when standing or when abdominal
pressure is increased (such as coughing).
o It may be reduced (pushed back into the abdomen) unless very
large.
• Irreducible hernia
o It may be an occasionally painful enlargement of a previously
reducible hernia that cannot be returned into the abdominal cavity on
its own or when you push it.
o Some may be chronic (occur over a long term) without pain.
o An irreducible hernia is also known as an incarcerated hernia.
o It can lead to strangulation.
o Signs and symptoms of bowel obstruction may occur, such as
nausea and vomiting.
• Strangulated hernia
 o This is an irreducible hernia in which the entrapped intestine
has its blood supply cut off.
o Pain is always present, followed quickly by tenderness and
sometimes symptoms of bowel obstruction (nausea and vomiting).
o The affected person may appear ill with or without fever.
o This condition is a surgical emergency.

Post Operative Health Teaching & Nursing Care:

Diet

You may resume a regular diet.

Activity

Use common sense in day to day activities; if it hurts, don't do it.

Realistically, most patients will spend the first two days resting in bed,
getting up only when necessary. However, there is no restriction on walking
or other routine activities if you feel able.

No heavy lifting for approximately 4 to 6 weeks after your surgery or until

your surgeon gives you permission.

Sexual activities may be resumed when comfortable.

Medications

For moderate to severe pain, use prescribed medication as directed. For mild
pain, you may try acetaminophen or ibuprofen following the manufacturer's
instructions.

Narcotic used for pain management may cause constipation. Take a laxative
such as Milk of Magnesia or prune juice if you have not moved your bowels in
2 days.

Resume all medications that you were taking prior to surgery unless
otherwise instructed by your surgeon.
Wound Care

If you have a gauze or an outer dressing over the incision, you may remove
it in 24 hours, but leave all paper strips (steri-strips) and sutures in place. Do
not cut or remove any sutures.
Once you have removed the outer gauze dressing, you may shower (24
hours after the surgery) but do not soak in a hot tub or swim for 2 weeks
following surgery.
Specialized Instructions

Be advised that there may be significant swelling and bruising in the area of
your hernia repair. In men this may extend to the scrotum. Generally, this
will go away within a couple of weeks.

Ma. Nina Carla DL. Tunay

2007170601

Procedure: Hemorrhoidectomy

Classification: Minor Surgery

Diagnosis: Internal Hemorrhoids

Signs & Symptoms:

Some of the symptoms of internal hemorrhoids include:

• Internal hemorrhoids swell and protrude through the rectum and are
painful.
 • Hemorrhoids can be felt at anus and can be pushed, but on swelling
may be trapped outside the anus.
• Patient may develop itching in the anus with a condition called pruritus
ani (8).

Post Operative Health Teaching & Nursing Care:

Diet

Avoid constipating foods while resuming a normal diet. Increase fluids and
fiber in your diet. Fiber supplements such as Metamucil and Citracel will
produce bulky stool which is easier to pass. Follow the manufacturer's
instructions.
Activity

Lying flat as much as possible for 1 to 2 days after surgery can decrease the
amount of swelling in the anal area and is more comfortable than sitting.
Other activities are encouraged as soon as is comfortable.

Medications

For moderate to severe pain, use prescribed medication as directed. For mild
pain, you may try acetaminophen or ibuprofen following the manufacturer's
instructions.

Narcotic used for pain management may cause constipation. A stool softener
(e.g., Colace or mineral oil) is typically prescribed. Take a laxative such as
Milk of Magnesia or prune juice if you have not moved your bowels by the
third day. Resume all medications that you were taking prior to surgery
unless instructed otherwise by your surgeon.
Wound Care

Take Sitz baths (sitting in warm water) at least three times a day or more if
you wish. At first you will be unable to wipe after a bowel movement. You
may be more comfortable rinsing in the shower or tub.

There will be some drainage and perhaps blood for the first several weeks
after surgery. This is normal. You may use gauze or feminine "napkins" with
a sticky strip on the back to protect your underwear. These should be
changed after each Sitz bath.

Ma. Nina Carla DL. Tunay

2007170601