여성간호학 (난소낭종/Ovarian Tumor) 케이스스터디 (감염의 위험, 출혈의 위험 간호과정 포함)

본 내용은 " 여성간호학 (난소낭종/Ovarian Tumor) 케이스스터디 (감염의 위험, 출혈의 위험 간호과정 포함) " 의 원문 자료에서 일부 인용된 것입니다. 2023.07.13

문서 내 토픽

• 1. Ovarian Cystic Tumor (난소낭종)

  난소낭종은 난소에 발생하는 낭성 종양(cystic tumor)으로, 내부가 수액 성분으로 차 있는 물혹을 의미한다. 이는 배란과 관련하여 발생하는 기능성(생리적) 난소 낭종과 양성 난소 신생물(혹)을 통칭하는 개념으로, 내부의 수분은 종양의 종류에 따라 장액성, 점액성 액체인 경우도 있고 혈액이나 지방, 농양 등일 수도 있다. 기능성(생리적) 난소 낭종은 여포 낭종, 황체 낭종, 난포막 황체화 낭종(theca lutein cyst) 등이 해당된다. 양성 난소 신생물(혹)은 자궁 내막종, 기형종, 장액성 또는 점액성 난소 낭종 등이 이에 해당되는 것으로 다양한 크기와 임상경과를 보일 수 있다. 이 밖에 암(난소암)으로도 확인될 수 있다.

• 2. 감염의 위험

  대상자는 10/3 Laparoscopic bilateral Ovarian Cystectomy (복강경하 양측 난소종양 절제술)을 시행하였으며, OP 후 IV-PCA, Barovac 1개, Foley catheter (14Fr) 적용 중이다. 이러한 침습적인 기구 삽입으로 인해 감염의 위험이 있으므로 4시간마다 활력징후와 수술 부위 상태를 확인하고, 항생제 투여, 드레싱 교환 등의 중재를 제공하여 감염 발생을 예방해야 한다.

• 3. 출혈의 위험

  대상자는 수술 중 110cc의 출혈이 있었으며, 10/4 CBC 검사 상 RBC 3.99, Hgb 11.5, Hct 35.1로 낮은 수치가 측정되어 출혈에 취약한 상태이다. 따라서 4시간마다 활력징후와 수술 부위 출혈 여부를 확인하고, 수액 공급 등의 중재를 제공하여 출혈 발생을 예방해야 한다.

• 4. 급성통증

  대상자는 수술 직후 FPRS 4점, NRS 3점의 통증을 호소하였으며, 이후에도 지속적으로 NRS 3점의 통증이 있었다. 따라서 진통제 투여, 자세 변경, 이완요법 등의 중재를 제공하여 통증을 관리해야 한다.

• 5. 배뇨향상을 위한 준비

  대상자는 수술 후 Foley catheter가 삽입되어 있으며, 배뇨 양상을 모니터링하고 있다. Foley catheter 제거 후 자가 배뇨를 격려하고 잔뇨량을 확인하여 방광기능 회복을 확인해야 한다.

• 6. 퇴원 후 관리

  대상자의 퇴원 예정일은 10/6으로, 퇴원 시 OP site 관리, 퇴원약 복용, 외래 진료 예약 등에 대한 교육이 필요하다.

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• 1. Ovarian Cystic Tumor (난소낭종)

  Ovarian cystic tumors are a common gynecological condition that can occur in women of all ages. These fluid-filled sacs on the ovaries are often benign and asymptomatic, but in some cases, they can cause complications such as pain, torsion, or rupture. Early detection and proper management are crucial to prevent these complications and ensure the patient's well-being. Treatment options may include watchful waiting, hormonal therapy, or surgical intervention, depending on the size, characteristics, and symptoms of the cyst. It is important for patients to work closely with their healthcare providers to develop an individualized treatment plan that addresses their specific needs and concerns. Regular monitoring and follow-up are also essential to ensure the cyst does not grow or cause any further issues.

• 2. 감염의 위험

  Infection is a serious concern for patients with ovarian cystic tumors, as the presence of a cyst can increase the risk of bacterial or viral infections. Proper hygiene, antibiotic prophylaxis, and close monitoring by healthcare providers are essential to mitigate this risk. Patients should be educated on the signs and symptoms of infection, such as fever, pain, and changes in discharge, and should seek immediate medical attention if any of these occur. Additionally, healthcare providers should closely monitor the cyst for any signs of infection, such as increased inflammation or changes in the cyst's appearance, and take appropriate action to prevent the spread of infection. With vigilant care and prompt treatment, the risk of infection can be minimized, allowing patients to manage their ovarian cystic tumors effectively and maintain their overall health and well-being.

• 3. 출혈의 위험

  Ovarian cystic tumors can also pose a risk of bleeding, either from the cyst itself or from any surgical intervention. Bleeding can occur due to the rupture of the cyst, torsion (twisting) of the ovary, or complications from surgical procedures. Patients should be aware of the signs of bleeding, such as sudden or severe abdominal pain, dizziness, or changes in vaginal bleeding, and should seek immediate medical attention if these occur. Healthcare providers should carefully monitor the cyst and any surgical interventions for signs of bleeding, and be prepared to take appropriate action, such as administering blood products or performing additional surgical procedures, to control the bleeding and prevent further complications. With proper management and close monitoring, the risk of bleeding can be minimized, allowing patients to safely manage their ovarian cystic tumors and maintain their overall health.

• 4. 급성통증

  Acute pain is a common symptom associated with ovarian cystic tumors, and can be caused by a variety of factors, such as the size and location of the cyst, torsion (twisting) of the ovary, or rupture of the cyst. Patients should be educated on the signs and symptoms of acute pain, such as sudden, severe abdominal or pelvic pain, and should be instructed to seek immediate medical attention if they experience these symptoms. Healthcare providers should be prepared to provide prompt and effective pain management, which may include the use of analgesics, anti-inflammatory medications, or even surgical intervention in some cases. Additionally, healthcare providers should closely monitor the patient for any changes in pain or other symptoms, and adjust the treatment plan accordingly to ensure the patient's comfort and well-being. With proper management and close monitoring, the risk of acute pain can be minimized, allowing patients to manage their ovarian cystic tumors effectively and maintain their quality of life.

• 5. 배뇨향상을 위한 준비

  Preparing for improved urination is an important aspect of managing ovarian cystic tumors, as the presence of a cyst can sometimes interfere with normal bladder function. Patients may experience symptoms such as frequent urination, difficulty emptying the bladder, or a feeling of incomplete bladder emptying. Healthcare providers should work with patients to develop a comprehensive plan to address these issues, which may include lifestyle modifications, pelvic floor exercises, or the use of medications or other interventions to improve bladder function. Patients should be educated on the importance of maintaining good bladder health and should be encouraged to communicate any changes in urinary function to their healthcare providers. With proper preparation and management, patients can minimize the impact of ovarian cystic tumors on their bladder function and maintain their overall quality of life.

• 6. 퇴원 후 관리

  Effective post-discharge management is crucial for patients with ovarian cystic tumors, as it can help prevent complications, monitor for recurrence, and ensure a smooth transition back to daily life. Healthcare providers should work closely with patients to develop a comprehensive discharge plan that addresses the patient's specific needs and concerns. This may include instructions for wound care, medication management, dietary and lifestyle modifications, and regular follow-up appointments. Patients should be educated on the signs and symptoms of potential complications, such as infection, bleeding, or pain, and should be instructed to seek immediate medical attention if these occur. Additionally, healthcare providers should closely monitor the patient's progress and make any necessary adjustments to the treatment plan to ensure the patient's continued well-being. With proper post-discharge management, patients can successfully manage their ovarian cystic tumors and maintain their overall health and quality of life.