A. Definition
Myoma uteri were: benign neoplasm that originates from the muscles of the uterus, also known as leiomyoma uteri or Uterine Fibroids.
Myoma uteri generally occurs at the age of 35 years. There are two places of origin are known myoma uteri which the cervix uteri (2%) and corpus uteri (97%), has never been found myoma uteri occurs before menarche.
B. Etiology
Although myoma uteri was found to occur with no obvious cause, but from the research and Lipschlutz Miller said that myoma uteri occurs depends on immature muscle cells contained in the "Cell Nest" which can then be continuously stimulated by the hormone estrogen.
C. Localization myomas uteri
1. Intramural myomas; When the tumor is in its growth remained in the uterine wall.
2. Myomas Submukosum; myomas that grow toward the uterine cavity and the cavity was prominent.
3. Myomas Subserosum; myomas that grow outward and stand on the surface of the uterus.
D. Complication
1. Growth leimiosarkoma.
Suspected uterine sarcoma when enlarged for several years, suddenly - suddenly becomes big when it happens after menopause
2. Torque (round shaft)
There are times when stalk on myoma uteri experiencing subserosum round. If this process occurs suddenly, the tumor will experience acute circulatory disorders with tissue necrosis and it would seem the clinical picture of abdomenakut.
3. Necrosis and Infection
In myoma subserosum the polyp, tumor end, sometimes it can be through the cervical canal and was born from the vagina, in this case the possibility of interference with the situation by necrosis and secondary infection.
E. Diagnostic Examination
Myoma uteri were: benign neoplasm that originates from the muscles of the uterus, also known as leiomyoma uteri or Uterine Fibroids.
Myoma uteri generally occurs at the age of 35 years. There are two places of origin are known myoma uteri which the cervix uteri (2%) and corpus uteri (97%), has never been found myoma uteri occurs before menarche.
B. Etiology
Although myoma uteri was found to occur with no obvious cause, but from the research and Lipschlutz Miller said that myoma uteri occurs depends on immature muscle cells contained in the "Cell Nest" which can then be continuously stimulated by the hormone estrogen.
C. Localization myomas uteri
1. Intramural myomas; When the tumor is in its growth remained in the uterine wall.
2. Myomas Submukosum; myomas that grow toward the uterine cavity and the cavity was prominent.
3. Myomas Subserosum; myomas that grow outward and stand on the surface of the uterus.
D. Complication
1. Growth leimiosarkoma.
Suspected uterine sarcoma when enlarged for several years, suddenly - suddenly becomes big when it happens after menopause
2. Torque (round shaft)
There are times when stalk on myoma uteri experiencing subserosum round. If this process occurs suddenly, the tumor will experience acute circulatory disorders with tissue necrosis and it would seem the clinical picture of abdomenakut.
3. Necrosis and Infection
In myoma subserosum the polyp, tumor end, sometimes it can be through the cervical canal and was born from the vagina, in this case the possibility of interference with the situation by necrosis and secondary infection.
E. Diagnostic Examination
- Examination Complete Blood: Hb: dropped, Albumin: down, leukocytes: down / up, Erythrocytes: down
- Ultrasound: visible mass in the region of the uterus.
- Vaginal toucher: obtained vaginal bleeding, palpable mass, consistency and size.
- Cytology: determine the degree of malignancy of the neoplastic cells.,
- Rontgen: to find abnormalities that may exist that could hinder surgery.
- ECG: Detecting abnormalities that may occur, which may affect the surgery.
F. How myomas Handling uteri
Indication of uterine myoma uteri were removed uteri subserosum is stemmed. In myoma uteri are still small especially in patients approaching menopause treatment is not necessary, just do regular pelvic examinations every three months or six months. The handling of the myoma uteri that needs to be addressed is the operative treatment of them is with a hysterectomy and total abdominal hysterectomy generally. Measures total hysterectomy is known as Total Abdominal Histerektomy and Salphingo Bilateral oophorectomy (TAH-BSO). TAH-BSO is a surgery to remove the uterus, cervix, ovaries and both fallopian falofii by making an incision in the wall, abdominal neoplasmatic malignant disease, and chronic leymyoma endrometriosis (Tucker, Susan Martin, 1998).
Indication of uterine myoma uteri were removed uteri subserosum is stemmed. In myoma uteri are still small especially in patients approaching menopause treatment is not necessary, just do regular pelvic examinations every three months or six months. The handling of the myoma uteri that needs to be addressed is the operative treatment of them is with a hysterectomy and total abdominal hysterectomy generally. Measures total hysterectomy is known as Total Abdominal Histerektomy and Salphingo Bilateral oophorectomy (TAH-BSO). TAH-BSO is a surgery to remove the uterus, cervix, ovaries and both fallopian falofii by making an incision in the wall, abdominal neoplasmatic malignant disease, and chronic leymyoma endrometriosis (Tucker, Susan Martin, 1998).
NURSING CARE CONCEPTS
A. Assessment
B. Nursing Diagnosis
- Impaired urinary elimination (retained) are associated with suppression by neoplasm tissue mass in the
- region sekitarnnya, impaired sensory / motor.
- Impaired sense of comfort (pain) associated with tissue damage
- Self-concept disturbance related to concerns about the inability to have children, change in female issues,
- due to the sexual relationship.
- High risk of hypovolemic shock associated with hemorrhage repeated.
- Lack of knowledge about the condition, prognosis and treatment needs related to misinterpretation of
- information, do not know the source of information.
Nursing Plan
Dx 1
Impaired sense of comfort (pain) associated with tissue damage and nervous system caused by narrowing of the cervical canal by myoma
Destination
Clients can control the pain with the criteria the results were able to identify how to reduce pain, expressing a desire to control the pain.
Interventions and Rational
1. Observation of pain and level of pain.
Facilitate nursing actions
2. Teach and record the type of pain and act of to cope with pain
Improve client perception of the pain they experienced.
3. Teach relaxation techniques
Increase client comfort
4. Recommended to use warm compresses
Helps reduce pain and enhance client comfort
5. Collaboration of analgesic
Reduce pain
Dx 2
Impaired urinary elimination (retained) are associated with suppression of the neoplastic tissue mass in the region sekitarnnya, impaired sensory / motor.
Destination
Maternal urinary elimination pattern returns to normal with the mother understands the outcome criteria urinary retention, are willing to take action to reduce or eliminate urinary retention.
Interventions and Rational
1. Record and monitor expenditure patterns of micturition urine
Seeing clients elimination pattern changes
2. Perform palpation of the bladder, observing the discomfort and pain.
Determining the level of pain experienced by the client
3. Encourage clients to stimulate micturition with warm water delivery, posture, flowing tap water.
Preventing urinary retention
Dx 1
Impaired sense of comfort (pain) associated with tissue damage and nervous system caused by narrowing of the cervical canal by myoma
Destination
Clients can control the pain with the criteria the results were able to identify how to reduce pain, expressing a desire to control the pain.
Interventions and Rational
1. Observation of pain and level of pain.
Facilitate nursing actions
2. Teach and record the type of pain and act of to cope with pain
Improve client perception of the pain they experienced.
3. Teach relaxation techniques
Increase client comfort
4. Recommended to use warm compresses
Helps reduce pain and enhance client comfort
5. Collaboration of analgesic
Reduce pain
Dx 2
Impaired urinary elimination (retained) are associated with suppression of the neoplastic tissue mass in the region sekitarnnya, impaired sensory / motor.
Destination
Maternal urinary elimination pattern returns to normal with the mother understands the outcome criteria urinary retention, are willing to take action to reduce or eliminate urinary retention.
Interventions and Rational
1. Record and monitor expenditure patterns of micturition urine
Seeing clients elimination pattern changes
2. Perform palpation of the bladder, observing the discomfort and pain.
Determining the level of pain experienced by the client
3. Encourage clients to stimulate micturition with warm water delivery, posture, flowing tap water.
Preventing urinary retention
Bibliography
Department of Obstetrics & Gynecology, Faculty of Medicine. Unpad. 1993. Gynecology. Elstar. Bandung
Carpenito, Lynda Juall, 2000. Handbook of Nursing Diagnosis. Edition 8. EGC. Jakarta
Galle, Danielle. Charette, Jane.2000. Oncology Nursing care plan. EGC. Jakarta
Hartono, Poedjo. 2000. Cervical Cancer / Cervical Screening & Problems in Indonesia. Pre-congress courses Kogi XI Denpasar. Pulpit vol.5 2 May 2001
Saifidin, Abdul Bari, et al. , 2001. National Reference Books for Maternal and Neonatal Health Services. Yayasan Bina Library Sarwono Prawirohardjo & JNKKR-POGI. Jakarta
Department of Obstetrics & Gynecology, Faculty of Medicine. Unpad. 1993. Gynecology. Elstar. Bandung
Carpenito, Lynda Juall, 2000. Handbook of Nursing Diagnosis. Edition 8. EGC. Jakarta
Galle, Danielle. Charette, Jane.2000. Oncology Nursing care plan. EGC. Jakarta
Hartono, Poedjo. 2000. Cervical Cancer / Cervical Screening & Problems in Indonesia. Pre-congress courses Kogi XI Denpasar. Pulpit vol.5 2 May 2001
Saifidin, Abdul Bari, et al. , 2001. National Reference Books for Maternal and Neonatal Health Services. Yayasan Bina Library Sarwono Prawirohardjo & JNKKR-POGI. Jakarta
