L T COLLEGE OF NURSING

SNDT UNIVERSITY CHURCHGATE

LESSON PLAN ON
NURSING CARE OF A PATIENT
WITH MENSTRUAL DISORDERS

F. Y. MSc Nursing student

  Subject : Medical Surgical Nursing 2
 Topic : Nursing care of a patient with menstrual disorders.
 Group : 3rd Year Basic BSc. Nursing
 Date and Time : 8am-8:45am
 Venue : 3rd year BSc nursing virtual classroom.
 Method of Teaching : Lecture cum discussion.
 Teaching Aids : chart, flash cards, ppt, model

 Knowledge assumed : The students have the basic knowledge of anatomy and physiology of female
reproductive system.

 Aim : At the end of the class , student will be able to give comprehensive nursing
care to a patient with menstrual disorders .

specific objectives : The student should be able to ;

1. Introduce the topic

2. Define menstruation and menstrual disorders
3. Describe the various menstrual disorders in detail
4. Enumerate the causes of each menstrual disorders
5. Illustrate the clinical manifestations
6. Prepare the patient for the diagnostic evaluation
7. Explain the medical management of menstrual disorders
8. Compute the nursing management of menstrual disorders
9. Summarize and conclude the topic
TIME CONTRIBUTORY LEARNING CONTENT TEACHING , AV AIDS
OBJECTIVES LEARNING,
ACTIVITIES
3 min INTRODUCTION: Student teacher will
Good morning class introduce the topic ppt
with the help of video
Student teacher will explain the anatomy and or ppt
physiology of female reproductive system
specially about menstruation.
1 min 1.The students
will be able to ppt
define DEFINITION: The teacher explains
menstruation and Menstruation is the female reproductive the definition with the
menstrual cycle that is characterized by the bleeding of help of ppt
disorders the uterus as a response to the system of
hormonal changes.

MENSTRUAL DISORDERS
Menstrual disorders are the condition in which
ppt
5 min it affects normal menstrual cycles and causes
abnormalities. The teacher will
2.The students describe the various
will be able to types of menstrual
describe types of TYPES OF MENSTRUAL DISORDERS
1.Dysmenorrhea disorders with the
menstrual help of ppt
disorders 2.Premenstrual syndrome
3.Abnormal uterine bleeding
 Menorrhagia
 Metrorrhagia
 Polymenorrhea
ppt
 Menometrorhagia
3.The students 3. The teacher define
will be able to the what is
define the dysmenorrhea with
dysmenorrhea 1.Dysmenorrhea the help of ppt
Definition:
Dysmenorrhea literally means painful ppt
menstruation. But a more realistic and
practical definition includes cases of
4.The students painful menstruation of sufficient The student teacher
will be able to magnitude so as to incapacitate day-to- explains the types of
discuss various day activities. dysmenorrhea with
types of the help chart
dysmenorrhea Types:
 Primary
 Secondary

Primary dysmenorrhea: ppt

 The primary dysmenorrhea is one

The students will where there is no identifiable pelvic

be able to explain pathology. The teacher explains
the etiology of  Usually starts 2-3 years after menarche the etiology with the
primary and ceases after childbirth help of primary Flash cards
dysmenorrhea dysmenorrhea
Causes:
 Psychosomatic factors
 Abnormal anatomic and functional
The student teacher
myometrium will enliat clinical
 Role of vasopressin
manifestations of
primary
Clinical manifestions: dysmenorrhea with ppt
 Uterine cramps the help of flash
 Fatigue cards
 Vomiting
4. The students  Diarrhea
discuss the  Giddines The student teacher
etiology, clinical will explain
manifestations of secondary
secondary dysmenorrhea with
dysmenorrhea the help of ppt
Secondary dysmenorrhea:

 Secondary dysmenorrhea is usually

associated with pelvic pathology
 Usually starts 3-5 days prior
menstruation and stops with bleeding
 Usually occurs in age of 30’s

Causes:
 Chronic pelvic infection
 Endometriosis
 Adenomyosis
 Uterine fibroids ppt
 Endometrial polyp
 IUCD in utero

Clinical manifestations:
 Pain in lower back
5. The students  Abdominal pain
will be able to  Fatigue The student teacher
explain  Abnormal bleeding will describe
premenstrual premenstrual
syndrome Treatment : syndrome with the
 Prostaglandin synthasase inhibitors help of ppt chart
Mefenamic acid, ibuprofen

 Oral contraceptives didrogestorone

2.Premenstrual syndrome
Premenstrual Syndrome (PMS) is defined as
Students will be the cyclic recurrence in the luteal phase of the The student teacher
able to enlist menstrual cycle of a combination of will explain clinical
clinical distressing physical, psychological, and/or manifestation with
manifestation of behavioral changes of sufficient severity to the help of chart
PMS result in deterioration of interpersonal chart
relationships and/or interference with normal
activities.

Etiology :
Unknown but it might be due to psychological
symptoms mainly

Clinical manifestation

 Behavioural ppt
 Fatigue
 Irritability
 Labile mood with alternating
 sadness and anger
 Depression
 Oversensitivity
 Crying spells
The students will  Social withdrawal The teacher will
be able to explain  Forgetfulness explain the treatment
treatment of PMS  Difficulty concentrating with the help of ppt

2. Physical ppt
 Abdominal bloating
 Breast tenderness
 Acne
 Appetite changes and
 food cravings
 Swelling of the extremities
  Headache
6.The students  Gastrointestinal upset The student teacher
will be able to will explain abnormal
explain detail uterine bleeding in ppt
Treatment:
about abnormal detail with the help of
uterine bleeding  Oral contraceptives ppt
 Vitamin B6
 Bromocriptine
 Monoamine oxidase inhibitors
 Synthetic progestational agents
 Calcium
 Prostaglandin synthesis inhibitors
7.The students The student teacher
 Alprazolam (Xanax) ppt
will be able to will discuss the
 Naltrexone opiate antagonist
discuss the causes of abnormal
 Fluxetine (Prozac)
causes of uterine bleeding with
abnormal uterine the help of ppt
bleeding

3.Abnormal uterine bleeding

images
Vaginal bleeding is abnormal if
 Volume is usually more than normal
8.The students  Occurs at time other than expected time The student teacher
will be able to will illustrate the
illustrate the types There are various types of uterine bleeding types of AUB with
of AUB which may cause due to various conditions. the help of ppt

CAUSES ppt
1.Structural: Endometrial polyps, fibroids,
endometritis, endometrial hyperplasia, uterine
cancer, IUD
 2.Pregnancy related: Implantational
bleeding, abortion, ectopic pregnancy

3.Hormonal and endocrine causes:

hypothyroidism, hormonal replacement
therapy, ovarian cyst
7.The students The student teacher
will be able TYPES: will be able to explain
prepare patient for the diagnostic
diagnostic test A. Menorrhagia evaluation with the
Menorrhagia is prolonged or excessive help of ppt
bleeding at the time of the regular menstrual
flow Ppt

B. Metrorrhagia
Metrorrhagia vaginal bleeding between
regular menstrual period

C.Menometrorrhagia
Heavy vaginal bleeding between and during Ppt
periods

D. Polymenorrhea
8. The students Polymenorrhea is defined as cyclic bleeding
will be able to where the cycle is reduced to an arbitrary limit The teacher will ask
describe the of less than 21 days and remains constant at the students explains
that frequency. the medical
medical and management and ppt
surgical DIAGNOSTIC EVALUATION surgical with the
management. help ppt
 History- no of sanitary pads, LMP,
cycles days, color, flow,
 Internal examination - to view internal
structure of uterus
  Blood tests- to measure hormones and
check for bleeding disorders
 Ultrasound- to view pelvic organs
 Hysteroscopy- A tube is passed to the
9.The students uterus through the vagina to view the Teacher will explain
will be able to uterus about nursing
compute nursing  Endometrial biopsy- tissue is scraped management of
management of a from the uterus and looked at using a menstrual disorders
patient with microscope with the help of ppt
menstrual
disorders

MANAGEMENT:
1.Medical
 Combined hormonal contraceptives
(cyclical or continuous)
 DMPA (depot medroxyprogesterone
 Progestins
 Estrogens including oral contraceptives
 Cyclic NSAIDS

2. Surgical
 IUD
 Dilatation and curettage
 Endometrial ablation
 Hysteroscopic endometrial resection

NURSING MANAGEMENT
Dysmenorrhea
  Acute Pain related to increased uterine
contractility, hypersensitivity
 Imbalanced nutrition less than body
requirement related to nausea and
vomiting
 Ineffective individual coping related to
emotional excess. 10.The teacher
explains the
Nursing Interventions for Dysmenorrhea prevention of ARF
with the help of chart
1. Acute Pain related to increased uterine
contractility, hypersensitivity.

Goal: pain reduced client

Nursing Interventions:
1. Warm the abdomen.
Rational: may cause vasodilation and reduce
the spasmodic contractions of the uterus.
2. Massage the abdominal area that feels
pain.
Rational: reduce pain due to the stimulus of
therapeutic touch.
3. Perform light exercise
Rational: it can improve blood flow to the
uterus and muscle tone.
4. Perform relaxation techniques. Student teacher will
Rational: reduce the pressure to get relaxed. summarize the topic
5. Give the natural diuresis (vitamin) sleep and ask about
and rest. doubts
Rational: reduce congestion.

2. Ineffective individual coping related to

emotional excess.

Nursing Interventions: Teacher will ask the

1. Assess client's understanding of her illness. questions about topic
Rational: maternal anxiety of the pain will be
greatly influenced by knowledge.
2. Determine the additional stress that
accompanies it.
Rational: stress can impair the autonomic Questionnaire
nervous response, so it is feared to increase
the pain.
3. Provide an opportunity to discuss how the Teacher will
pain. conclude the class
4. Help clients identify coping skills during the
period covered.
Rational: the use of behavior management
techniques can help clients adapt to the pain
they experienced.
5. Give the period of sleep or rest.
Rational: the pain and fatigue due to spending
a lot of body fluids tends to be a problem that
must mean a lot of the body tends to be
significant problems that must be addressed
immediately.
6. Push the skills of stress, such as relaxation
techniques, visualization, guidance,
imagination and deep breathing exercises.
Rational: it can reduce pain and distract the
client to pain.

SUMMARY
We have seen what are the menstrual
 disorders in detail with etiology, clinical
manifestations, diagnostic evaluation, medical
management, surgical management, nursing
management

RECAPITULISATION :
Do you have any queries related to topic. if no
I like to ask some questions
1. Enlist the menstrual disorders
2. Explain what is menorrhagia
3. What is dysmenorrhea?

ASSIGNMENTS :
Multiple choice questions

CONCLUSION:
I hope you understand the class. so, I will
conclude my class. I assume that you all will
be able to apply this in clinical area. Thank
you so much for listening.

BIBLIOGRAPHY

 Janice L Hinkle and Kerry H. Cheever “Brunner’s and Suddarth’s Textbook of medical surgical nursing”, 13 th
edition, Volume 2 Page no 1627 Reprint 2014, Published by wolters Kluwer.
 Hiralal konar “DC Dutta’s Textbook of gynecology”, 8 th edition, page no 187 publiashed by Jaypee publications
New Delhi,2015
 https://www.nurseslabs.net