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Menorrhagia and metorrhagia
- 1. 01 Menorrhagia and Metorrhagia 3rd Year {Bsc(Honors) } Insha Aziz Insha Aziz
- 2. Menorrhagia is the most common type of abnormal uterine bleeding characterized by heavy and prolonged menstrual bleeding. A normal menstrual cycle is 21-35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 mL. A blood loss of greater than 80 ml or lasting longer than 7 days constitutes menorrhagia (also called hypermenorrhea) MENORRHAGIA
- 3. Etiology Hormone imbalance. If a hormone imbalance occurs between the hormones estrogen and progesterone, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding. 2 Dysfunction of ovaries Dysfunction of the ovaries. If ovaries don't ovulate during a menstrual cycle (anovulation),body doesn't produce the hormone progesterone, as it would during a normal menstrual cycle. This leads to hormone imbalance and may result in menorrhagia. 1 Harmonal imbalance
- 4. Etiology 3 Uterine fibroids Uterine fibroids. These noncancerous (benign) tumors of the uterus which may also induce menorrhagia. 4 Polyps Small, benign polyps may cause heavy or prolonged menstrual bleeding.
- 5. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Etiology 5 Adenomyosis 6 IUD Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control.
- 6. Miscarriage, Ectopic pregnancy Etiology 7 Pregnancy Complications 8 Cancer Rarely uterine cancer, ovarian cancer, and cervical cancer 9 Inherited bleeding disorder Von Willebrand's disease, thrombocytopenia,leukemia 10 Medications PID(PELVIC INFLAMMATORY DISEASE), THYROID PROBLEM'S(Hypothyroidism), Endometriosis, liver or kideney disease 11 Other Medical conditions Certain drugs, Anti-inflamtory medications (Aspirin) and Anticoagulants
- 7. Absenceofprogesterone Menorrhagia Lackofvasoconstriction Deficiencyoffactor(Vii,ix) Resultsinexcessiveuterinebleeding Deficiencyoffactor(ii,Vii,ix,x) Resultsinexcessiveuterinebleeding Inherited bleeding disorders (von willebrand's disease), Coagulation disorders (thrombocytopenia,leukemia) Lackofovulation(anovulation) Itputspressureagainst theuterinelining Estrogenandprogesteronedoesn'tregulate thebuildupofliningofuterus(endometrium) Eventuallyitshedsbywayofheavy menstrualbleeding Bloodvesselsbleedincreasingmenstrual flow DeficiencyofvitKduetoitshighrequirementby vitKdependentproteintoinhibitcalcification Dysfunctionaofovaries AbsencesorlowlevelsofPGF2alpha Uterinefibroids Uterusisunabletocontract properlytostopbleeding Hormonalimbalance Endometriumdevelopsinexcess Polyps Irritatethesurroundingtissue Tissueruboffexposingtinybloodvessels Kidneydisease Liverdisease Defectinhemostasis
- 9. Pelvic and Rectal Examination Diagnostic Evaluation Pap Smear cells from cervix are collected and tested for infection, inflammation or cancerous changes.
- 10. Diagnostic Evaluation Blood tests Evaluate for iron deficiency (anemia) and other conditions, such as thyroid disorders or blood-clotting abnormalities. Endometrial Biopsy Endometrial biopsy. is the removal of a small piece of tissue from the endometrium (the lining of the uterus).
- 20. METRORRHAGIA
- 22. Clinical Manifestation Mild or heavy bleeding Profuse sticky discharge Intermittent cramping pain of short duration Metrorrhagia caused by miscarriage or a tubal pregnancy almost always always includes cramping, which can be severe 1 4 3 2 Diagnostic Evaluation Physical examination rectovaginal examination Hysteroscopy . . . Complete Medical History . Sonohysterogram . Hysteroscopy . Hysterosalphingography . (Pelvic examination)
- 24. The nurse should assess and obtain health history, noting when the bleeding started,how long it lasts ,if u have ever been pregnant and child birth. A nutritional history is also obtained to determine if the diet is high in salt,caffeine or alcohol or low in essential nutrients. Assess the level of understanding regarding the menstrual disorders Nursing diagnosis Goal Acute pain related to menstrual cramps , increased uterine contractions or hypersensitivity to prostaglandins To realive Pain Nursing Interventions Evaluation Assess Intensity, location, level & onset. . . For relief of painfull menstrual cramps and associated discomfort, start with a Hot bath. (The water helps relax the uterus and other tensions that may contribute to the problem. . . Exercise regularly Aerobic exercises such as swimming, running, bicycling may diminish Cramp Symptoms. Place a heating pad on abdomen, the flow of heat can provide soothing, temporary pain relief . Teach the use of Relaxation techniques like yoga, meditation etc . Administer analegeses as prescribed . Advise patient to avoid those factors which elevate pain . After using following interventions patient Pain is relieved .
- 25. Nursing diagnosis Goal Nursing Interventions Evaluation . . . . . . .Imbalanced nutrition related nausea, vomiting or apetite changes, food cravings, To improve nutritional status Monitor body weight Advise patient to eat smaller, more frequent meals to reduce bloating & sensation of fullness Choose foods high in carbohydrates, such as fruits,vegetables & whole grains Take a daily multivitamin supplements Take a daily iron supplements to prevent iron deficiency anemia By using following interventions nutritional status is improved . Anxiety related to excessive bleeding loss, altered day to day life activities To reduce anxiety . Encourage the pateint To use exercise & creative activities to reduce stress . Encourage the pateint To use relaxation techniques like Yoga,Meditation,massage therapy etc .. . Pateint is encouraged to continue her usual activities as this seems to relieve discomfort for some women . By using following interventions Anxiety is reduced