3. OUTLINES
• introduce the topic
• define the pelvic inflammatory disease
• modify pathophysiology
• illustrate clinical manifestation
• adopt assessment
• explain health education
• summarize the topic
• assignment
• recapitalization
8/20/2022 3
Pelvic inflammatory disease
4. INTRODUCTION
• Pelvic inflammatory disease, also known as pelvic
inflammatory disorder (PID), is an infection of the
upper part of the female reproductive system namely
the uterus, fallopian tubes, and ovaries and inside of
the pelvis.
8/20/2022 4
Pelvic inflammatory disease
5. DEFINITION
• Pelvic inflammatory disease is an infection of
the female reproductive organs. It most often
occurs when sexually transmitted bacteria
spread from your vagina to your uterus,
fallopian tubes or ovaries.
8/20/2022 5
Pelvic inflammatory disease
7. Endometriosis
• A condition resulting from the appearance of
endometrial tissue outside the uterus and
causing pelvic pain, especially associated with
menstruation.
• Endometriosis is a chronic disease affecting between
6% and 10% of women of reproductive age (Falcone &
Lebovic, 2011) and consisting of a benign lesion or
lesions that contain endometrial tissue (similar to that
lining the uterus) found in the pelvic cavity outside the-
uterus.
8/20/2022 7
Pelvic inflammatory disease
8. Pathophysiology
• Misplaced endometrial tissue responds to and depends on
ovarian hormonal stimulation
• During menstruation, this ectopic tissue bleeds, mostly
into areas having no outlet, which causes pain and
adhesions
• The lesions are typically small and puckered, with a
blue/brown/gray powder-burn appearance and brown or
blue-black appearance, indicating concealed bleeding
8/20/2022 8
Pelvic inflammatory disease
9. Endometrial tissue contained within an ovarian cyst has
no outlet for the bleeding; this formation is referred
to as a pseudocyst or chocolate cyst.
• Adhesions, cysts, and scar tissue may result, causing
pain and infertility
• Endometriosis may increase the risk of ovarian
cancer.
8/20/2022 9
Pelvic inflammatory disease
10. Clinical Manifestation
• Dysmenorrheal,
• Dysparenuria,
• Pelvic discomfort or pain.
• Dyschezia
• Radiation of pain to the back or leg may occur.
• Depression
• Loss of work due to pain..
8/20/2022 10
Pelvic inflammatory disease
11. Assessment Or diagnostic findings
• A health history : -
• Include an account of the menstrual pattern, is
necessary to elicit specific symptoms.
• Bimanual pelvic examination :- fixed tender nodules
are sometimes palpated and uterine mobility may be
limited, indicating adhesions
8/20/2022 11
Pelvic inflammatory disease
12. • Laproscopic examination:-
• confirms the diagnosis or helps stages the disease.
• Stage 1 – patient have superficial or minimal lesion
• Stage 2 – mild involvement
• Stage 3 - moderate involvement
• Stage 4 – extensive involvement and dense adhesion
with obliteration of the cul-de-sac.
8/20/2022 12
Pelvic inflammatory disease
13. Management
• Treatment depends upon the symptoms, the patient’s
desire for pregnancy and the extent of the disease. If
the women does not have symptoms, routine
examination may be all that is required. Other
therapies for varying degree of symptoms may be
NSAIDs, oral contraceptive agents, or surgery.
8/20/2022 13
Pelvic inflammatory disease
14. • Medical Therapy
• Palliative measure include the use of medications,
such as analgesic agents and prostaglandin inhibitors,
for pain.
• Hormonal therapy is effective in suppressing
endometriosis and relieving
dysmenorrheal{menstrual pain}.
• Oral contraceptive agents provide effective pain relief
and may prevent disease progression. {prostaglandin
inhibitor}.
8/20/2022 14
Pelvic inflammatory disease
15. Side effects
• Fluid retention
• Weight gain
• Nausea.
8/20/2022 15
Pelvic inflammatory disease
16. Surgical Management
• Laproscopy – may be used to fulgurate ( cut with
high frequency current).endometrial implants and to
release adhesion.
• Laser surgery – vaporize or coagulates the
endometrial implants, thereby destroying this tissue.
8/20/2022 16
Pelvic inflammatory disease
17. • Other surgery includes
• Oophorectomy – removal of the ovary
• Salpingo – oophorectomy – removal of the ovary and
its fallopian tube.
8/20/2022 17
Pelvic inflammatory disease
18. Nursing Management
• The health history and physical examination focus on
specific symptoms the effect of prescribed
medications, and the women reproductive plan.
Explaining the various diagnostic procedures may
help to alleviate the patient anxiety.
• Patient goals include relief of pain, dysmennorhea,
dysparenunia, and avoidance of infertility.
• Women with endometriosis and her partner may find
that pregnancy is not easily possible, and
psychosocial impact of this realization must be
recognized and addressed.
8/20/2022 18
Pelvic inflammatory disease
19. Adenomyosis
• The tissue that lines the endometrium invades the
uterine wall.
8/20/2022 19
Pelvic inflammatory disease
21. • Assessment -
• Physical examination finding on palpation include an
enlarged, firm, and tender uterus.
• Treatment -
• Treatment depends on the severity of bleeding and
pain.
• Surgical management-
• Hysterectomy may be the best option in providing
relief symptoms.
8/20/2022 21
Pelvic inflammatory disease
23. Endometrial Hyperplasia
• Endometrial hyperplasia (a buildup of endometrial
tissue). Can be a precursor to endometrial cancer and
often results from unopposed estrogen from any
source.
8/20/2022 23
Pelvic inflammatory disease
24. Diagnosis
• Biopsy and ultrasounds findings of thickness of the
endometrium.
8/20/2022 24
Pelvic inflammatory disease
25. Management
• Medical management –
• Broad spectrum antibiotic therapy – combination of
ceftriaxone ( Rocephin), azithromycin and
doxycycline.
• Oral microbial therapies.
8/20/2022 25
Pelvic inflammatory disease
26. Nursing Management
• The nurse assess both physical and emotional effects
of PID. The patient may feel well one day and
experience vague symptoms and discomfort the next.
She may also suffer from constipation and menstrual
difficulties. If the patient is hospitalized, the nurse
prepares the patient for further diagnostic evaluation
and surgical intervention as prescribed.
8/20/2022 26
Pelvic inflammatory disease
27. • Promoting Home and Community Based Care
• Educating patient about self care-
• The patient must be informed of the need for
precautions and must be encouraged to take
part in procedure to prevent infecting others
and protect herself from infection. The use of
condoms is essential to prevent infection and
sequelae.
8/20/2022 27
Pelvic inflammatory disease
28. Summary
• At the end of the topic, we discussed about
introduction of pelvic inflammatory disease,
classification which contains endometriosis,
adenomyosis and endometrial hyperplasia.
Pathophysiology clinical manifestation assessment
and diagnostic findings and management which
include pharmacology, surgical and nursing
management.
8/20/2022 28
Pelvic inflammatory disease
29. Assignment
• Make a careplan on pelvic inflammatory disease
8/20/2022 29
Pelvic inflammatory disease
30. Recaptulization
• How many classification is there in pelvic
inflammatory disease?
• What is adenomyosis?
8/20/2022 30
Pelvic inflammatory disease
31. REFERENCES
•
• Wilkins and Lippincott Williams. Manual of Nursing practice. 9th edition;
Wolters Kluwer Publication; China, 2010;
• page no:
• Bucher Heitkemper Dirksen Lewis. Medical Surgical Nursing Assessment
and Management of Clinical Problems. 9th edition; Elsevier publisher;
Canada, 2014; page no: 596-601.
• Black M.J. Medical Surgical Nursing. 8th edition; Volume 2; Elsevier
Publication; Canada ,page no:
• Suddhart’s and Brunner. Textbook of Medical Surgical Nursing. 10th
edition; page no.
•
• ONLINE REFERNECES-
• endometriosis adenomyosis and endometrial hyperplasia - Yahoo India
Search Results
8/20/2022 31
Pelvic inflammatory disease
