nursing care plan for uterine fibroids

Eligible studies must report one or more patient-centered outcome (e.g., symptom improvement, blood loss, pain, quality of life). If you are a Mayo Clinic patient, this could Using both instruments provides your doctor with two views of a uterine fibroid, allowing for more-thorough treatment than would be possible with just one view. Because there is minimal concern for malignancy in women with asymptomatic fibroids, watchful waiting is preferred - for management.4 There are no studies that support - surveillance with imaging or repeat imaging in asymptomatic women with fibroids.4,11, Hormonal Contraceptives. But depending on the size and location of the fibroids, your doctor may advise that you have a C-section in a future pregnancy because the scar on the uterus can open during labor. AHRQ Publication No. The Key Questions evolved from the EPC team discussions, expert input, and reviewer comments during the topic refinement period. Nursing Care Plan-Uterine Fibroids Student: John Micahel C. Manaig Date: May 27,2021 Client: Aiken Manaig Age: 13 Sex: Male Room # 14 Assessment Nursing Diagnosis Nursing Plan Nursing Intervention Scientific Rational Expected Outcome SUBJECTIVE: Medical history, physical examination, and pelvic. Stewart EA. The best evidence we have for vitamin supplements is for vitamin D. Vitamin D deficiency, which is very common in people with dark skin, has been associated with fibroid growth in some studies. The Scientific Resource Center (SRC) will request information from stakeholders, including Scientific Information Packets (SIP) and regulatory information on medications, procedures, and devices used to treat uterine fibroids. We summarize the inclusion criteria in Table 2. Ultrasonography is the recommended initial imaging modality for diagnosis of uterine fibroids. ACOG committee opinion number 770: Uterine morcellation for presumed leiomyomas. Management of uterine fibroids (Evidence Report/Technology Assessment No. Treatment of symptomatic patients depends on the patient's . We believe that additional evidence is needed before concluding either that the findings are stable or that the estimate of effect is close to the true effect. Clinical Obstetrics and Gynaecology. Uterine carcinosarcoma (considered an epithelial neoplasm), Uterine sarcoma (leiomyosarcoma, endometrial stromal sarcoma, mixed mesodermal tumor), Preoperative treatment to decrease size of tumors before surgery or in women approaching menopause, Decrease blood loss, operative time, and recovery time, Long-term treatment associated with higher cost, menopausal symptoms, and bone loss; increased recurrence risk with myomectomy, Levonorgestrel-releasing intrauterine system (Mirena), Treats abnormal uterine bleeding, likely by stabilization of endometrium, Most effective medical treatment for reducing blood loss; decreases fibroid volume, Irregular uterine bleeding, increased risk of device expulsion, Yes, if discontinued after resolution of symptoms, Anti-inflammatories and prostaglandin inhibitors, Do not decrease fibroid volume; gastrointestinal adverse effects, Treat abnormal uterine bleeding, likely by stabilization of endometrium, Reduce blood loss from fibroids; ease of conversion to alternate therapy if not successful, Selective progesterone receptor modulators, Decrease blood loss, operative time, and recovery time; not associated with hypoestrogenic adverse effects, Headache and breast tenderness, progesterone receptor modulatorassociated endometrial changes; increased recurrence risk with myomectomy, Reduces blood loss from fibroids; ease of conversion to alternate therapy, Does not decrease fibroid volume; medical contraindications, Surgical removal of the uterus (transabdominally, transvaginally, or laparoscopically), Definitive treatment for women who do not wish to preserve fertility; transvaginal and laparoscopic approach associated with decreased pain, blood loss, and recovery time compared with transabdominal surgery, Surgical risks higher with transabdominal surgery (e.g., infection, pain, fever, increased blood loss and recovery time); morcellation with laparoscopic approach increases risk of iatrogenic dissemination of tissue, Magnetic resonanceguided focused ultrasound surgery, In situ destruction by high-intensity ultrasound waves, Noninvasive approach; shorter recovery time with modest symptom improvement, Heavy menses, pain from sciatic nerve irritation, higher reintervention rate, Surgical or endoscopic excision of tumors, Resolution of symptoms with preservation of fertility, Recurrence rate of 15% to 30% at five years, depending on size and extent of tumors, Interventional radiologic procedure to occlude uterine arteries, Minimally invasive; avoids surgery; short hospitalization, Recurrence rate > 17% at 30 months; postembolization syndrome, Infertile women with distorted uterine cavity (i.e., submucosal fibroids) who desire future fertility, Symptomatic women who desire future fertility, Symptomatic women who do not desire future fertility but wish to preserve the uterus, Medical treatment, myomectomy, uterine artery embolization, magnetic resonanceguided focused ultrasound surgery, Symptomatic women who want definitive treatment and do not desire future fertility, Hysterectomy by least invasive approach possible. Although aetiology and natural history of the conditions are markedly different, symptoms can overlap and make differential diagnoses necessary, often using invasive methods such as laparoscopy. nursing care plan for uterine fibroids. Shamseer L, Moher D, Clarke M, et al. How big are they? To be excluded, publication abstracts must be reviewed and excluded independently by two members of the investigative team. Cost data are linked with operative time and clinician skill sets, which may be affected by a number of factors. 7th ed. Uterine leiomyomas. We will extract additional information, when reported, to assess whether the effectiveness of interventions differ by patient or fibroid characteristics. Risk for Bleeding. We will carry out hand searches of the reference lists of recent systematic reviews or meta-analyses of therapies for uterine fibroids. In a pelvic exam, your health care provider inserts two gloved fingers inside your vagina. Am J Obstet Gynecol. Accessed April 24, 2019. Best Practice and Research: Clinical Obstetrics and Gynaecology. AHRQ Publication No. 2008 Jan;198(1):34 e1-7. All Rights Reserved. During laparoscopic radiofrequency ablation, your doctor sees inside your abdomen using two special instruments. In: Ferri's Clinical Advisor 2019. We will search government and regulatory agency web sites for information on morcellation. Be upfront about your treatment goals and concerns. The body of evidence has some deficiencies. 13(14)-EHC 130-EF. NURSING DIAGNOSIS Acute pain related to post operative wound as manifested by facial expression and pain scale score Imbalanced nutrition less than body requirements related to pain as manifested by decreased food intake. They are also called uterine leiomyomas or myomas. One of the main goals . Accessed April 24, 2019. Deficient Fluid Volume. A preliminary assessment of the published literature on uterine fibroid treatment suggests that limiting the search to studies published in or after 1985 does not omit critical literature. 21. 3rd ed. Medications include: Gonadotropin-releasing hormone (GnRH) agonists. In a myomectomy, your surgeon removes the fibroids, leaving the uterus in place. Ferri FF. most common benign neoplasm in the female. Larger fibroids can cause you to experience a variety of symptoms, including: Excessive or painful bleeding during your period (menstruation). Uterine fibroids are the most common benign (not cancerous) tumors, or growths, in women of childbearing age. Uterine fibroids. Limited data does not support the use of herbal supplements like black cohosh or vaginal steaming. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. July 2001, Wegienka G, Baird DD, Hertz-Picciotto I, et al. Your doctor may prescribe a GnRH agonist to shrink the size of your fibroids before a planned surgery or to help transition you to menopause. This can be done during a laparoscopic or transcervical procedure. Peer reviewers do not participate in writing or editing of the final report or other products. 2018;40:e747. Accessed May 2, 2019. The TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. We will prespecify the harms that we will extract and will use consistent and precise terminology for reporting data on harms to the degree the literature includes operational definitions.22 We will check sources other than published literature (e.g., FDA, clinical trial data from device manufacturers or pharmaceutical companies via SIPs) for additional information on harms. Uterine fibroids may be associated with infertility, and some experts recommend that women with infertility be evaluated for fibroids, with potential removal if the tumors have a submucosal component.14 However, there is no evidence from randomized controlled trials to support myomectomy to improve fertility.15 One meta-analysis included two studies that showed improvement in spontaneous conception rates in women who underwent myomectomy for submucosal fibroids (relative risk [RR] = 2.034; 95% confidence interval [CI], 1.081 to 3.826; P = .028).16 However, no statistically significant difference was noted in the ongoing pregnancy/live birth rate. As a result, menstruation stops, fibroids shrink and anemia often improves. The nursing management for uterine fibroids involves pain management, fluid replacement, bleeding control, and patient education. Many women with uterine fibroids experience no signs or symptoms, or only mildly annoying signs and symptoms that they can live with. Typically, endometrial ablation is effective in stopping abnormal bleeding. Review/update the KENNEDY K. ABNORMAL UTERINE ACTION Normal uterine Actions Normal labor is characterized by coordinated uterine . Hi, I'm Dr. Michelle Louie, a minimally invasive gynecologic surgeon at Mayo Clinic. 2014 May-Jun;20(3):309-33. In: Endocrinology: Adult and Pediatric. Accessed May 3, 2019. PMID: 12548202, Wise LA, Palmer JR, Stewart EA, et al. We will develop a simple categorization scheme for coding the reasons that articles at full review are excluded. https://www.uptodate.com/contents/search. Uterine fibroids: An update on current and emerging medical treatment options. Don't be afraid to ask for a second opinion or referral to a fibroid specialist. called uterine cancer, but there are other cells in the uterus that can become After 4 hours of nursing interventions, the patient will display appropriate range of feelings and lessened fear. 2001 Jan 27;357(9252):293-8. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. . This content does not have an English version. Uterine fibroids can lead to gynecologic complications. 2018;46:113. EPC core team members must disclose any financial conflicts of interest greater than $1,000 and any other relevant business or professional conflicts of interest. We will use the criteria and established tools described in the Methods Guide for Effectiveness and Comparative Effectiveness Reviews.23 Two senior investigators will assess each included study independently. 12-EHC047-EF. We will provide a qualitative and quantitative synthesis of studies meeting our review criteria. In: Williams Gynecology. Overview of treatment of uterine leiomyomas (fibroids). We are moderately confident that the estimate of effect lies close to the true effect for this outcome. Some differences among study populations may be accounted for in the model by adjusting for factors such as age distribution, demographic attributes, and the prevalence of concomitant conditions in the study sample. If the fibroids are few in number, you and your doctor may opt for a laparoscopic or robotic procedure, which uses slender instruments inserted through small incisions in your abdomen to remove the fibroids from your uterus. This technique can be effective in shrinking fibroids and relieving the symptoms they cause. is sometimes performed for removing fibroids while sparing the uterus.