Endometriosis Speech
4 Pages

Endometriosis Speech

Course Number: NURS 325, Fall 2012

College/University: Davenport

Word Count: 279

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Chamia,youwillspeakduringslides13.Words~410 Youhavethemostslidestocoverbecausetheyarelessinformative. Slide1:Firstintroducethegroupandourtopic Slide2:Introduction: Endometriosisisoneofthemostcommongynecologicaldiseases,affecting morethan5.5millionwomeninNorthAmericaalone.Thetwomostcommon symptomsofEndometriosisarepainandinfertility.Somewomenhavepainbefore...

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morethan5.5millionwomeninNorthAmericaalone.Thetwomostcommonecologicaldiseases,affecting Chamia,youwillspeakduringslides13.Words~410 Youhavethemostslidestocoverbecausetheyarelessinformative. Slide1:Firstintroducethegroupandourtopic Slide2:Introduction: Endometriosisisoneofthemostcommongyn symptomsofEndometriosisarepainandinfertility.Somewomenhavepainbefore andduringtheirperiods,aswellasduringoraftersex.Thispaincanbeso intensethatitaffectsawomansqualityoflife,fromherrelationships,toherday todayactivities.SomewomendonthaveanysymptomsfromEndometriosis. Othersmaynotfindouttheyhavethediseaseuntiltheyhavetroublegetting pregnant.SymptomsmaydependonthesiteofactiveEndometriosis.Currently, thereisnoknowncureforEndometriosis.Evenwithlaparotomythereisachance arecurrence.Therearesomeallopathicandholistictreatmentsusedtoreduce pain,inhibitgrowth,andimprovequalityoflife. (RefertothestatsontheslideandintroducetheshortvideoonEndometriosis andnutrition.) Slide3:Possiblecausesforpain&Commonsymptoms MostwomenwithEndometriosisexperiencepainonoraroundthetimeof theirmenstrualperiod.ThemeansinwhichEndometriosiscausespainissubject tomuchresearch.Onetheoryonthecauseofpainisthesmallsurfaceareasthe endometriosisrupture,thiscouldproducepelvicirritationorpelvicpain.Another Theoryforthecauseofpainisthepresenceofadhesionsinthepelvicare,any motionoftheseorgans(i.e.duringintercourse),couldproducepelvicpain.One othertheoryforpelvicpainduringthemenstrualcycleinpatientswith Endometriosisisthechemicalchangesthatoccurintheperitonealfluid.The suddenonsetofseveregeneralizedabdominalpainissuggestedtobecausedfrom leakageorrupturefromanendometriomacausingbleedingfromthe Endometriosissite.SymptomsofEndometriosisinclude:nausea,vomiting, fainting,dizzyspells,constipation,ordiarrhea(usuallypriorto,duringorafter theperiod).Symptomsmayalsoincludechronicfatigue,moodswings,backpain, Dyspareunia)painduringintercourse,andabdominalandintestinalpain. Changesinmenstruationhavealsobeenreported,itcanbecomefrequent, constant,heavy,and/orclotty. Slide4:Dimensionsofhealth Likeothers,thisdiseasecanbetryingonthewomanphysically,mentally, socially,andspiritually.Thepaincanbecomeextremeenoughtointerferewith daytodaylifeandmaymakeactivitiesdifficultorimpossible.Theminor symptomssuchasfatigue,moodswings,dizzyspells,etc.canmakeworkordaily lifedifficultorfrustrating.Changesinmenstruationcanmakeperiods unpredictableandaffectdailyscheduleorcauseembarrassment(iefrom accidentsorfrequenttripstothebathroom).Worriesofbecominginfertilecan causewomentobecomedepressed,andmakethemquestionwhyGoddidthisto them.Symptomsoccurringatnightcanmakesleepingdifficult.Causingthe womantobetiredduringtheday(increasingfatigue,moodswings,and decreasingtheiroverallfeelingwellness). Kirsten,youwillhaveslides56.Words~410. Slide5:NormalAnatomy/PhysiologyoftheEndometrium Themainfunctionsoftheuterusarereceivingtheembryo,shelteringthe fetusduringpregnancyanddeliveringthenewbornatterm.TheEndometriumis themucousmembranethatlinestheuterus,itthickensunderhormonalcontrol.If pregnancydoesnotoccurthemembraneisshedinmenstruation,ifpregnancy occursitisshedalongwiththeplacentaatparturition.Theendometriumconsists ofasinglelayeredprismaticepitheliumwithorwithoutcilia,dependingonhow faralongthemenstruationcycleisanditsbasallamina,uterineglands,anda specializedcellrichconnectivetissue(stroma)containingarichsupplyofblood vessels.Onerecognizesthespiralarteriesendbranchesoftheuterinearteriesas wellasavenousoutflowsystem.Endometrialfunctionsinclude:Cyclicalterations oftheuterineglandsandbloodvesselsduringthecourseofthemenstruation,as preparationfortheimplantation.Itisthelocationwheretheblastocystis normallyimplantedandwheretheplacentadevelops. Slide6:EndometriosisPathophysiology Endometriosisisamedicalconditionthatoccursinwomeninwhich endometrialcellsappearandgrowoutsideoftheuterinecavity.Theendometrial cellsareinfluencedbyhormones.Theendometriallikecellsinareasotherthan insidetheuterusreactsimilarlytothecellsfoundinsidetheuterus.Andasa resultSymptomsoftenworsenintimewiththemenstrualcycle.Most Endometriosisisfoundinthepelviccavitysuchasontheovaries,behindthe uterus,onthetissuesthatholdtheuterusisplace,andonthebowelsandbladder. InextremecasesEndometriosiscanspreadtothecervixandvaginaortositesofa surgicalabdominalincision,andinmoreextremecasesitcanalsobespreadto thelungsandthecentralnervoussystem.Endometriosisisthepresenceof endometrialtissueoutsideoftheuterinecavity,mostcommonlysurroundingthe ovariesandfallopiantubes.Itisrelativelycommondisorderinreproductiveage womenandisassociatedwithsignificantpainandmorbidity.Inmostcases,the spreadofextrauterineendometrialtissueappearstoresultfromretrograde menstruationandcapillaryorlymphspreading.Endometrialcellsimplanted ectopicallyrespondtocyclicalchangesinestrogenandprogesteronewith proliferationandsecretion.Theirpresenceinextrauterineareascaninitiate immuneandinflammatoryresponsesthatleadtopainandperitonealadhesions, mediatorsthatcausepainandinflammation,aswellasscarringorfibrosisof andmayinterferewithfertility.Activeendometriosisproducesinflammatory surroundingtissue. Nicole,Slides78.Words~427+mystory Slide7:DiagnosisandTreatment Thereisnoknowncauseofendometriosis.Somepossiblecausesinclude retrogrademenstrualflow,inwhichsomeofthetissuethatawomansheds duringherperiodflowsintoherpelvis,genes,estrogenlevels,andenvironmental agents.UltrasoundorMRIimagingcanbeusedtolocatelargeEndometriosis areassuchasnodulesorcysts.However,theonlywaytoacquireanaccurate diagnosisisbylaparoscopy.Thepatient'ssymptomsanddesireforchildbearing dictateappropriatetreatment.Notalltherapyworksforallpatients.Some patientshaverecurrencesaftersurgeryorpseudomenopause.Inmostcases, treatmentwillgivepatientssignificantrelieffrompelvicpainandassistthemin achievingpregnancy.Thereiscurrentlynoknowncureforendometriosis,theonly waytogetridofgrowthspresentisbysurgicalremoval.Therearesome allopathicapproachestakentoreducethesymptomaticeffectsandgrowthofthe Endometriosisincluding: NSAIDs:NonSteroidalAntiinflammatoryDrugs.Theyarecommonlyused inconjunctionwithothertherapy. MST:Morphinesulphatetabletsandotheropioidpainkillersworkby mimickingtheactionofnaturallyoccurringpainreducingchemicalscalled endorphins. Diclofenac:insuppositoryorpillform.Istakentoreduceinflammation andasananalgesicforreducingpain. ProgesteroneorProgestins:Progesteronecounteractsestrogenand inhibitsthegrowthoftheendometrium.Progestinsarechemicalvariantsof naturalprogesterone. Hormonecontraceptiontherapy:Oralcontraceptivesreducethe menstrualpainassociatedwithendometriosis.Typically,itisalongterm approach. Danazol(Danocrine)andgestrinone:aresuppressivesteroidswithsome androgenicactivity.Bothagentsinhibitthegrowthofendometriosis,shortterm use. GonadotropinReleasingHormone(GnRH)agonist:TheyInduce menopausalsymptoms,andovertimemayleadtoosteoporosis.Shorttermuse LupronDepo:IsaGnRHagonistshotandisusedtolowerthehormone levelsinthewoman'sbodytopreventorreducegrowthofendometriosis. Aromataseinhibitors:aremedicationsthatblocktheformationof estrogenandhavebecomeofinterestforresearcherswhoaretreating endometriosis. Othertreatmentsinclude:Eatingfoodshighinindole3carbinol,suchas cruciferousvegetables(whichinclude:mustards,cabbages,broccoli,turnips,and cresses)appearstobehelpfulinbalancinghormonesandmanagingpain,asdo omega3fattyacidsfoundinfishoils.Physicalexertionsuchaslifting,prolonged standingorrunningdoesexacerbatepelvicpain.Usingheatingpadsonthelower backarea,mayprovidesometemporaryrelief.Properdietandexerciseare recommendedasinanyhealthydiettoachievewellness. Slide8:MyStory Gregnika,Youwillhaveslides910(Includesconclusion).Words~390 Slide9:CaseStudy Inaclinicalstudya26yearoldwomanwhowasfourmonthspostpartum, complainedofexcruciatingbackpain.Thepainworsensaboutoneandahalf weekspriortoherperiodsandcontinuesduringhermenses.Shereceivedonly mildrelieffrompainbytakingNSAIDsandsometimesresortedtoTylenol#3 (Tylenol+codeine).Sinceherdeliveryshehasbeentakingoralcontraceptives, thatregulatedhercyclebutdidnotalleviatethepain.Theclientrecountsthat duringherpregnancyshewaspainfreeforthefirsttimeinfiveyears.Theclient notesoccasionaldyspareuniaespeciallyduringorjustbeforemenses.Pelvicexam (doneduringearlymenses)revealsaretroverteduterus,tendertopalpation,and tendernodularmassesalongthickeneduterosacralligaments.Externalgenitalia, cervixandvaginalmucosaareunremarkable.PAP ,GCandChlamydiaarenegative Endometriosisissuspected. Theclientagreestotryleuprolideacetate(DepoLupron),aGnRH analogue.Thiswillhelpcontrolthesymptomswhileawaitinglaparoscopyfor diagnosticconfirmation.ThesubjecttriedDepoLupronforthreemonthspriorto herdiagnosticlaparoscopy.Whileshedidreportpainrelief,shealsocomplained ofterribleheadaches,flushing,nausea,andvomitingforthefirstweekaftereach monthlyinjection.Afterherlaparoscopicremovaladhesionsandlesionablation alleviatedherpain.Atoneyearpostopsheisstillpainfree,andistillcontinuing contraceptiontherapytoregulatemenstruation. Slide10:Conclusion Whilethereisnocureforendometriosis,inmanypatientsmenopause (naturalorsurgical)willabatetheprocess.Inpatientsintheirreproductiveyears, endometriosisissimplymanaged:thegoalistoprovidepainrelief,torestrict progressionoftheprocess,andtoavoidinfertilityifthatshouldbeanissue. Endometriosisisthemostcommonlyreportedmedicalconditioninwomen.It effectsboththewomanandherfamily.Eachpatientssymptomsandcondition varies.Althoughthereisnocureforthisidiopathicdiseasetherearetreatment optionsthatcanremovethegrowthsandalleviatethesymptoms.Dealingwith thephysicaleffectscausedbyEndometriosismaycausethepatienttofeel emotionssuchassadness,fright,anger,confusion,andloneliness.Itisimportant togetcommunitysupport.Itisalsoimportantforthepatienttoacquire knowledgeaboutthedisease,knowtheiruniquecondition,andcheckinregularly withadoctortomaintainpropertreatment.

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