Nursing Care for Myoma Uteri Patients with Anemia in Total Abdominal Hysterectomy with Salpingo-oophorectomy : Two-Case Study

Abstract

Myoma uteri is found in approximately 20 – 25 percent of women over 25 years old. The most effective and curative treatment is surgery. Providing standard and effective nursing care for surgical patients will help patients achieve safety, minimize the chance of complications, and return to everyday life. The instruments employed in the study were data from medical records, patient and family interviews, observation, physical examinations, pathological analysis, signs and symptoms, treatment and assessment of health conditions, 11 headings of Gordon's functional health patterns, nursing diagnosis ,nursing implementation and nursing  evaluation.

 The first case was a married woman aged 46 reported to have hypermenorrhea, dizziness, and fatigue. She was diagnosed with myoma uteri with anemia. The second case was a married woman aged 49 reported to have pelvic pain, vaginal itching, and foul smell of vaginal discharge. She was diagnosed with myoma uteri with hyperlipidemia. Both patients had undergone TAH with BSO. They received preoperative nursing care to anxiety and prevent miss patient, miss site, and miss procedure. Aseptic techniques were used at every step to prevent surgical site infections. They receive perioperative nursing care to prevent a shock from excessive blood loss. In the first case, she was total blood loss 900 ml and was given one unit. No shock was detected. In the postoperative period, the patients were ensured to have no foreign body left intra abdomen. The patients were safe during movements. Postoperative nursing care also prevented postoperative complications, reduced pain in the surgical wound, and prevented surgical wound infections. Nurses also provided accurate instructions on surgical wound care after discharge. In conclusion, nurses play a critical role in caring for myoma uteri patients with anemia after TAH with BSO in complicated nursing care practices. Nurse practitioners assessed various conditions, predicted potential risks to patients, planned timely solutions to problems when patients' symptoms changed rapidly, gave advice on correct and appropriate practice for patients and relatives to participate in their care, followed up and evaluate results, and continuously take care of each case until the patients could safely recover and continue with daily life normally.