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CHAPTHER ONE
ASSESSMENT OF PATIENT AND FAMILY
Assessment is the first step in the nursing process in which the nurse carries out a complete and
holistic nursing assessment of every patient needs. Psychological, sociological, physiological and
spiritual statuses are all forms of information gathered about patient. Assessment is done through
observation, physical examination, interview of patient and family, medical investigation and
laboratory investigation. The information gathered serve as a foundation upon which appropriate
nursing intervention will be established for speedy patients recovery. and also to identify
patients problems which are expressed as actual or potential.
PATIENTS PARTICULARS
Mrs. D.O is 43 year woman born to Mr. O.O and Mrs. R.T. sshe hails from cape coast in the
central region of Ghana. She but stays at Kwadaso. She is half Ashanti and half Fanti. Mrs. D.O
is 5.4feet tall and weighs 68kg. She is an alcohol [local gin] seller and also a farmer. She is a
Christian and worship with the Presbyterian church of Ghana at Kwadaso. Mrs. D.O had no
formal education.
FAMILYS MEDICAL AND SOCIO-ECONOMIC HISTORY
There are no known hereditary illnesses like asthma, diabetes mellitus, hypertension and absence
of or mental illness in their family. The family sometimes experiences headache, slight stomach
aches which are mostly managed by taking paracetamol and sometimes flaggly flagyl tablets.
There are no food and drugs allergies. She gains her income from the products from her farm and
selling of local gin [apteshie]. She is sociable and adapt to situations that are challenging.
PATIENTS DEVELOPMENTAL HISTORY
Patient was born by vaginal delivery with an assistance of a traditional birth attendantce at the
house. She experienced her secondary characteristics such as breast enlargement, menstrual flow
and enlargement of hips at the age of 14years. Mrs. D.O is currently living with her husband with
five children, two males and three females.
She was immunized against the six childhood killer diseases now known as childhood
preventable diseases. Client had no formal education.
PATIENTS LIFESTYLE AND HOBBIES
Patient normally goes to bed at 10:00pm and wakes up around 4:30am and prays to God for
protecting her throughout the night. She maintains her personal hygiene and goes to the farm at
6:30am. She normally closes from the farm around 1:00pm and come to continue her selling of
local gin [apteshie] at the house. She watches television, maintains her personal hygiene and
goes to bed at 10:00pm. Patient baths twice daily with soap, sponge and warm water. She cleans
her teeth twice daily with toothpaste and brush and before and after going to bed. She empties
her bowel once daily. Her favorite food is banku and okro stew. She does not smoke but drink s
alcohol. Mrs. D.O favorites hobby is music and often likes to dance to her children sight.
PATIENTS PAST MEDICAL/SURGICAL HISTORY
Patient had never experienced any medical conditions like diabetes mellitus, hypertension etc.
she had no known allergies. She hasd, had no surgical condition which might have needed her
admission to any hospital; this was her first surgery to be done. Total abdominal hysterectomy
was done for uterine fibroid.
PATIENTS PRESENT MEDICAL HISTORY
Patient was apparently well until 6th day of September 2013 when she started experiencing
profuse bleeding and, abdominal pains that was associated with her when she got into
menstruation. Prior to that, she was admitted at the SDA Hospital Kwadaso to be taking care of.
It was later confirmed that patient was having uterine fibroid of which she was to undergone total
abdominal hysterectomy.
ADMISSION OF PATIENT
Mrs. D.O was admitted to the surgical ward at the S.D.A hospital Kwadaso on the 10th
September, 2013 at 11:30am with the diagnosis of uterine fibroid. She was in the company of
two relatives, the husband and the child. The patients folder was collected from the admission
nurse and patients name and other particulars were verified mentioned to confirm whether she
was the right patient. Patient and her family were warmly received and given seats to make them
comfortable and were reassured that all the necessary measures would be put in place to ensure
her comfort throughout her hospitalization. Patient was put on a comfortable bed and quick
assessment from head to toe was done to ascertain her general condition.
Her vital signs were checked and recorded as follows;
Temperature = 38.4 degree Celsius
Pulse = 80 beats per minute
Respiration = 20 cycles per minute
Blood pressure= 130/80 mmHg
Tepid sponging was done to reduce patients body temperature to 37.5 degree Celsius.
Family members were educated on visiting hours and the meal time and all ward policies were
explained to them. They were also shown to the bathroom and toilet. They were also introduced
to doctors, nurses and other staff on the ward as well as other patients.
Anxiety level of patients rose up due to the impending surgery, so she was reassured that she will
have a successful surgery. This helped to allay anxiety and wins her cooperation. She was
introduced to other patients who have undergone similar surgery successfully; this and it helped
to release relieve her psychologically. She was also allowed tos expressing her fears through
questioning. and Hher questions were answered in simple terms to clear any misconception.
Patient had inadequate knowledge on the condition (uterine fibroid) and so the definition, causes,
signs and symptoms and treatment of the condition were explained to patient. Clients and
familys questions were answered in simple and appropriate terms to aid in the full understanding
of the condition.
Bed rest was ensured and in a quit environment provided. Assisted bed bath and oral care were
given. Clients vital signs were was checked and recorded and all measures were put in place to
relieve pain. Nil per oS was instituted due to the impending surgery. Patient went to bed around
7:20pm to prepare for the operation on the following day, (11th September 2013). Procedures
done were recorded and documented in the nurses notes.
Vital signs checked and recorded for the ranges within;
Temperature= 37.5-38.4 degrees Celsius
Pulse = 78-80 beats per minute
Respiration = 18-20 cycles per minute
Blood pressure= 120/70-130/80millimetre per mercury
PATIENTS CONCEPT OF ILLNESS
Patient does not know what actually contributed to her illness. She believes that with God on her
side and with care rendered she would be able to pass through the surgery successfully.
Hereditary or family history: uterine fibroids are the most common tumor found in female
reproductive organs. If your mother or sister had fibroid, you are at increased risk of developing
them.
Race and ethnicity: black women are more likely to have fibroids than women of other racial
groups. Also black women have fibroids at younger ages and they are likely to have more or
larger fibroids.
Age: fibroids are more common in women who are their 30s through early 50s. [After
menopause, fibroids tend to shrink]. About 20-40percent of women age 35 and over have
fibroids.
Other factors: onset of menstruation at an early age, having a diet higher in red meat and lower
in green vegetables and fruits, and drinking alcohol such as beer appears to increase risk of
developing fibroid.
LOCATION OF FIBROIDS
-Sub mucosal fibroids: fibroids that grow into the inner cavity of the uterus are more likely to
cause prolonged, heavy menstrual bleeding and sometimes problem for women attempting
pregnancy.
-Subserosal fibroids: fibroids that projects to the outside of the uterus can press on the bladder
causing one to have urinary symptoms.
-Intramural fibroids: some fibroids grow within the muscular uterine wall. If large enough,
they can distort the shape of the uterus and cause prolonged, heavy periods as well as pain.
PATHOPHISIOLOGY
Uterine fibroids develop from the smooth muscular tissue of the uterus [myometrium]. A single
cell divides repeatedly, eventually creating a firm, robbery mass distinct nearby tissues. The
growth patterns of uterine fibroids vary, grow slowly or rapidly, remain the same size, some
fibroids go through growth sports and some may shrink on their own. Many fibroids that present
during pregnancy shrink or disappear after pregnancy as the uterus goes back to a normal size.
They can be single or multiple expanding the uterus so much it that it reaches the rib cage.
CLINICAL FEATURES
-Heavy menstrual bleeding
-Prolonged menstrual periods
-Pelvic pressure or pain
-Frequent urination
-Difficulty emptying the bladder
-Constipation
-Lows backache
COMPLICATIONS
-Infertility
-Pregnancy loss
-Anemia
-Urinary tract infection
-Uterine cancers
DIAGNOSTIC INVESTIGATION
-Ultrasound: the ultrasound device [transducer] is moved over the abdomen [Trans abdominal]
or places it inside the vaginal [transvaginal] to get images of the uterus.
-Laboratory tests: These might include a complete blood count to determine if there is anemia
due to chronic blood loss and other blood test to rule out bleeding disorders.
Other imaging test
-Magnetic resonance imaging [MRI]: this shows the size and location of the fibroid, identify
different types of tumors and help determine appropriate treatment options.
-Hysterosonography: Also called a saline infusion sonogram, uses sterile saline to expand the
uterine cavity making it easier to get images of the cavity and endometrium. It is useful when
one has heavy bleeding.
-Hysterosalpingography: Uses a dye to highlight the uterus and fallopian tube on x-ray images
to determine if the fallopian tubes are opened.
-Hysteroscopy: A small lighted telescope called a hysteroscope is inserted through the cervix
and into the uterus.
Other diagnosis
-Physical examination.
-History from the patient.
-Signs and symptoms.
SPECIFIC MEDICATIONS
Medications for uterine fibroid target hormones that regulates menstrual bleeding and pelvic
pressure. They do not eliminate fibroid but may shrink them. Medications include;
-Gonadotropin releasing hormone [Gn-RH] agonist. Example; Lupron, synarel and others are
used to treat fibroid by blocking the production of estrogens and progesterone putting a person
into a temporally postmenopausal state.
-Progestin releasing intrauterine device [IUD] to help relieve heavy bleeding caused by fibroid. It
provides symptom relieve only and does not shrink fibroid or make them disappear.
-Non steroidal anti-inflammatory drugs [NSAIDS] may be effective in relieving pain but not to
reduce bleeding caused fibroid.
-Oral contraceptives or progestin can help control menstrual bleeding but do not reduce fibroid
size.
-Intravenous fluids such as dextrose saline, normal saline may be given to correct fluid and
electrolyte loss.
severe pelvic pain, after a very thorough evaluation to identify the cause of the pain, and only
after several attempts at non-surgical treatments. Clearly a woman cannot bear children herself
after this procedure, so it is not performed on women of childbearing age unless there is a serious
condition, such as cancer. Total abdominal hysterectomy allows the whole abdomen and pelvis to
be examined, which is an advantage in women with cancer or investigating growths of unclear
cause.
COMPLICATION OF SURGICAL TREATMENT
-Infection
-Pain
-Bleeding at the surgical area
a. Vital signs such as temperature, pulse, respiration and blood pressure are observed to
serve as a baseline to evaluate the patients condition.
b. Patient must be observed for pain, and to be encouraged to assume the position she find
comfortable which is not contradicted to her condition.
CONSENT OF PATIENT
After all the explanations necessary for the patient to gain knowledge, understand the surgery, a
consent form is signed by the patient and this give the legal right for the operation to be
performed on her.
INVESTIGATION
All investigations must be done on the patient to correct any abnormalities related to blood,
hemoglobin estimation, white blood cell count, and etc.
NUTRITION
Serve fluid diet the night before the surgery. Intravenous fluids such as dextrose saline, normal
saline, ringers lactate may be given to correct fluid and electrolytes loss. Nothing is given by
mouth on the morning of the operation.
SKIN PREPARATION
The area to be shaved must be washed and dried, and clean the shaved area with antiseptic
lotion. Sterile procedure of shaving should be done.
VALIDATION OF DATA
With reference to the data collected clinical features of uterine fibroid were confirmed by the
literature review of the condition. Data collected from the patient and relatives were cross
checked with patients folder, laboratory investigations and assessment. All these proved that
patient was suffering from uterine
CHAPTER TWO
ANALYSIS OF DATA
Analysis of data is the interpretation of data collected to identify patients specific needs and
strengths, which help in the information of an appropriate nursing diagnosis. It includes actual
and potential identified needs. It also covers diagnostic investigations, causes, clinical features,
treatment, complications and pharmacology of drugs.
INVESTIGATION RESULTS
NORMAL
VALUE
INTERPRETATION
REMARKS
07/08/13
SPECIFIC/
BODY PART
INVOLVED
Blood
Hemoglobin level
estimation
10.1gldl
Below normal
07/08/13
Blood
4.21[106/ul]
07/08/13
Blood
07/08/13
Blood
07/08/13
Blood
3.8mmol/l
07/08/13
Blood
Male: 1418gldl
Female: 1216gldl
4.505.50[106/ul]
2.608.50[10/ul]
2.152.55mmol/l
3.5-5.5mmol/l
98mmol/l
90-100mmol/l
Normal
3.65[10/ul]
2.45mmol/l
Below normal
Normal
Normal
Normal
.Frequent urination
.Constipation
.Low backache
.Dehydration
DRUG
Pethidine
CLASSIFICATION
DESIRED EFFECTS
Narcotic analgesics
Relieves of pain
Antipyretic, sedatives
,NSAIDS
Relieves inflammation,
pain
Antiprotozoa,
Amoebicide
To treat infection
Provides
supplementary
Diclofenac
11/09/13
Metronidazole
11/09/13
Dextrose Saline
11/09/13
Normal Saline
Route: intravenous
Patient: 2 litres for 48hours,
intravenously
Highly individualized
Restores normal
sodium and chlorine
level
Antiprotozoa,
Amoebicide
To treat infection
Haematimics
Route: intravenous
11/09/13
Ringers lactate
11/09/13
Tablet Flagyl
11/09/13
Tablet Zincovit
11/09/13
Atropine
Antisecretory agent
Anesthetic drug
Relaxes skeletal
muscles
Antibiotics
Kills susceptible
bacteria and prevent
infection
Child dose:0.4mg
Route: intravenous
11/09/13
Suxamethionum
11/09/13
Ciprofloxacin
CHAPTER THREE
PLANNING FOR PATIENT AND FAMILY CARE
Nursing care plan is a step by step process designed to enhance delivery of nursing care on
individual.
approach to patients care and serves as communication between patient and the entire health
team. Nursing care plan ensures that, the nursing team work efficiently to bring out a holistic
goal oriented and individual care to patient.
PRE OPERATIVE PROBLEMS
1.
2.
3.
4.
Fever.
Abdominal pain.
Knowledge deficit (Partial).
Anxiety.
Altered body comfort (incision pain) related to wound at the incision site.
Altered skin integrity (incision wound) related to surgical manipulation on the abdomen.
High risk for urinary tract infection related to urethral catheter in situ.
Self care deficit (bathing, mouth care, etc.) related to post operative restrictions.
Patient will have intact skin throughout the period of hospitalization as evidenced by:
a. Patient verbalizing her skin has minimal scar at incision site.
b. Nurse observing that patients wound will heal by first intension.
3. Patient will be free from urinary tract infections within the period of catheterization
hospitalisation as evidenced by:
a. Nurse observing no signs of redness and discharge at the site of the catheter.
b. Patient verbalizing that she feels no pain at the site.
4. Patient will be able to meet her self careself-care needs within 72 hours as evidenced by:
a. Nurse observing patient taking her bath, grooming and caring for her mouth without
assistance
NURSING
DIAGNOSIS
OBJECTIVES/OUTCOME
CRITERIA
NURSING
ORDERS
NURSING
INTERVENTIONS
Altered in body
temperature
(38.4C) related to
inflammatory
process.
2. Tepid sponge
patient.
12:00pm
3. Open nearby
windows.
b. Patient verbalizing that her
temperature has reduced.
EVALUATION
4. Re-checks patients
4. Patient body temperature
body temperature every was rechecked every 15
15 minutes.
minutes to determine reduction
in body temperature.
6:30pm
A.F
DATE
AND
TIME
10/09/13
at
1:15pm
NURSING
DIAGNOSIS
Altered body
comfort
(abdominal
pain) related to
inflammatory
process
secondary to
uterine fibroid.
OBJECTIVE/
OUTCOME
CRITERIA
Patient will be
reduced of pain
within 24 hours as
evidenced by:
NURSING ORDERS
NURSING
INTERVENTIONS
EVALUATION
1. Reassure client.
a. Nurse
observing that
patient is relaxed
with cheerful
facial expression.
2. Perform pain
assessment.
2. Assessment of pain
was done before and 30
minutes after analgesics
were served.
10/09/13
b. Patient feeling
comfortable in
bed and
verbalizing
absence of pain.
3. Assists patient to
assume a comfortable
position.
4. Reduce noise
5. Provide diversion
8:10pm
therapy.
DATE
AND
TIME
NURSING
DIAGNOSIS
OBJECTIVE/
OUTCOME
CRITERIA
NURSING ORDERS
in conversation to divert
her attention from the
pain
NURSING INTERVENTION
EVALUATION
10/09/13
at
2:00pm
Inadequate
knowledge
(partial) related
to information
on the causes
and
management of
uterine fibroid.
a. Patient and
family verbalizing
their full
understanding of
the condition and
how to care of
surgical wounds.
2. Put client in a
comfortable position.
10/09/13
3. Educate client on
condition.
5. Give appropriate
answers to client and
family.
5:20pm
A.F
DATE
AND
TIME
10/09/13
At
3:45pm
NURSING
DIAGNOSIS
Anxiety related
to unknown
outcome of the
impending
surgery
OBJECTIVE/
NURSING ORDERS
OUTCOME
CRITERIA
Patient and family 1. Reassure patient.
will be relieved of
an anxiety within 4
hours as evidenced
by:
2. Assess patient and
familys state of
a. Nurse observing anxiety, fear and
that patient have a concern.
cheerful facial
expression.
3. Explain to her the
theater environment
b. Patient
and what she should
verbalizing that
expert expect in the
she is relieved of
theater.
anxiety.
NURSING INTERVENTION
EVALUATION
10/09/13
5:00pm
5. Encourage
diversional therapy.
A.F
DATE
AND
TIME
12/09/13
At
7:00am
NURSING
DIAGNOSIS
Altered body
comfort
(incision pain)
related to
wound at the
incision site.
OBJECTIVES/
OUTCOME
CRITERIA
Patient pain will
be reduced within
72 hours as
evidenced by:
NURSING ORDERS
NURSING INTERVENTION
EVALUATION
1. Reassure patient.
a. Patient
verbalizing that
she is relieved of
pain.
2. Assist patient to
assume a comfortable
position that relieves
her pain.
14/09/13
10:20am
b. Nurse
observing patient
having a cheerful
facial expression
and looking
relaxed in bed.
3. Provide diversional
therapy.
4. Teach patient to
support incision site
when coughing or
laughing.
5. Administer
A.F
analgesics.
TABLE FOUR:
DATE
AND
TIME
12/09/13
At
10:00am
pain.
NURSING
DIAGNOSIS
Altered skin
integrity
(incision
wound)
related to
surgical
manipulation
on the
abdomen.
OBJECTIVE/OUT
NURSING ORDERS
COME
CRITERIA
Patient will have
1. Reassure patient.
intact skin throughout
the period of
hospitalization as
evidenced by:
NURSING INTERVENTION
EVALUATION
a. Patient verbalizing
that her skin has a
minimal scar at
incision site.
15/09/13
b. Nurse observing
that patient wound
will heal by first
intention.
2. Change soiled
dressing as per
hospital policy
frequent and
aseptically.
3. Educate patient to
avoid touching the
wound site.
4. Administer
prescribed antibiotics.
9:30am
3. Patient was instructed not to
touch the wound site to avoid
infection of the wound.
A.F
NURSING
DIAGNOSIS
12/09/13
At
12:30pm
OBJECTIVE/
OUTCOME
CRITERIA
Patient will be free
from infection
within period of
catheterization as
evidenced by:
NURSING
ORDERS
NURSING
INTERVENTION
EVALUATION
1. Reassure client.
1. Patient was
reassured that the
catheterization was
temporal.
a. Patient
verbalizing that she
feels no pain at the
site
2. Patients catheter
was cared for daily
with antiseptic lotion
such as salvon and
normal saline.
b. Nurse observing
no signs of redness
and discharge at the
catheter site.
12/09/13
3:10pm
A.F
4. Assist patient to
perform personal
NURSING
DIAGNOSIS
Self-care deficit
(bathing and
mouth care)
related to postoperative
restrictions.
hygiene such as
bathing and care of
mouth.
5. Administer
prescribed
antibiotics
5. Prescribed
antibiotics were
administered to prevent
infection.
OBJECTIVE/OUTCOME
CRITERIA
Patient will be able to meet
her self-care needs within
72 hours as evidenced by:
a. Nurse observing patient
taking her bath, caring for
her mouth without
assistance.
NURSING
ORDERS
1. Reassure
patient.
NURSING
INTERVENTION
1. Patient was reassured
that her personal hygiene
would be taken care of until
her condition allows her to
perform them by herself.
EVALUATION
2. Assist patient to
bath twice daily.
15/09/13
7:00am
A.F
3. Treat pressure
areas as such.
CHAPTER FOUR
Implementation is the fourth stage of the nursing process and it involves the execution of the
proposed plan of care. Implementation includes specific measurable nursing intervention and
patients activities with emphasis on performing procedures like administrating of drugs,
education, providing comfort, ensuring safety and prevention of complications.
Patients and family are involved as the nurse assesses the patients response to the nursing care
rendered.
After the surgery, patient was brought back to the ward on a stretcher in the company of two
theatre nurses at 12:45pm. She was was taken back to the surgical ward as ordered by the
surgeon at 2: 45pm in a semi-conscious and had state with 500ml of Ringers lactate in place that
was driping well.in-situ, accompanied by two theatre staff nurses and
patency of urethral
incision site when coughing, sneezing, or getting out of bed to prevent wound gabbing. The
doctor came for review around 10: 25am, ordered the following; analgesic injection Pithidine
500mg., starting sips of water, removal urethral catheter and to discontinue the infusion. The
patient was given sips of water and there was no complication and catheter was cared for,
removed and infusion was discontinued. Relatives were urged to prepare a light soup the next
day and she went to bed around 8: 00pm. Due medications were served as ordered.
Vital signs were checked and recorded for the day ranges within;
Temperature = 36.5-37.6 degree Celsius
Pulse = 78-80 beats per minute
Respiration = 18-20 cycles per minute
Blood pressure = 110/70-120/70millimeters of mercury
ordered by the surgeon. She was advised not to touch the wound site to prevent infection and
also was advised to adhere to all medications to promote wound healing.
Patient was taught how to get out of bed without putting pressure on the incision site and was
also encouraged to walk around the ward to improve circulation and prevent joint stiffness. She
was served with light porridge in the morning, rice balls with light soup in the afternoon and
slice yam with light soup in the evening. Patient was made comfortable in bed and her relatives
were reassured of her speedy recovery.
Vital signs checked and recorded for the day ranges within;
Temperature = 36.6-36.9 degree Celsius
Pulse = 78-80 beats per minute
Respiration = 22-24 cycles per minute
Blood pressure = 120/70-130/80 millimeters of mercury
date of discharged were documented into the admission and discharged book as well as the daily
ward state. Patient and family said goodbye to other patients on the ward and left to the house
around 3:30pm. Bed linen of patient was stripped off and bedstead, lockers were clean with
disinfectants and were made ready for the next admission.
PREPARATION
OF
PATIENT
AND
FAMILY
FOR
DISCHARGE
AND
REHABILITATION
Mrs. D.O and family were made to understand that patients hospitalization was a temporal one
since she would be discharged to go home after her condition has improved. The preparation for
discharge started on the day of admission till the day of discharge. Patient and family were
educated on the causes, signs and symptoms, complications, treatment and prevention of the
disease.
The patient and family were educated to keep the mouth clean at least twice daily to prevent oral
infection. They were educated to bath twice daily to remove dirt and to promote circulation. Also
they were advised to trimmed fingers to prevent microbes. They were educated to wash their
hands with soap and water before and after eating and after visiting the toilet to prevent
microbes.
Mrs. D.O and family were educated on their food, thus washing fruits and vegetables before
eating to prevent contamination of the food. She was educated to take in diet containing protein,
vitamins and mineral salts to aid in promoting wound healing. The patient was advised to avoid
heavy lifting which could lead to wound gaping. They were educated on the harmful effects of
alcohol and smoking and to avoid the intake of them.
Lastly, Mrs. D.O was educated to adhere to her drugs and also to take note of the review date 27th
September, 2013 and the date for removal of stitches 23rd September, 2013. Patient was finally
discharged on 16th September, 2013. Rendered procedures were documented in the nurses note,
admission and discharge book, and daily ward state.
was adhering to treatment regimen. Patient was given the mandate to verbalize how she feels and
I observed the wound for any complication of which none was observed. Mrs. D.O had no
complained and the wound was well clean.
The patient was reminded of the review date which comes on 27 th September, 2013. She was
adviced to take in well-balanced diet to help prevent infection and also promote early wound
healing. She was also educated to avoid putting much pressure on her wound through lifting of
heavy objects. It was made clear to the patient that if she encounters any problem she should
report to the hospital before the review date. Termination of care was explained to them and that
would be possible on the third home visit. Another home visit was promised. Permission was
granted for me to leave.
CHAPTER FIVE
An objective was set at 3:45pm to reduce patient and family level of anxiety within 4hours. Goal
fully met on 10/09/2013 at 5:00pm as nurse observed that patient have ahad a cheerful facial
expression, patient verbalized that she is relieved of anxiety.
condition improved and was discharged on the 16th September, 2013 and care was terminated on
the 2nd October, 2013.
Also, home visits were made to patients house and it was found out that the condition of patient
has improved. She was educated on her diet, drugs, personal and environmental hygiene and also
to report any sickness to nearest hospital which is Kwadaso Sda Hospital. This ended the
interaction and Mrs. D.O hospitalization.
CONCLUSION
This care study has equipped me with the knowledge and skills to on uterine fibroid, its causes
signs and symptoms, surgical intervention [total abdominal hysterectomy], nursing and medical
management.
It was observed that a successful patient and family care depends on the cooperation of the
patient and family with the nurses willingness to help throughout the care.
Psychological and spiritual wellbeing of patient and family were promoted all because of their
opinions and cooperation given.
I would like to come out with a point that any patient who comes to the hospital should be given
such an individualized and specialized nursing care which will help improve patients self-image
and its recovery.