Pre Operative nursing care

Assess patient. The health history and the physical and pelvic examinations
are completed and the laboratory tests are performed.
Encourage patient to share details of her menstrual history, the date of her last
menstrual period, the events leading up to admission and the current degree of
vaginal blood loss or discharge.
Assess client’s knowledge of her condition and the surgery.
Perform skin operation: The lower half of the abdomen and the pubic and
perineal area may be shaved and these areas may be cleaned with soap and
water.
To prevent contamination and injury to the bladder or intestinal tract, the
bladder and intestinal tract need to be empty before the patient is taken into
the OR.
The patient who has previously been prescribed with oral contraceptive drug
will have to stop taking the drug 6 weeks prior to operation.
Preoperative medications may be administered before surgery to help the
patient relax.
The patient must be allowed time to talk and ask questions.
The nurse must know what information the physician has given the patient
about the surgery.
Encourage patient to practice foot and leg exercises before operation to
understand how to carry out the exercises while in bed after surgery.
Let the patient will wear anti-embolism socks to prevent venous stasis during
the operation.
Provide education: Loss of fertility if ovaries are to be removed in conjunction
with the operation. Discuss surgical menopause.
 Discuss how sexual intercourse may change.
 Client whose ovaries are removed may complain of a decrease in libido.
 Tell the client that once healing has occurred, intercourse should be pain
free.
Let the patient relax on bed until she leaves the ward escorted by her nurse
who completes a safe transfer to the operating theater staff.
Intra Operative Nursing Care
Prepare and assist for anesthesia.
Maintain homeostasis and asepsis.
Assist the surgeon and the whole team
Assist in transferring the patient to the Operating table in a supine position.
Ask patient to remove any jewelry or other objects that may interfere with the
procedure.
Ask patient to remove clothing and be given a gown to wear.
Check for patency of the IV system.
Monitor client’s HR, BP and breathing and report abnormalities.
The skin over the surgical cite will be cleansed with an antiseptic solution
Post Op
Perform usual post operative assessments.
Evaluate psychological manifestations
Monitor proximity of the bladder to the reproductive organ.
Monitor Foley catheter to prevent susceptibility to UTI and temporary urinary
retention
Assist GI functions by listening to bowel sounds.
Note distention and palpate whether abdomen is soft or firm
Assess abdominal incision for bleeding and intactness.
Assess vaginal bleeding.
There is no distinct diet. Simple, strong, distinct flavors rather than complicated and
multi-flavored dishes seem to be preferred with anything with smaller-than-usual
portions. It’s best to avoid gassy foods like beans, broccoli and cabbage and/or foods
that typically cause gas for you. Many suggest avoiding extra-spicy foods. Remember
that all pos top surgical patients need protein to aid in healing. Include fiber in your
post op diet, drink lots of water, and consume caffeinated drinks sparingly.
If pain is experienced during sexual intercourse let the patient manipulate the
penetration.
Avoid heavy lifting for about 6 weeks to prevent straining the abdominal muscles and
surgical sites.
Avoid activities that increase pelvic congestion such as aerobics activity, horseback
riding and prolonged standing.
Report any fresh bleeding and any abnormal vaginal discharge to surgeon.
Return for follow-up care as requested by the surgeon.
Post op pain and discomfort are common, therefore the nurse should assess it’s
intensity and administer analgesics as prescribed.
If the patient has abdominal distention or flatus, rectal tube and application of heat to
the abdomen may be prescribed
Encourage patient to contact nurse or surgeon when bleeding is excessive.
Encourage early ambulation o facilitate the return of normal peristalsis
Montior and manage potential complications such as:
 Hemorrhage: Count perineal pads used, assess the extent of saturation with blood
and monitor vital signs. Guidelines for activity restriction are given above to
promote healing and prevent post operative bleeding.
 Deep Vein Thrombosis: Encourage and assist patient to change position
frequently and exercise leg and feet while in bed. Instruct patient to avoid
prolonged sitting in the chair with pressure on the knees, sitting cross legs and
inactivity.