Nursing Care of Uterine Fibroid Patients Undergoing Total Hysterectomy and Cervical Dissection with open Abdominal Surgery and Laparoscopic Surgery: 2 Case Studies

Abstract

Purposes : The purpose of this case study is to compare problem conditions and study nursing needs in 2 uterine fibroid patients. Who underwent total hysterectomy and cervix with open abdominal surgery and laparoscopic incision with differences in personal factors, treatment plans, and nursing needs according to nursing diagnosis.

Materials and Methods : The sample was purposively selected in 2 patients with Uterine Fibroid, who were admitted Chaloem Phrakiat Monks Special Ward 3,4, Roi Et Hospital. Unlucky to be admitted to Roi Et hospital during November–December 2023. Tools used to collect data include: data recording form patient medical records patient information record, caregiver interviews and symptom observation. Analyze data by comparison, patient's pathology and signs treatment plan evaluate nursing problems with Gordon's 11 health plans, and plan nursing action according to nursing diagnosis and assist in accordance with patient-care-standards in the royal care. Summarize and evaluate nursing results.

Main findings : The results of the study found that 1. The period before surgery both patients had the same surgical anxiety, although the type of surgery was different. 2. In the postoperative period, it was found that both patients had problems and their needs were: 1) Unwell due to wound pain. Patients who had abdominal surgery had more pain levels than those who had laparoscopic incision surgery because the incision was larger and the tissue was injured more. 2) That the recovery after surgery using a small incision laparoscopic surgery is faster than an open abdominal surgery. The different problem is that patients undergoing abdominal surgery still need to monitor for anemia due to blood loss during surgery of 700 ml and receiving 1 PRC unit in the operating room. The results of this study can be used as a basis for improving the operating room service in order to operate more efficiently and reduce complications that may occur to patients.

Conclusion and recommendations : This study resulted that; Nurses should develop competency in helping patients according to inpatient standards and skills in comprehensively assessing signs and symptoms. Including monitoring and observing abnormal symptoms that will occur in both types of surgery. To keep the patient safe, no complications will occur.