Myoma nursing, medical, surgical managements

1. Myoma
NURSING MANAGEMENT
IDEAL
Assessment:
-pain, menstrual irregularity, possible urinary symptoms, constipation
-understanding of condition as benign
Nursing Dx:
 Acute/ Chronic Pain r/t tumor growth
 Anxiety
 Hopelessness
 Ineffective Coping Pattern
 Ineffective Sexuality Pattern
Key Outcomes:
Pt will:
 Express feelings of comfort
 Express feelings of reduced anxiety
 Be involved in planning own care
 Use available support systems
 Express feelings about condition and its effect on sexuality
Nursing Interventions:
o Administer iron and BT as ordered
o Encourage verbalization of feelings
o Offer emotional help
o Help pt develop effective coping strategies
o Refer for counseling
Patient Education and Health Maintenance
 Tell pt to report increase symptoms
 Explain effects of operation
 Encourage regular follow-up visits

2. SURGICAL MANAGEMENT
IDEAL
 MYOMECTOMY
 For small tumors
 Done through hysteroscope
 HYSTERECTOMY
 For large or numerous tumors
 UTERINE ARTERY EMBOLIZATION
 Transvenous procedure in which the blood supply to the myoma is obstructed and the myoma degenerates
 MYOLYSIS
 Laparoscopic procedure to treat fibroids

3. MEDICAL MANAGEMENT
IDEAL
 DIAGNOSTIC EVALUATION
 Ultrasound-identify size and location of myoma
 Dilatation and Curretage, Cytology-rule out cancer
 Blood Studies-show anemia
 Submucosal Hysterosalphingography-detect submucosal myoma
 MRI-fibroid imaging
 Laparoscopy-visualize subserous biomyomas on the uterine surface
 Diagnostic Hysteroscopy-view endocervical canal and lower uterine segment
 TREATMENT
 GnRH antagonist (Lupron) therapy-create hypoestrogenic environmentand try to shink tumors
 Pelvic examination q 4-6 months to monitor the growth of small biomyomas that produce no symptoms