Nursing Care for Patients with Tubo-Ovarian Abscess: 2 case studies

Abstract

Abstract

Background and Significance: Tubo-ovarian abscess (TOA) due to infection of the fallopian tubes and ovaries is a severe complication that often results from untreated or delayed-treated pelvic inflammatory disease (PID). If the abscess ruptures, it becomes an emergency as pus leaks into the abdominal cavity, leading to rapid bloodstream infection and possibly progressing into a critical condition. Monitoring for abscess rupture and providing appropriate nursing care to reduce infection can decrease hospitalization time and mortality rates.

Objective: To compare the nursing process used in the care of patients diagnosed with tubo-ovarian abscess

Methodology: A case study was conducted using a purposive sampling method. Two patients diagnosed with tubo-ovarian abscesses were selected from the gynecology ward at Khon Kaen Hospital. The study applied the nursing process framework and Gordon's 11 health patterns to evaluate the patients' health status.

Results: In Case 1, 8 nursing diagnoses were identified: 1) Sepsis due to rupture of a right fallopian tube abscess, with pus leaking into the abdominal cavity,  and bloodstream 2) Risk of hypoxia post-surgery due to morbid obesity and obstructive sleep apnea 3) Acute kidney injury 4) Electrolyte imbalance due to vomiting and diarrhea 5) Postoperative pain 6) Surgical wound separation and infection by Escherichia coli 7) Risk of hypo- or hyperglycemia 8) Knowledge deficit in self-care. In Case 2, 4 nursing diagnoses were identified: 1) Pelvic and right tubo-ovarian infection 2) Lower right abdominal pain 3) Electrolyte imbalance due to vomiting 4) Knowledge deficit in self-care. Although both cases were diagnosed with the same condition, the severity differed. Case 1 had a more severe infection, including sepsis, due to the rupture of the tubo-ovarian abscess, requiring surgery and a 25-day hospitalization. Case 2 did not experience abscess rupture, responded well to antibiotic treatment, and did not require surgery, resulting in a 6-day hospitalization.

Recommendations: The findings should be used to develop nursing guidelines for monitoring and managing abnormal symptoms in patients with tubo-ovarian abscesses. This will help enhance the professional competencies of nurses caring for these patients.

Keywords: Nursing care, tubo-ovarian abscess, fallopian tube and ovary infection, pelvic inflammatory disease, Gordon's health patterns.

* * Registered Nurse, Professional Level, Khon Kaen Hospital