The nursing management for uterine fibroids involves pain management, fluid replacement, bleeding control, and patient education. Uterine fibroids can lead to gynecologic complications. The conditions that can also affect pregnancy are fibroids, endometriosis, ovarian cysts, cervical dysplasia and more.
As a nurse, I had the honor to care for teens girls and adult women. I spent a few years working on a surgical unit with a section reserved for gynecology oncology service. Thus, I observed the patients with signs and symptoms of pain, dehydration and excessive bleeding.
Uterine fibroids necessitate the complex management of a highly trained team of gynecologists, oncologists, and surgeons. In addition, “Gynecologic oncologists also specialize in complex benign gynecologic surgery, including procedures for advanced-stage endometriosis, fibroids, ovarian and uterine masses, cervical dysplasia, ovarian cysts and risk-reducing surgery to prevent gynecologic cancers.” (John Hopkins Medicine )
The patients often present with acute bleeding, unmanageable pain, and volume deficit. Therefore, the nursing care of uterine fibroids includes blood product transfusion to reverse blood loss. In addition, the pain regimen is very crucial because the patients often report severe pelvic pain. Lastly, nurses will maintain oral or intravenous hydration as recommended by the doctor.
I obtained clinical knowledge about uterine fibroids and gynecologic conditions that can affect pregnancy. I understand that nursing management can be complex but patient-focused. Thus, nursing implementations should be patient-specific.
Nursing Assessment Of Endometriosis
Many women suffer from endometriosis. This is a condition where tissues that belong in the uterus ( endometrium) grow outside the uterus. The tissues are often scattered over the ovaries, fallopian tubes or the intestines. The most common clinical manifestations are pain and irregular or abnormal menstruation.
Pain can be referred to as the lower back, rectum, and vagina. Women also report heavy & painful menstruation and spotting. Medical providers often order laboratory diagnostic testing and/or imaging to confirm their assessment findings. The condition can last for many years and can become chronic. There is no specific age group at risk for this condition.
Nursing Care For Endometriosis
The treatment plan is individualized and is aimed to manage and reverse associated symptoms. Besides, conservative recommendations ( heat pad, pain medication) often alleviate minor symptoms. Many surgical interventions can be performed, outpatient and inpatient. Cauterization-burning or freezing part of the body to remove affected tissue.
Ablation – laser removal of tissue and electrocoagulation where blood vessels are sealed using electric current in order to stop bleeding. Please advise patients to consult a gynecologist if they suffer constant pelvic pain and consistent menstrual irregularities. Can you tell a woman who suffers from endometriosis and uterine fibroids might have difficulty becoming pregnant or maintaining a successful pregnancy?
Clinical Manifestations OF Uterine Fibroids
Some women suffer from uterine fibroids which is a condition of abnormal growth in the uterus. It is most common during the childbearing years and affects mostly African American, obese women and early onset of puberty. The cause of uterine fibroids remain unknown, but successful treatment is available to eligible candidates.
Some of the symptoms include heavy menstrual bleeding, more extended periods, abdominal pain, lower back, and pelvic pain. Gynecologists validate diagnosis with laboratory testing and imaging.
Nursing Management For Uterine Fibroids
Treatment goals aim to minimize bleeding and prevent associated clinical symptoms – acute anemia, pain crisis, cardiac symptoms, dehydration and more. Nurses should anticipate cardiac monitoring and fluid volume replacement.
Pain regimen is also effective in some instances, and some Providers often recommend surgical procedures. In order to manage bleeding, some patients receive birth control prescription and hormone therapy to regulate periods. Some procedures include ablation, uterine artery embolization, removal of the uterus (hysterectomy) and uterine myomectomy ( non-cancerous removal of fibroids).
Some of the uterine fibroids sizes can be as big as a twenty-four- week size baby. I have cared for college students in their twenties with uterine fibroids who passed out at school from syncope (sudden collapse) and transferred to the hospital urgently for treatment. The nursing management for uterine fibroids can be complex.
This is a pre-cancerous condition that affects the cervix ( head of the uterus). The condition is due to abnormal cell growth and often diagnosed following a pap smear test and caused by the HPV ( human papillomavirus). It can lead to cervical cancer if untreated or diagnosed later. Women are asymptomatic (no associated symptoms) and rely on the gynecologic exam to detect the abnormalities.
When detected early, treatments include surgery or laser therapy. Please see a gynecologist if you are sexually active regardless of age. The American Cancer Society recommends HPV testing for all women between the age of 30-64 and cervical cancer screening every five years. Can you tell that many women might experience difficulty with pregnancy when diagnosed with this condition? I will cover other severe conditions in future posts.
Nursing Care For Uterine Fibroids
Nurses should educate themselves about the pathophysiology of uterine fibroids and other gynecologic conditions mentioned above in order to care for patients safely. It is highly recommended to be familiar with treatment plans, clinical expectations, and outcomes. Nurses should educate the patients about the prescribed treatment plan and advise the patients to seek medical assistance when they observe persistent symptoms.
In addition, the healthcare team should establish a therapeutic relationship with the patients and promote open communication. Nurses also need to provide emotional support to the patients. For instance, provide education about positive coping strategies to prevent depression in women and body image issues related to physical changes.
Education In Nursing Management For Uterine Fibroids
Patients should receive education to complete prescribed treatment in its entirety. Remember to identify patients’ support systems and involve health care partners with the patients’ approval. Patients might need social work referrals to manage psychosocial issues. For example, some culture does not accept women who experience reproductive challenges.
Lastly, the healthcare team can educate patients about alternatives to childbirth like surrogacy, adoption or cryopreservation – egg freezing. Please visit nursesophiedebtfree for additional nursing topics.
Uterine fibroids and other gynecologic conditions can affect pregnancy and can be detrimental to women and their significant others. People often offend others involuntarily and cause unintended emotional trauma. It is wiser to wait for expectant mothers to disclose their pregnancy status. There should be no assumptions based on physical body changes. A large or obese abdomen does not validate pregnancy and can be related to multiple medical conditions.
Nurses play a vital role in the management of patients with gynecologic conditions. They are also qualified to educate patients about symptoms, prescribed treatment plans, and outcomes. Women should visit primary care providers periodically in order to promote early screening and diagnosis.
Some gynecologic conditions are asymptomatic and are only detectable during a medical examination. Safe nursing management for uterine fibroids includes fluid replacement, pain management, bleeding control and patient education. Take charge of your health today and discuss all medical concerns with an independent provider.
Nurse Sophie has been a registered nurse for over a decade. I have a Master's degree in nursing, and my clinical experiences include staff nurse, clinical nurse supervisor, and manager, and most recently, nurse consultant in Patient Safety and legal nursing. I was always passionate about system operations and practice standards.
I have completed over 2000 hours of medical chart reviews. I am an expert in clinical investigations, and I also develop event timelines. I can assist the legal team with the Discovery process: Deposition, Interrogatories questionnaire, event timelines, locate expert witnesses, and more. I provide and formulate clinical opinions based on the investigative summary.
Nurse Sophie, MSN, RN, LNC
Legal Nurse Consultant
Patient Safety Specialist
Email: [email protected]