Histerectomía abdominal total a paciente por miomatosis uterina con enfoque en el proceso de atención de enfermería

Abstract

Introduction: The uterus is a hollow muscular organ that is located in the female pelvis, between the bladder and the rectum. It is also considered a site of many conditions, both benign and malignant. The giant uterine myoma is a benign tumor of very low incidence. Its resolution represents a challenge for medical and nursing staff, due to the variability in clinical manifestations that range from asymptomatic to severe symptoms that involve neighboring organs due to uterine growth and in effect due to the large volume of the surgical piece. Rarely, these tumors become malignant (<1%). Although to date it has not been detailed with certainty the causes that produce the appearance of fibroids in the uterus, other authors mention in their publications that there are risk factors related to this pathology of a benign nature, such as: age, overweight or obesity, nulliparity, estrogen-producing ovarian tumors and any other condition that increases exposure to estrogens and progestogens during the reproductive age of these women. In researches conducted by twentieth century scientists, reveal that the weight of the "giant" myoma, to be considered as such, should weigh more than 2 kg, for the reason given, the treatment of choice is hysterectomy. Presentation of the Case: A 44-year-old patient admitted on 6/12/2017 to a hospital ward with a request for hospitalization with a medical diagnosis of uterine myomatosis, benign ovarian tumor and moderate anemia at the Hospital Gineco-Obstétrico Angela Loayza de Ollague from the city of Santa Rosa. Vital signs: T °: 36.6ºC, TA: 100/60 mmHg, FC: 78 beats per minute, FR: 20 breaths per minute, SO2: 99%, Weight: 67.1Kg and Size: 150.7cm. The assessment refers to constipation (compression on the rectum), urination many times (compression in the bladder), nocturia, lumbar pain, globular abdomen attributable to the diagnosis, slightly painful on palpation, irregularly (asymmetric), and no evidence transvaginal bleeding. She was submitted to surgery on 8/12/2017 (Start: 12: 17- End: 13:33), where gynecologist performed a Total Abdominal Hysterectomy, obtaining after extraction, a MU of 24 cm, with a weight of 3.5 Kg The woman evolved satisfactorily after the intervention, her hospital stay was 6 days, later histopathological study confirmed that it was a giant uterine myoma. General Objective: To analyze the case of a patient undergoing Total Abdominal Hysterectomy through the assessment of the 14 needs established by Virginia Henderson and the nursing care process according to NANDA, NOC and NIC.