2. INTRODUCTION
•UTERINE FIBROID IS A LEIOMYOMA (BENIGN (NON-
CANCEROUS) TUMOR FORM FROM SMOOTH MUSCLE TISSUE)
THAT ORIGINATES FROM THE SMOOTH MUSCLE LAYER
(MYOMETRIUM) OF THE UTERUS.
•SYNONYMS: MYOMA, FIBROMYOMA.
•MOST COMMON BENIGN NEOPLASM IN THE FEMALE.
•INCIDENCE: 20 TO 40% OF REPRODUCTIVE AGE WOMEN.
3.
4. DEFINITION
“UTERINE FIBROIDS ARE NONCANCEROUS GROWTHS OF THE
UTERUS THAT OFTEN APPEAR DURING CHILDBEARINGYEARS.”
•UTERINE FIBROIDS AREN'T ASSOCIATED WITH AN INCREASED
RISK OF UTERINE CANCER AND ALMOST NEVER DEVELOPINTO
CANCER.
14. FIBROID SIGNS
G/E- PALLOR
P/A-IF >12 WEEKS SIZE, FIRM, NODULAR, ARISING FROM PELVIS,
LOWER LIMIT CAN’T BE REACHED, RELATIVELY WELL DEFINED,
MOBILE FROM SIDE TO SIDE, NONTENDER, DULL ON PERCUSSION, NO
FREE FLUID IN ABDOMEN.
P/S-CERVIX PULLED HIGHER UP.
P/V-UTERUS ENLARGED, NODULAR, UTERUS NOT SEPARATELY FELT,
TRANSMITTED MOVEMENT PRESENT,NOTCH NOT FELT.
15. FIBROID USG: WELL DEFINED HYPOECHOIC LESIONS.
PERIPHERAL CALCIFICATION WITH DISTAL
SHADOWING IN OLD FIBROIDS
16. TAS& TVS-
SIZE, SITE AND NUMBER OF FIBROIDS
DIFFERENTIATES THE TUMOR FROM OTHER SWELLING
AS OVARIAN TUMOR.
19. MRI-
MOST ACCURATE IMAGING
MODALITY FOR DIAGNOSIS OF
FIBROID. IT DOES PRECISEFIBROID
MAPPING & CHARACTERIZATION.
DETECTS ALL FIBROIDS
ACCURATELY.
OVARIES ARE EASILY SEEN
DETECTS SMALL MYOMAS (0.5CM)
20.
21. LAPAROSCOPY- IT IS HELPFUL, IF THE UTERINE SIZE IS
LESS THAN 12 CMS AND ASSOCIATED WITH PELVIC
PAIN AND INFERTILITY.
22. ENDOMETRIAL BIOPSY- TISSUE SAMPLE IS
TAKEN TO SEND IT FOR BIOPSY PROCEDURE TO
FIND OUT THE TYPE OF FIBROIDMALIGNANCY.
23. COMPLICATIONS
•MENORRHAGIA
•ABDOMINAL PAIN
•PREMATURE BIRTH, LABOR PROBLEMS,MISCARRIAGE
•INFERTILITY
•TWISTING OF THE FIBROID
•ANEMIA
•URINARY TRACT INFECTIONS
•SOME PREGNANT WOMEN WITH FIBROIDS HAVE HEAVY BLEEDING
IMMEDIATELY AFTER GIVING BIRTH.
25. Oral
contracep
tive pills-
reduce
the heavy
flow
GnRH
agonists
(e.g.,
leuprolide)-
used pre-
postoperativ
ely to shrink
the size of
the tumor.
Antihor
monal
drugRU-
486
(mifepri
stone)
Danazol
(Danocrine)-
decreasing
the number
ofhormones
made by the
ovaries
Antifibrinoly
tics
(tranexamic
acid)-
inhibitorsof
fibrinolysis
Nonsteroidal
anti-
inflammator
y agents- to
treat
symptomati
csymptoms
34. HYSTERECTOMY
A SURGICAL OPERATION TO REMOVE ALL OR PART OF THE
UTERUS IN CASE OF LIFE THREATENING CONDITION OFTHE
WOMEN I.E., MENORRHAGIA, POST-MENOPAUSALPERIOD.
MOST COMMON SURGICAL TREATMENT DONE ININDIA.
38. NURSING INTERVENTIONS
•THE NURSE DETERMINES WHATTHE EXPERIENCE MEANS TO THE PATIENT AND ENCOURAGES HER
TO VERBALIZE HER CONCERNS.
•EXPLANATIONS ARE GIVEN ABOUT PHYSICAL PREPARATIONS AND PROCEDURES THAT ARE
PERFORMED.
•THE PATIENT NEEDS REASSURANCE THAT SHE WILL STILL HAVE A VAGINA AND THAT SHE CAN
EXPERIENCE SEXUAL INTERCOURSE AFTER TEMPORARY POSTOPERATIVE ABSTINENCE WHILE
TISSUES HEAL.
•THE NURSE NEEDS TO APPROACH AND EVALUATE EACH PATIENT INDIVIDUALLY IN LIGHT OF THESE
FACTORS.
•A NURSE WHO EXHIBITS INTEREST, CONCERN, AND WILLINGNESS TO LISTEN TO THE PATIENT’S
FEARS WILL HELP THE PATIENT PROGRESS THROUGH THE SURGICAL EXPERIENCE.
39. •THE
CONT…
NURSE ASSESSES THE INTENSITY OF THE PATIENT’SPAIN AND ASSISTS THE
PATIENTWITH ANALGESIA AS PRESCRIBED.
•THE NURSE COUNTS THE PERINEAL PADS USED, ASSESSES THE EXTENT OF
SATURATION WITH BLOOD, AND MONITORS VITAL SIGNS.
•ABDOMINAL DRESSING IS MONITORED FOR DRAINAGE IF AN ABDOMINAL
SURGICAL TECHNIQUE WAS USED.
•NURSE SHOULD INSTRUCT TO CONTACT THE NURSE OR SURGEON IF BLEEDING IS
EXCESSIVE.
•THE PATIENTIS ENCOURAGED AND ASSISTED TO CHANGE POSITIONS FREQUENTLY.
•NURSE HELPS THE PATIENTTO AMBULATE EARLYIN THE POSTOPERATIVE PERIOD.
40. CONT…
•INTAKE AND OUTPUT CHART IS MONITORED.
•EXPLAIN THE PATIENTABOUT FOLLOW UP VISITS.
•ADMINISTER IRON AND BT AS PRESCRIBED.
•ENCOURAGE VERBALIZATION OF FEELINGS
•MONITOR ACTIVE FLUID LOSS FROM WOUND DRAINAGE,
BLEEDING.
•ENCOURAGE PATIENTTO DRINK PRESCRIBED FLUID AMOUNTS
41. CONT…
•MONITOR SERUM ELECTROLYTES.
•ENCOURAGE CLIENTS TO INCREASE FLUID INTAKE
•OBSERVATIONS OF CHANGES IN MENTAL STATUS, BEHAVIOR OR LEVEL OF
CONSCIOUSNESS.
•NOTE THE CATHETERPATENCYWAS SETTLED (WHEN USING CATHETER)
•ASSESS NUTRITIONAL STATUS, INCLUDING WEIGHT,HISTORY OF WEIGHT LOSS
AND SERUM ALBUMIN.
•ENCOURAGE INTAKE OF PROTEIN AND CALORIE-RICH FOODS.
•HELP IN DEVELOPING EFFECTIVE COPING STRATEGIES.
