SYMPTOMATOLOGY

Clinical Actual Ideal Significance Basis

Manifestations
Fever √ X Women with fibroids also may experience
reproductive problems. Urinary tract infections
typically occur when bacteria enter the urinary tract
through the urethra and begin to multiply in the
bladder. These bacteria cause the patient to have a
fever.

(According to the study published by Mayo

Foundation for Medical Education and Research,
2020)

Justification: Choy has a high fever her temperature

reached at 40 Degrees Celsius. Normal temperature is
36.5-37.5 Degrees Celsius.
Pelvic √ √ Pelvic discomfort is common in women with fibroids
pressure if discomfort is present it is likely to be chronic,
intermittent, dull pressure or pain and difficult to
control urination.

(According to the study published by Mayo

Foundation for Medical Education and Research,
2019)

Justification: Choy have experienced the feeling of

increase pressure or heaviness in her pelvic area which
causes her in pain.
Constipation √ √ Women can experience pressure on the bowel and /or
bladder due to fibroids. Fibroids affect the urinary and
G.I. systems, leading to variety of side effects and can
press on the ureters leading to kidney dysfunction.

(According to the study published by Brigham and

Woman’s Organization, 2018)

Justification: Choy is constipated and having a hard

time to do bowel elimination.

Backache or √ √ Low backpain and leg pains rarely, fibroids press

Leg pains against the muscles and nerves of the lower back and
cause back pain. A large fibroid on the back surface of
 the uterus is more likely to cause back pain than a
small fibroid within the uterine wall.

(According to the study published by Regents of the

University of the California, 2020)

Justification: Choy is complaining of having a painful

back and legs
Pain during √ √ Fibroids can create a sensation of pressure that
sexual interferes with sexual enjoyment. If fibroids are close
intercourse to the cervix, they may trigger not only pain, but
bleeding during sexual penetration. Painful intercourse
can affect a woman’s libido; she may find herself less
interested in sex, knowing that it will hurt.

(According to the article of Azura Vascular Care,

2020)

Justification: Choy is complaining of having a painful

sexual intercourse.
Risk for √ √ Heavy bleeding from GYN conditions such as fibroids
bleeding can cause anemia. In addition to the loss of red blood
cells from the body, which your bone marrow must
replace the loss of iron that is contained in these cells
will ultimately lead to iron deficiency once tissue
stores have been depleted.

(According to the study of the center for Innovative

GYN Care, 2019)

Justification: Choy’s lab results on January 19, 2020

shows that her RBC results is 3.9, HCT is 0.30, and
HGB is 10.4. Normal values for RBC are 3.92-5.13
Trillion cells/L, HGB is 11.6-15 grams/dL and HCT
35.5-44.9 percent. Choy has low results for RBC, HCT
and HGB.
 Urinary √ √ The most common issue concerning fibroids and
retention urinary problems is the need to urinate frequently. In
some cases, fibroids can cause urinary retention. This
can happen when large fibroids press against a ureter.
If a ureter becomes completely pinched off, surgery is
needed quickly to prevent urine from flowing back,
which may permanently damage the kidney on that
particular side.

(According to the study of Fresenius Medical Care,

2020)

Justification: Choy was on foley catheter for 3 months

due to difficulty in urination. Foley catheter is changed
every 2 weeks.

ETIOLOGY

Precipitating Actual Rationale

Factors
High blood X Women with fibroids have a notably high hypertension risk. Both
pressure women of Asian and of African descent with fibroids had a higher
prevalence of hypertension. Although women of African descent
more often had obesity and Asian women have more Hypertension
it may cause smooth muscle cell injury and cytokine release,
promoting the proliferation of smooth muscle cells in the vascular
wall as well as in the uterine wall. As shown in the lab results of
choy her protein is higher than normal and may also be caused by
hypertension.

(According to Wiley Online Library, 2018)

Anxiety/Stres √ The stress levels or Anxiety can influence the production of

s estrogen and progesterone in the body. This can cause adrenal
gland exhaustion as well as reduced progesterone levels. This tilts
the estrogen to progesterone ratios in favor of estrogen. Excessive
estrogen in turn causes insomnia and anxiety, which further taxes
the adrenal glands. This leads to a further reduction in
progesterone output and even more estrogen dominance. After a
few years in this type of vicious cycle, the adrenal glands become
exhausted. This dysfunction leads to blood sugar imbalance,
 hormonal imbalances, and chronic fatigue. Women with fibroids
have specific stress due to the diseases themselves, including
concerns about their health and about the painful symptoms that
are disrupting with their lives and well-being. Choy have
experienced painful feeling on her lower body parts this can result
an upsetting problem for women also, the pain during sexual
intercourse that is also common in women with fibroids can
disrupt a healthy sexual relationship, causing anguish and discord
as the patient is complaining of having a painful sexual
intercourse.

(According to the study of USA Fibroid Center, 2020)

Predisposing Actual Rationale

Factors
Age √ Age is a risk factor in the disease process of uterine fibroids. The
client is 39 years old. Maturation and growth are known to cause
fibroids this is due to the differences of estrogen and progesterone
levels in females as they get older and undergo the processes of
menopause.

(According to the article of Health line Media, 2020)

Hereditary X Women who has a family history of myoma themselves are more
susceptible to getting the disease than those who have no family
history of the disease. Although any woman of reproductive age
can develop fibroids.

(According to the study of National Library of Medicine, 2018)

Race X Although an actual connection between the disease process and
race have yet to been validated and affirmed, many studies have
shown that particular races such as American and African
Americans are more susceptible to tumor growth in the
endometrial lining among premenopausal women rather than
Asians. However, these factors, can only somewhat explain the
racial differences in myoma occurrence and their growth rates.

(According to the study of International Journal of Fertility &

Sterility, 2018)