Endometiosis Tutorial

Adult Nursing 2

This Photo by Unknown Author is licensed under CC BY-SA

 This Photo by Unknown Author is licensed under CC BY

What is
▪ It occurs when functioning endometrial tissue is
endometriosis implanted in the pelvis outside the uterine cavity
▪ “A benign lesion or lesions with cells similar to those
lining the uterus grow aberrantly in the pelvic cavity
outside the uterus.”

▪ Chronic pelvic pain & infertility

 Potential Risk Factors

Family history of 1st-

Delayed childbearing
degree relatives with Early menarche Late menopause
or nulliparity
endometriosis

Shortened menstrual
Exposure to
cycles (< 27 days)
Müllerian duct diethylstilbestrol in
with menses that are
defects utero - synthetic
heavy and prolonged
oestrogen
(> 8 days)
Pathophysiology
▪ Misplaced endometrial tissue responds to hormone
changes
▪ During menstruation, the extopic tissue bleeds, mostly
into areas having no outlets pain and adhesions
▪ Causes lesions, cysts and or scar tissue
 ▪ Symptoms depend on location of the implants
▪ may include
▪ dysmenorrhea,
▪ dyspareunia,
▪ Pelvic pain
▪ Depression
Clinical ▪ Loss of work
▪ Relationship difficulty
Manifestations ▪ infertility,
▪ Dysuria
▪ pain during defecation and sexual intercourse

*Severity of symptoms is not related to disease stage

 Health hx

Pelvic exam
Assessment and
Diagnostic
findings Laparoscopy exam

• direct visualization
• Biopsy
▪ anti-inflammatory drugs - NSAIDS
▪ drugs to suppress ovarian function and
endometrial tissue growth
▪ Oral contraceptives
▪ Side effects
▪ fluid retention
▪ weight gain
▪ Nausea Medical
▪ Surgery
▪ surgical ablation and excision of
Management
endometriotic implants
▪ if disease is severe and no childbearing is
planned, hysterectomy alone or hysterectomy
plus bilateral salpingo-oophorectomy.
▪ Pregnancy
▪ Assessment
▪ Hx & PE focus on specific symptoms, effects of meds,
reproductive plans

▪ Diagnosis, Planning and Goals

▪ Relief of pain, Dysmenorrhea, dyspareunia Nursing
▪ Avoidance of infertility
▪ Nursing Interventions
Process
▪ Dispel myths and encourage the patient to seek
care if dysmenorrhea or dyspareunia occurs
▪ Evaluations/Expected patient outcomes
Nursing Care ▪ https://wps.prenhall.com/wps/media/objects/7
37/755395/endometriosis.pdf
Plan