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Risk for Disturbed Body Image - NCP for Endometriosis

Nursing Care Plan for Endometriosis

Endometriosis is a condition that is reflected by the presence and growth of endometrial tissue outside the uterus. The endometrial tissue can grow on the ovaries, fallopian tubes, uterine ligaments forming, or it could be grown in the appendix, colon, ureter and pelvis. (Scott, James R, et al. 2002).

Endometriosis is the presence of endometrial tissue outside the uterine cavity. If there is endometrial tissue within the myometrium is called adenomyosis (internal adenometriosis) whereas when outside of the uterus is called (external endometriorisis).

Endometriosis for about the last 30 years show an increasing incidence. The incidence of between 5-15% can be found among all pelvic surgery. What is interesting is that it is slightly more common in women who are not married at a young age, and did not have many children.

In the United States, endometriosis occurs in 7-10% of the population, usually affects women of childbearing age. The prevalence of endometriosis in infertile women amounted to 20-50% and 80% in women with pelvic pain. There is a family connection, where the risk increased 10-fold in women with first degree relatives who suffer from this disease.

Etiology of endometriosis is not known but there are several theories that have been advanced:
  • In congenital existing endometrial cells outside the uterus.
  • Displacement of endometrial cells through blood circulation or lymph circulation.
  • Menstrual reflux containing endometrial cells into the fallopian tubes, up to the pelvic cavity.
  • Hereditary because the incidence is higher in women whose mothers also have endometriosis. (Mary Baradero et al, 2005).
In general, women with endometriosis have no symptoms. Symptoms generally occur when menstruation and intensified every year because of an enlarged area of endometriosis. The most common symptoms are pelvic pain, dysmenorrhea (painful when menstruation), dyspareunia (pain during intercourse), and infertility (impaired fertility, can not have children).

Signs and symptoms of endometriosis include:

1. Pain
  • Secondary dysmenorrhea
  • Primary dysmenorrhea is bad
  • Dyspareunia: Painful ovulation
  • Pelvic pain was severe and diffuse pain in the thigh, and pain in the lower abdomen during the menstrual cycle.
  • Pain due to physical exercise or during and after sexual intercourse.
  • Pain at the time of the examination by the doctor.

2. Abnormal bleeding
  • Hypermenorrhea
  • Menorrhagia
  • Spotting before menstruation
  • Menstrual blood is so dark that out before menstruation or at the end of menstruation.
  • Complaints defecation and urination.
  • Pain before, during and after defecation
  • Blood in the stool
  • Diarrhea, constipation and colic. (Scott, James R, et al., 2002.)


Nursing Diagnosis : Risk for Disturbed Body Image related to menstrual disorders

Goal: increase client self-image.

Outcomes:
  • Clients say do not be ashamed, feel useful, neat appearance of the client, to accept what was happening.

Interventions :

1. Construct a trusting relationship with the client.
R/: Clients can easily express the problem only to those who believe.

2. Encourage clients to express feelings , thoughts , and views about themselves.
R/: Improving the client's self- awareness , and assist nurses in making the settlement.

3. Discuss with the client about the need for support systems deliver value and meaning for their clients.
R/: Submission of the meaning and value of the client's support system makes the client feel welcome.

4. Find the strength and resources that exist on the client and carrying strength as positive aspects.
R/: Identify client strengths can help clients focus on the positive characteristics that support the overall concept of self.

5. Involve the client in any activity in the group.
R/: Allows receiving social and intellectual stimulus which can increase the client's self- concept.

6. Inform and discuss honestly and openly about treatment options such as menstrual disorders clinic to womanhood, obstetrician.
R/: Honest and open to control the feelings of the client and the information provided to make clients look for the handling of his problems.

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