fibroids are composed of _______muscle cells and can develop in any of the layers of the uterus.
symptoms of uterine fibroids include
bleeding(most common), bladder, rectal, and pelvic pressure. urinary frequency/retention, and constipation common.
with chronic blood loss of uterine fibroids, women may experience _______deficiency.
iron(anemia may develop)
uterine fibroids are usually diagnosed through a pelvic examination that demonstrates an
enlarged uterus and presence of nodular tumors.
CT scans, MRI, or sonography can be used to
confirm the diagnosis and determine the size and location of the tumors.
In some cases of symptomatic uterine fibroids, ___________therapy will be used to resect fibroid.
In some cases of symptomatic uterine fibroids, a ____________may be performed to remove fibroid, leaving uterus intact.
The decision for a woman to have a hysterectomy is influenced by several factors. These factors include
severity of symptoms, age of pt, pt's desire to retain her ability to bear children.
the nursing assessment of uterine problems include:
history of unusual bleeding,any complaints of bladder, rectal, or pelvic pressure , urinary frequency or retention, constipation, tiredness ( anemia)
if a pt is scheduled for uterine surgery the nurse will
assess the pt's understanding of the surgical procedure and will address any concerns the pt may have.
prior to treatment for symptomatic uterine fibroids, the primary potential or actual nursing diagnosiss include the following:
urinary elimination, altered, secondary to bladder pressure from uterine fibroid.
constipation secondary too rectal pressure from urterine fibroid tumor.
risk for fatigue secondary to chronic blood loss or anemia.
anxiety related to lack of knowledge about hysterectomy and impact on sexual functioning.
Ineffective sexuality patterns, altered, related to experiencing pain during intercourse.
If the pt has a hysterectomy (vaginal or abdominal), as a result of the uterine fibroids, postop nursing diagnoses will include following:
acute pain, related to surgical intervention.
urinary retention related to edema, loss of bladder tone, and pain.
constipation related to surgical manipulation of bowel.
ineffective sexuality patterens related to perceived feeling of undesirabiliy and fear of partner rejection.
Risk for distrurbed body image related to loss of uterus and childbearing ability.
primary pt centered goals of care following hysterectomy include:
pt will experience relief of pain.
pt will demonstrate normal return of normal urinary elimination pattern.
Pt will have a normal bowel elimination pattern.
Pt will report decreased anxiety about effect of surgery on sexual functioning.
Pt will verbalize on having a positive body image.
Preop care for hysterectomy includes:
teaching and addressing any concerns the pt may have about sexual functioning after surgery. Teaching about indwelling catheter following surgery, and pain management. The importance of early ambulation will be emphasized.
upon removal of urinary catheter, pt urinary pattern will be
monitored, because it is common for pt's to have difficulty voiding, and urinary tract infections.
for pt with vaginal hysterectomy
perineal care , sitz bath and heat lamps may be used to promote healing and provide comfort
discharge teaching after hysterectomy include:
UTI signs, incision care(clean and dry) and left open to air after Dr removes the surgical dressing,encouraged to mild exercising,avoid long sittings or long car rides, avoid heavy lifting,and not to resume sexual activity for six weeks after surgery.
the effectiveness of nursing interventions can be measured by the achievement of the following expected outcomes for the pt with a hysterectomy
pt verbalizes relief of pain.
pt demonstrates ability to urinate without difficulty.
pt experiences normal perstaltic activity.
pt verbalizes positive feelings related to body image and sexual functioning.
pt avoids postop complications(wound infections, uti's, thrombophlebitis,paralytic ileus)