SYMPTOMATOLOGY

Clinical Actua Ideal Significance Basis

Manifestation l
s
Fever √ √ Fibroids can rarely become infected. In most cases this
only happens when an infection is already in the area.
Fibroids can grow rapidly, and outgrow their blood
supply, causing degeneration of the tissue in the
middle of the fibroid which causes fever and pain.
(According to the article of Arizona Wellness Center
for Women, 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. The pain is localized to specific spot
and improves on its own within two to four weeks.

(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.

ETIOLOGY

Precipitating Actual Rationale

Factors
High fat diet √ Some studies states that High fat diet is also considered a source
of estrogen whereas diets rich in fiber and low in fat decreases
estrogen reabsorption. Fat has an enzyme that converts adrenal
steroids to estrogen. The higher the fat intake, the higher the
conversion of fat to estrogen. Diet can help balance hormones that
may trigger these growths.

(According to the study published by American Journal of Clinical

Nutrition, 2019)
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. The patient also
 mentioned that she had an abortion which also a factor that can
cause emotional distress.

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

Caffeine or √ Coffee intake is linked with higher estrogen levels regardless of

Coffee Intake age, body mass index (BMI), caloric intake, smoking, alcohol, and
cholesterol intake. Some studies states that women who consumed
five or more cups of coffee, had nearly 70% more estrogen during
the early follicular phase than women who consume no more than
100mg of caffeine daily, or less than one cup of coffee.

(According to the study published by Psych Central, 2018)

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 √ 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)