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Impaired Urinary Elimination related to Uterine Fibroids


Nursing Care Plan for Uterine Fibroids

A uterine fibroid is a leiomyoma (benign tumor from smooth muscle tissue) that originates from the smooth muscle layer (myometrium) of the uterus. Fibroids are very common in women in their 30s and 40s. But fibroids usually do not cause problems. Many women never even know they have them.

Uterine fibroids are noncancerous growths of the muscle tissue of the uterus. Fibroids can range in number and size from a single growth to multiple growths, and from very small to large. As many as 70% to 80% of all women will have fibroids by age 50. The medical term for fibroids is leiomyoma or myoma.

Often fibroids do not cause symptoms. Or the symptoms may be mild, like periods that are a little heavier than normal. If the fibroids bleed or press on your organs, the symptoms may make it hard for you to enjoy life. Fibroids make some women have:

Long, gushing periods and cramping.
Fullness or pressure in their belly.
Low back pain.
Pain during sex.
An urge to urinate often.


Fibroids, particularly when small, may be entirely asymptomatic. Symptoms depend on the location of the lesion and its size. Important symptoms include abnormal gynecologic hemorrhage, heavy or painful periods, abdominal discomfort or bloating, painful defecation, back ache, urinary frequency or retention, and in some cases, infertility. There may also be pain during intercourse, depending on the location of the fibroid. During pregnancy they may also be the cause of miscarriage, bleeding, premature labor, or interference with the position of the fetus.

Fibroids may cause very mild symptoms or none at all. In women who do feel symptoms, these uterine growths can cause:
  • Pressure on the bladder or rectum
  • Frequent urination
  • Constipation and/or rectal pain
  • Lower back and/or abdominal pain
If fibroids become very large, they can distend the stomach, making a woman look pregnant.


Impaired Urinary Elimination related to Uterine Fibroids :

  • Monitor inputs and outputs as well as the characteristics of urine
  • Determine the client's normal voiding pattern and note the variations
  • Encourage clients to increase fluid intake
  • Check all the urine, note the presence of stones and send output to a laboratory for analysis
  • Investigate complaints of a full bladder: suprapubic palpation to distention. Note the decrease in urine output, edema periorbital / dependent
  • Observations of changes in mental status, behavior or level of consciousness
  • Supervise laboratory tests, samples of electrolytes, BUN creatinine
  • Take a urine for culture and sensitivity
  • Give the drug as indicated, for example:
  • Note the catheter patency was settled, when using
  • Irrigation with acidic or alkaline solution as indicated

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