Nursing Care Plan for Hysterectomy/TAHBSO

Hysterectomy is the surgical removal of the uterus through an abdominal incision. It may be a total hysterectomy (removal of the uterus and cervix) or panhysterectomy (removal of the uterus, cervix, fallopian tubes and ovaries). It is done to treat endometriosis, tumors (benign and malignant of the cervix, endometrium, or muscle of the uterus), severe abnormal bleeding, and prolapse of the uterus.

Nursing diagnosis for hysterectomy: Body image disturbance related to biophysical factor of hormonal imbalance and loss of body part resulting in loss of childbearing ability and possible sexual dysfunction.

Expected Outcomes: Improved body image evidenced by verbalization of more positive feelings about loss of childbearing function and self-worth; adaptation to hormonal changes with treatment.

Nursing intervention with rationale:
I. Assess for:
1. Knowledge of effect of surgery on sexuality and physiology.
Rationale: Provides information about feeling of loss and meaning to patient.

2. Feelings about changes and effect on femininity, relationships, self-worth.
Rationale: Provides information about impact on personal life.

II. Administer:
1. Hormone (estrogen)
Rationale: Acts to provide estrogen replacement in bilateral oophorectomy

III. Perform or Provide
1. Encouragement to express feelings about changes in life and acceptance by others.
Rationale: Facilitates communication about impact surgery has on lifestyle.

2. Opportunity for makeup and hair grooming.
Rationale: Provides active interest in personal appearance, which enhances self-image.

3. Support and opportunity for interaction with partner and others.
Rationale: Improves and maintains relationships with partner.

4. Encouragement and praise qualities and behaviors that have positive effect on self-image.
Rationale: Supports and reinforces adaptation to loss.

IV. Teach Patient and Family:
1. Inform that may feel depressed and have crying spells following surgery.
Rationale: Response to hormonal changes of vacillation in estrogen and progesterone levels.

2. Inform that menstruation will cease.
Rationale: Effect of total hysterectomy

3. Inform that hot flashes and other menopausal changes may occur.
Rational: Symptoms of surgically induced menopause from bilateral oophorectomy

4. Administration of hormonal therapy.
Rationale: Provides needed and accurate hormone replacement.