Posted: January 5th, 2023

Endometriosis

Endometriosis
• Pathophysiology
In endometriosis, the endometrium, the tissue that lines the interior of the uterus, develops outside of the uterus. Ovaries, fallopian tubes, and the tissue lining the pelvic are the areas most frequently impacted by endometriosis. Other body regions like the bladder, bowel, or rectum can also develop endometriosis. During the menstrual cycle, the endometrium thickens and sheds each month if pregnancy does not occur. In endometriosis, this same process occurs, but the endometrial tissue that is outside the uterus has no way to exit the body. This leads to inflammation, scarring, and the development of adhesions (abnormal tissue that binds organs together).

Endometriosis can range in severity, with some women experiencing mild cases with minimal symptoms, while others may have severe cases with significant pain and fertility problems. It is not clear what causes endometriosis, but it is thought to be related to hormonal imbalances and immune system dysfunction.

Symptoms of endometriosis may include pelvic pain, particularly during periods, painful sex, and difficulty getting pregnant. The diagnosis of endometriosis is typically made through a combination of a medical history, physical exam, and imaging tests.

Treatment options for endometriosis may include medications to manage pain and hormone therapy to reduce the growth of endometrial tissue. In some cases, surgery may be necessary to remove the endometrial tissue and repair any damage caused by the disease.
•
Signs and symptoms:
Common symptoms of endometriosis are:
1. Pelvic pain, ranging from mild to severe
2. Pain during or after sex
3. Pain with urination or bowel movements
4. Excessive bleeding during menstruation
5. Infertility
• Risk factors:
Several factors may increase the risk of endometriosis, including:
1. Family history: If you have a close relative (mother, sister, aunt, etc.) with endometriosis, you are more likely to develop the condition.
2. Age: Endometriosis is most common in women in their 30s and 40s, but it can occur at any age.
3. Reproductive history: Women who have yet to give birth are at higher risk of endometriosis.
4. Certain medical conditions: Women with certain medical conditions, such as polycystic ovary syndrome (PCOS) or immune system disorders, are at higher risk of endometriosis.
• Preventative screening:
There is no sure way to prevent endometriosis, but there are some things that may reduce your risk. These include:
1. Exercising regularly
2. Eating a healthy diet
3. Avoiding smoking
• Diagnostic tests:
No one test can diagnose endometriosis. The Physician may recommend the following tests:
1. Pelvic exam: The pelvic exam, checks for abnormalities in the pelvic organs.
2. Ultrasound: An ultrasound is used through sound waves to create a picture of the pelvic organs.
3. Laparoscopy: In a laparoscopy, the doctor will insert a small camera into the abdomen to look for signs of endometriosis.
• Treatment:
There is still no cure for endometriosis, however there are treatments that can help relieve the symptoms. These include:
1. Pain relievers. Over-the-counter pain relievers, such as ibuprofen can help relieve pain caused by endometriosis.
2. Hormone therapy: Hormone therapy can help reduce the amount of endometrial tissue.
3. Surgery: Surgery to remove endometrial tissue can help relieve pain and improve fertility.
• Multidimensional nursing care interventions:
Nurses play a vital role in the care of patients with endometriosis. Interventions may include:
1. Education: Nurses can provide patients with information about endometriosis, its symptoms, and treatment.
2. Support: Nurses can provide emotional support to patients dealing with the pain and other symptoms of endometriosis.
3. Advocacy: Nurses can advocate for patients with endometriosis by working to raise awareness of the condition and its effects.

References
Mohamed, A. (2021). Endometriosis: Causes, Complications, and Treatment. Healthline. Retrieved 14 April 2022, from https://www.healthline.com/health/endometriosis#treatment.
Parasar, P., Ozcan, P., & Terry, K. L. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical Management. Current obstetrics and gynecology reports, 6(1), 34-41. https://doi.org/10.1007/s13669-017-0187-1

Introduction

Anxiety in some situations is normal. In fact, it is a normal stress response. It can alert us to
potential risks, help us plan, and focus our attention (Morgan, 2020). Excessive fear or anxiety,
as opposed to natural feelings of apprehension or concern, is the hallmark of anxiety disorders.
About one-third of all individuals will experience an anxiety disorder at some point in their lives,
making it the most common mental condition. Obsessions, compulsions, or both that are severe enough to impair social, occupational, or other essential aspects of functioning are among the signs of OCD (Morgan, 2020). Even though the activity is excessive or unreasonable, the individual feels obligated to keep doing it since it makes them feel better, and the act lessens the suffering it causes (Morgan, 2020). Hand washing, ordering, checking, praying, counting, and silently repeating sentences are common compulsions (Morgan, 2020). In the videos, there are some solid indications that Lauren has a social anxiety disorder and an obsessive-compulsive disorder.
Describe at least three clinical signs of Anxiety observed in the videos.
Lauren is seen biting her nails several times in the video. Anxiety or stress can be expressed
through nail biting (Cedars Sinai, 2020). According to Cedars Sinai, some individuals seem to
find comfort in the repetitive behavior when confronted with difficult emotions (2020). Lauren
avoided making eye contact with the interviewer, a typical cognitive sign of social anxiety.
Social anxiety was also reflected in Lauren’s mention of ongoing nervousness about saying the
wrong thing and discomfort when delivering a presentation to a group.
Describe at least three Obsessive-Compulsive behaviors observed in the videos.
Lauren appears to be suffering from obsessive-compulsive disorder in addition to her social
anxiety behavior (OCD). OCD symptoms include chewing nails and playing with the ends of one’s hair. Her obsessive-compulsive thoughts forced her to make her grandfather breakfast daily
by 9 am; otherwise, her day was ruined. According to Lauren, the only time she missed making
his breakfast at 9 am resulted in her body shaking, constant hand tapping, and overall discomfort
because she was worried about her grandfather. Lauren also disliked when things were uneven.
She noticed when things like someone’s shoelaces were uneven and regularly counted the
number of students in her class, including herself, to 17. If she saw that someone’s shoelaces
were uneven, Lauren would either says it in her head or write it down to ease the anxiety felt.
Also, if the number of students counted did not equal 17, Lauren became concerned. These
issues date back to her childhood when she would, for example, count the number of cars on the
street and make her mother go back if they were uneven.
Explain at least three therapeutic communication techniques used by the nurse in the
videos.
Asking open-ended questions, restating for clarification, and encouraging description of
perception are three therapeutic communication techniques practiced by the nurse in the videos.
The nurse employed the open-ended question technique when she asked Lauren if there were any
thoughts she found repeating for her over and over, or any particular kinds of worries. Asking an
open-ended question gives the client a reason to talk about something other than what they’re
saying (Jawad, 2017). The nurse’s open-ended question was helpful to Lauren because it enabled
her to freely share problems so that the nurse could provide her with knowledge, resources, and
guidance. Restating, a second therapeutic communication used by the nurse in the video occurred
when the nurse repeated Lauren’s statement, “Umm… Uh… that umm… I might say something
wrong,” by rephrasing. By restating Lauren’s statement differently, the nurse allowed Lauren to
clarify and continue her thought (Morgan, 2020). A third therapeutic communication technique used by the nurse in the video was “encouraging description of perception.” By asking, “is there
a reason to be concerned about your grandfather?” the nurse encouraged Lauren to describe her
concerns about her grandfather (Morgan, 2020). According to Morgan, asking patients to
verbalize their perceptions helps them develop awareness and understanding (2020).
Discuss at least two nursing interventions appropriate for Lauren. Support your choices
with rationales.
One appropriate nursing interventions for a patient suffering from anxiety and OCD like Lauren
include discussing with the client signs of increasing anxiety and techniques for interrupting the
response, such as breathing exercises, thought stopping, relaxation, and meditation. According to
Gulanick and Meyers, maladaptive behaviors are manifested during times of increased anxiety
(2021). Safety promotion is another appropriate intervention. The nurse accomplishes this by
assessing risks for self-harm and suicide and inspecting the client’s area of dangerous items. Another Intervention is encouraged Lauren to share the seemingly unnatural fears and feelings with others, especially to a nurse therapist. Once the client begins to acknowledge and talk about these fears, it becomes apparent that the feelings are manageable.

References

Cedars Sinai. (2020). How to Stop Nail Biting. https://www.cedars-sinai.org/blog/stop-nailbiting.html
Gulanick, M., & Myers, J. L. (n.d.). Nursing care plans. Nursing Care Plans – 10th Edition.
Retrieved July 21, 2022, from https://www.elsevier.com/books/nursing-careplans/gulanick/978-0-323-71118-0
Jawad Hashim M. Patient-centered communication: Basic skills. Am Fam Physician.
2017;95(1):29-34.
Morgan, K. I. (2020). Davis Advantage for Psychiatric Mental Health Nursing, 10th Edition.
[[VitalSource Bookshelf version]]. Retrieved from vbk://9781719645140

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