Endometriosis

A client with a history of endometriosis gives birth to a healthy infant. She expresses concern that the problems associated with endometriosis will return now that her pregnancy is over. What is the best response by the nurse?

"Breast-feeding will delay the return of the endometriosis.

What to do when patient has decreased self-esteem related to inability to get pregnant?

-Provide therapeutic communication. Include husband as appropriate. -Refer to support group.

What to do when patient feels discomfort related to menstruation secondary to endometriosis

-Assess location, type, and duration of pain and history of discomfort. -Administer nonsteroidal anti-inflammatory drugs as indicated. -Administer hormone-altering medications as ordered. -Provide information about use of nonpharmacologic methods such as heat.

The nurse is obtaining a health history from a client with endometriosis. What consequences can occur as a result of this disorder? Select all that apply.

-Metrorrhagia -Impaired fertility -Voiding difficulties -Bowel Strictures

what does treatment focus on?

-Reduction of pain -Restoration of sexual function -Decrease in anxiety -Education -Prevention of self-concept disturbance related to infertility

Elagolix

-suppressing FSH and Lh stimulation, pituitary gondadotropin secretion, and ovarian function decreases a lot. Treatment for endometriosis. -Helps to decrease the abnormal tissue and also the symptoms of endometriosis (such as pelvic pain, painful menstrual cramps, and pain during/after sex) -When given regularly to women it decreases estrogen levels which helps treat endometriosis. It prevents the growth of tissue caused by endometriosis in adult women

Leuprolide

-suppressing FSH and Lh stimulation, pituitary gondadotropin secretion, and ovarian function decreases a lot. Treatment for endometriosis. -Helps to decrease the abnormal tissue and also the symptoms of endometriosis (such as pelvic pain, painful menstrual cramps, and pain during/after sex) -When given regularly to women it decreases estrogen levels which helps treat endometriosis. It prevents the growth of tissue caused by endometriosis in adult women

SE of GnRH agonists

hot flashes and vaginal dryness. Occasionally women report headaches and muscle aches.

Side effects for GnRH agonists?

hot flashes, night sweats, absence of a period headache, nausea, difficult sleeping, anxiety, depression, SI thoughts, bone loss, and liver disease.

S/S of endometriosis

major symptoms are pelvic pain, dysmenorrhea, and dyspareunia (painful intercourse). Women may also have chronic noncyclic pelvic pain, pelvic heaviness, or pain radiating into the thighs. Many women report bowel symptoms such as diarrhea, pain with defecation, and constipation caused by avoiding defecation because of the pain. Other symptoms include abnormal bleeding (heavy menstrual bleeding, or premenstrual staining) and pain during exercise as a result of adhesions, infertility.

signs and symptoms of endometriosis

pain in lower abdomen,

A client at the women's health clinic tells the nurse that she has endometriosis. What factors associated with endometriosis does the nurse anticipate the client will report? Select all that apply.

rectal pressure and abdominal pain

How is Elagolix administered?

tablet form

What to do when patient needs health teaching related to insufficient understanding about disease process and prescribed therapy and the effects on self-care

Assess woman's current understanding of the disorder and related therapies. Give information to woman regarding the disorder and treatment regimen.

What are common treatments for endometriosis?

Common treatments include birth control pills taken continuously without using the reminder pills to keep hormone level constant. Leuprolide injections have been called "the cure" for endometriosis but many women experience menopausal side-effects. Laser surgery reduces the pain by removing the scar tissue that forms after the menstrual cycle ends.

A client with a history of endometriosis has abdominal surgery to remove abdominal adhesions. What should this client's postoperative plan of care include?

Encouraging the client to ambulate in the hallway

RF for endometriosis:

Family HX of endometriosis Never been pregnant Early menstrual cycle Late menopause

Goserelin acetate

GnRH agonist- suppressing FSH and Lh stimulation, pituitary gondadotropin secretion, and ovarian function decreases a lot. Treatment for endometriosis. -Helps to decrease the abnormal tissue and also the symptoms of endometriosis (such as pelvic pain, painful menstrual cramps, and pain during/after sex) -When given regularly to women, it decreases estrogen levels which helps treat endometriosis. It prevents the growth of tissue caused by endometriosis in adult women

Nafarelin acetate

GnRH agonist- suppressing FSH and Lh stimulation, pituitary gondadotropin secretion, and ovarian function decreases a lot. Treatment for endometriosis. -Helps to decrease the abnormal tissue and also the symptoms of endometriosis (such as pelvic pain, painful menstrual cramps, and pain during/after sex) -When given regularly to women, nafarelin decreases estrogen levels which helps treat endometriosis. It prevents the growth of tissue caused by endometriosis in adult women

What is endometriosis?

Growth of endometrial tissue outside of uterus

How is leuprolide administered?

Injection, once month. 3.75 mg IM for up to 6 months.

How is Nafarelin acetate administered?

Intranasally- twice a day. 200 mg for up to 6 months.

A client who has a diagnosis of endometriosis is concerned about the side effect of hot flashes from her prescribed medications. Which medication should the nurse explain causes this side effect?

Leuprolide

What is the most common S&S of endometriosis?

Pain in the lower abdomen.

A 37-year-old client with endometriosis visits the women's health clinic because she has dysmenorrhea and dyspareunia. Which statement is the most accurate description of dysmenorrhea?

Pain with menses

How is goserelin administered?

SQ & implantable. 3.6 mg every 28 days for up to 6 months

A 15-year-old adolescent is diagnosed with endometriosis. The client has severe, acute, and incapacitating symptoms. What would be the anticipated line of treatment?

Surgical intervention

Facts about endometriosis

Surgical intervention is needed in adolescents with severe, acute, and incapacitating symptoms. NSAIDs can be used for symptomatic pain relief. Women having mild symptoms and desire for future pregnancy are treated with limited use of NSAIDs during menstruation. Women having mild symptoms and who can postpone pregnancy are treated with oral contraceptive pills that have low estrogen-to-progestin levels. In adolescents less than 16 years of age diagnosed with endometriosis, continuous combined hormone therapy and NSAIDs is the treatment option.

A client with endometriosis asks the nurse what side effects to expect from leuprolide. What should the nurse include in the response?

Weight gain

Who elagolix for?

Women 18 and over. Not for pregnant women.