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Endometriosis .pdf - ACTIVE LEARNING TEMPLATE: System...

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Unformatted text preview: ACTIVE LEARNING TEMPLATE: System Disorder Morgan Molitor STUDENT NAME _____________________________________ Endometriosis DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________ Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Cause is uknown Affects 10-15% women of childbearing age Higher in women who delay childbearing Various Theories: *Metaplasia - asserts that endometrial tissue develops from embryonic epitheil cells as a result of hormonal or inflammatory changes. * Retrograde-menstrual tissue backs up through the fallopian tubes during menses, implants on various structures, and survives. *Transplantation- endometrial implants spread via lymphatic or vascular routes. A condition in which multiple, small, usually benign implantations of endometrial tissue develop ASSESSMENT Risk Factors Health Promotion and Disease Prevention There is no proven way to prevent endometriosis. Birth control pills may help to prevent the onset or slow the growth of the condition. Expected Findings Early menarche Regular periods with cycle of less than 27 days Menses lasting more than 7 days Heavier flow Increased menstural pain Hx of condition in first degree female relatives Possile immunologic defects * Heavy throbbing painof lower abd and pelvis, radiating down the thighs and around the back. * Pain can begin 2-3 days prior to menses and last for several days. *Feeling of rectal pressure and discomfort when having a BM * Dyspareunia *Dysfunctional uterine bleeding *Infertility Laboratory Tests Diagnostic Procedures CBCD- r/o pelvic abscess and infection H&H- for testing of menorrhagia, or bleed. CT/MRI BE Hystersalpinography -(radiographic exam of the uterus and fallopian tubes after injection of radiographic material.) Pelvic us and laparoscopy Laparotomy, sigmoidoscopy Hysteroscopy-( allows visualualization of all parts or uterine cavity, uterine perforations.) PATIENT-CENTERED CARE Nursing Care Pro iding viding pa in re educ lie ation abou f Help and tx o ption t conditio ing w n s o me n co pe w outc it ome h tx s Educate the patient on deep breathing procedures Have the patient use a hot or cold compress Have the patient sit or lay in positions to ease their pain ACTIVE LEARNING TEMPLATES Have a safety plan in action. Know when to call 911. Know the signs and symptoms of endometriosis and know when to contact your doctor. Complications Medications Prov Therapeutic Procedures SAFETY CONSIDERATIONS Oral contraceptives GnRH agonist therapy Oral or injectable progestin Anabolic steroid ( Danazol) Aromatase inhibitors NSAIDS, analgesics, observations MPA (medroxyprogesteron e acetate) Client Stress toEducation patients the importance of continuing medical therapy for the full 6month course. Medical therapy often relieves pain but induces uncomfortable adverse effects, and the patient needs encouragement to complete the course of treatment. Recurrence of symptoms after therapy should prompt the patient to return for further evaluation. Educate patients with severe disease about the symptoms of bowel and ureteral obstruction. Educate the client on deep breathing techniques Infertility, ovarian cysts (formed from endometrial tissue), peritonitis Interprofessional Care May be difficult to diagnose Hx of dysmenorrhea, dyspareunia, and infertility strongly suggests this diagnosis. Interventions: depend on severity of symptoms, extent of dx, women's age, desire for childbearing. TX: focuses on pain management and restoring fertility. THERAPEUTIC PROCEDURE A11 ...
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