Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside the uterus, causing pain, inflammation, and potential fertility issues. This nursing diagnosis focuses on managing symptoms, preventing complications, and improving quality of life.
Causes (Related to)
Endometriosis can affect patients in various ways, with several factors contributing to its severity and progression:
- Retrograde menstruation
- Genetic predisposition
- Immune system disorders
- Hormonal imbalances
- Environmental factors
- Previous pelvic surgery
- Early onset of menstruation
- Short menstrual cycles
- Heavy menstrual periods
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Chronic pelvic pain
- Painful menstruation (dysmenorrhea)
- Pain during intercourse (dyspareunia)
- Pain during urination or bowel movements
- Lower back pain
- Infertility concerns
- Fatigue
- Emotional distress
Objective: (Nurse assesses)
- Irregular menstrual patterns
- Pelvic tenderness on examination
- Visible endometrial lesions during laparoscopy
- Enlarged ovaries
- Adhesions
- Bloating
- Changes in bowel habits
- Elevated inflammatory markers
Expected Outcomes
- The patient will report decreased pain levels
- The patient will demonstrate effective pain management strategies
- The patient will maintain adequate nutrition
- The patient will express an understanding of the condition and treatment plan
- The patient will report an improved quality of life
- The patient will demonstrate effective coping mechanisms
- The patient will maintain regular activities of daily living
Nursing Assessment
Pain Assessment
- Evaluate pain characteristics
- Document pain patterns
- Assess the impact on daily activities
- Monitor response to pain interventions
Reproductive Health Assessment
- Track menstrual patterns
- Document fertility concerns
- Assess sexual health impact
- Monitor for complications
Psychological Assessment
- Evaluate emotional status
- Assess coping mechanisms
- Document support systems
- Monitor for depression/anxiety
Physical Assessment
- Monitor vital signs
- Assess abdominal/pelvic symptoms
- Document systemic manifestations
- Evaluate nutritional status
Nursing Care Plans
Nursing Care Plan 1: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to endometrial tissue inflammation and adhesions as evidenced by reported pelvic pain, dysmenorrhea, and disrupted daily activities.
Related Factors:
- Inflammatory process
- Endometrial implants
- Adhesion formation
- Pressure on surrounding organs
Nursing Interventions and Rationales:
- Assess pain characteristics and patterns
Rationale: Establishes baseline for pain management - Administer prescribed medications
Rationale: Provides pain relief and reduces inflammation - Teach non-pharmacological pain management
Rationale: Enhances pain control and promotes self-management
Desired Outcomes:
- The patient will report decreased pain intensity
- The patient will demonstrate effective pain management techniques
- The patient will maintain normal daily activities
Nursing Care Plan 2: Anxiety
Nursing Diagnosis Statement:
Anxiety related to chronic conditions and fertility concerns as evidenced by expressed worry, restlessness, and sleep disturbances.
Related Factors:
- Chronic health condition
- Fertility concerns
- Treatment uncertainties
- Impact on relationships
Nursing Interventions and Rationales:
- Provide emotional support
Rationale: Reduces anxiety and promotes coping - Teach relaxation techniques
Rationale: Helps manage stress and anxiety symptoms - Facilitate support group connections
Rationale: Provides peer support and resources
Desired Outcomes:
- The patient will demonstrate reduced anxiety levels
- The patient will utilize effective coping strategies
- The patient will verbalize feelings appropriately
Nursing Care Plan 3: Disturbed Body Image
Nursing Diagnosis Statement:
Disturbed Body Image related to treatment effects and physical changes as evidenced by dissatisfaction and altered relationship patterns.
Related Factors:
- Physical changes
- Surgical scarring
- Weight changes
- Treatment side effects
Nursing Interventions and Rationales:
- Assess body image concerns
Rationale: Identifies specific areas of distress - Provide supportive counseling
Rationale: Helps patient develop a positive self-image - Connect with support resources
Rationale: Facilitates peer support and coping strategies
Desired Outcomes:
- The patient will express improved body image
- The patient will demonstrate self-acceptance
- The patient will maintain healthy relationships
Nursing Care Plan 4: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to complex nature of condition as evidenced by questions about treatment options and expressed uncertainty about self-care.
Related Factors:
- Complex medical condition
- Multiple treatment options
- Varied symptoms
- Long-term management needs
Nursing Interventions and Rationales:
- Provide disease education
Rationale: Increases understanding and compliance - Teach self-management strategies
Rationale: Promotes independence and control - Review medication management
Rationale: Ensures proper treatment adherence
Desired Outcomes:
- The patient will demonstrate an understanding of the condition
- The patient will effectively manage symptoms
- The patient will adhere to the treatment plan
Nursing Care Plan 5: Impaired Social Interaction
Nursing Diagnosis Statement:
Impaired Social Interaction related to chronic pain and fatigue as evidenced by decreased social activities and altered relationship patterns.
Related Factors:
- Chronic pain
- Fatigue
- Depression
- Treatment demands
Nursing Interventions and Rationales:
- Assess the social support system
Rationale: Identifies available resources - Encourage social activities
Rationale: Maintains social connections - Teach energy conservation
Rationale: Enables participation in social activities
Desired Outcomes:
- The patient will maintain social relationships
- The patient will participate in desired activities
- The patient will report improved quality of life
References
- Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, Saridogan E, Tomassetti C, van Hanegem N, Vulliemoz N, Vermeulen N; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009. doi: 10.1093/hropen/hoac009. PMID: 35350465; PMCID: PMC8951218.
- Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Res. 2019 Apr 23;8:F1000 Faculty Rev-529. doi: 10.12688/f1000research.14817.1. PMID: 31069056; PMCID: PMC6480968.
- Santulli, P., Giraudet, G., Estrade, J., Indersie, E., Morin, S., Solignac, C., Arbo, E., & Roman, H. (2024). Impact of endometriosis on partners: Results from the French EndoVie survey. European Journal of Obstetrics & Gynecology and Reproductive Biology, 303, 310-316. https://doi.org/10.1016/j.ejogrb.2024.10.040
- Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
- Wang PH, Yang ST, Chang WH, Liu CH, Lee FK, Lee WL. Endometriosis: Part I. Basic concept. Taiwan J Obstet Gynecol. 2022 Nov;61(6):927-934. doi: 10.1016/j.tjog.2022.08.002. PMID: 36427994.
