ASSESSMENT Subjective: Hindi ko pa alam ang gagawin sakin eh, pano nga ba yung gagawin pag nasa loob

na ako ng OR? Patient verbalized when asked if she has any idea what she will be undergoing. Objective:

DIAGNOSIS Knowledge deficit related to lack of exposure or recall, information misinterpretati on, unfamiliarity with information resources as manifested by questions and request for information

RATIONALE Clients has not yet experience this kind of surgery before thats why she doesnt have any knowledge yet about the procedure. It is important to let the client have enough knowledge about the said procedure and verbalize her thoughts about it so that she will decrease her anxiety.

PLANNING After 8 hours of nursing intervention the client will:

INTERVENTION INDEPENDENT 1. Review effects of surgical procedure and future expectations; for example, the client needs to know that she will no longer menstruate or bear children, whether surgical menopause will occur, and whether hormonal replacement will be necessary. 2. Discuss complexity of problems anticipated during recovery, including emotional lability and expectation of feelings of depression or sadness, excessive fatigue, sleep disturbances, and urinary problems.

RATIONALE

EVALUATION After 8 hours of nursing intervention the client Knowledge: Disease Process Verbalized understanding of condition and potential complications. Identified relationship of signs and symptoms related to surgical procedure and actions to deal with them. Knowledge: Treatment Regimen Verbalize understanding of therapeutic needs.

1. Provides knowledge base from which client can make informed choices.

Verbalize understanding of condition and potential complications. Identify relationship of signs and symptoms relat ed to surgical procedure and actions to deal with them. Knowledge: Treatment Regimen Verbalize understanding of therapeutic needs.

2. Physical, emotional, and social factors can have a cumulative effect, which may delay recovery, especially if hysterectomy was performed because of cancer. Providing an opportunity for problem-solving may facilitate the process. Client and SO may benefit from the knowledge that a period of emotional lability is normal and expected during recovery.

3. Discuss resumption of activity. Encourage light activities initially, with frequent rest periods, increasing activities and exercise as tolerated. Stress importance of individual response in recuperation.

3. Client can expect to feel tired when she goes home and needs to plan a gradual resumption of activities, with return to work an individual matter. Prevents excessive fatigue; conserves energy for healing and tissue regeneration. Note: Some studies suggest that recovery from hysterectomy, especially when oophorectomy is performed, may take up to four times as long as recovery from other major surgeriesor 12 months versus 3 4. Strenuous activity intensifies fatigue and may delay healing. Activities that increase intra-abdominal pressure can strain surgical repairs, and prolonged sitting potentiates risk of thrombus formation.

4. Identify individual restrictions, such as avoiding heavy lifting and strenuous activities (such as vacuuming, straining at stool) and prolonged sitting or driving. Avoid tub baths and douching until physician authorizes.

Showers are permitted, but tub baths and douching may cause vaginal or incisional infections and are a safety hazard. 5. Encourage client to report bowel dysfunction constipation, loss of urge to defecate, severe straining, incomplete evacuation, and digital evacuationto healthcare providers if it occurs. 5.Constipation is a frequent symptom after hysterectomy and may be related to undiagnosed irritable bowel syndrome, which is often present preoperatively and/or associated with the particular procedure performedvaginal hysterectomy with posterior repair. 6. Postsurgical bowel dysfunction may be short-term or longterm and may require simple home management measures, or referral for medical intervention. 7. When sexual activity is cleared by the physician, it is best to

6. Discuss dietary modifications, medicinal bulk agents, and stimulation by suppository, as indicated.

7. Review recommendations of resumption of sexual

intercourse.

resume activity easily and gently, expressing sexual feelings in other ways or using alternative coital positions. 8. Facilitates healing and tissue regeneration, helps correct anemia when present. Note: Certain vegetables, such as broccoli, cabbage, cauliflower, brussels sprouts, and turnips, may have protective action against excessive estrogen effects. Some foods and substances to avoid or limit include rich dairy products, sugar, fried foods, caffeine, alcohol, and nicotine. 9. Establishes routine for taking drug and reduces potential for discontinuing drug because of nausea that is often an early side effect.

8. Identify dietary needs, such as highquality protein, complex carbohydrates, and additional iron. Provide information about foods to include and avoid in managing menopausal symptoms

9. Encourage taking prescribed drug(s) routinely, for example with meals or at bedtime. Determine when patch should be changed, wearing time altered.

DEPENDENT 1.Administer prescribed meds then explain the purpose of giving medications COLLABORATIVE 1.Endorse patient to other nurse to monitor any clients orientation and knowledge about the upcoming surgical procedure. 1.For further monitoring and to know additional knowledge that is needed to be shared to the patient 1.For continuity of pharmacotherapy

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