Page 1278 - Saunders Comprehensive Review For NCLEX-RN

pelvic contents, including bowel,
vagina, and bladder, is a radical
surgical procedure performed for
recurrent cancer if no evidence of
tumor outside the pelvis and no lymph
node involvement exist.
b. When the bladder is removed, an ileal
conduit is created and located on the
right side of the abdomen to divert
urine.
c. A colostomy may need to be created on
the left side of the abdomen for the
passage of feces.

2. Postoperative interventions

a. Similar to postoperative interventions
following hysterectomy.
b. Monitor for signs of altered respiratory
status.
c. Monitor incision site for infection.
d. Monitor intake and output and for
signs of dehydration.
e. Monitor for hemorrhage, shock, and
deep vein thrombosis.
f. Apply antiembolism stockings or
sequential compression devices as
prescribed.
g. Administer prophylactic heparin as
prescribed.
h. Administer perineal irrigations and sitz
baths as prescribed.
i. Instruct the client to avoid strenuous
activity for 6 months.
j. Instruct the client that the perineal
opening, if present, may drain for
several months.
k. Instruct the client in the care of the ileal
conduit and colostomy, if created.
l. Provide sexual counseling, because
vaginal intercourse is not possible after
anterior and total pelvic exenteration.
XIV. Ovarian Cancer
A. Description
1. Ovarian cancer grows rapidly, spreads fast, and is
often bilateral.
2. Metastasis occurs by direct spread to the organs in the
pelvis, by distal spread through lymphatic drainage,
or by peritoneal seeding.

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