MENORRHAGIA

DEFINITION

Menstrual bleeding that last more then 7 days. Its It can also be bleeding that is very heavy.

TYPE

1.Polymenorrhe: too frequent menstruation

2.Oligomenorrhea: infrequent or light menstrual cycles

3.Metrorrhagia: any irregular, acyclic non-menstrual bleeding from the uterus; bleeding between menstrual periods

4.Postmenopausal bleeding: any bleeding that occurs more than 6 months after the last normal menstrual period at menopause

ETIOLOGY

1.Uterine related problem

2.Hormone-related problems

3.Other illness or disorder

PATHOPHYSIOLGY

1.Due to etiological factor

2.Disruption of normal menstrual cycle

3.Excessive bleeding

CLINICAL MANIFESTATION

.• Have a menstrual flow that soaks through one or more pads or tampons every hour for several hours in a row.

• Need to double up on pads to control your menstrual flow.

• Need to change pads or tampons during the night.

• Have menstrual periods lasting more than 7 days.

• Have a menstrual flow with blood clots the size of a quarter or larger

• Have a heavy menstrual flow that keeps you from doing the things you would do normally.

• Have constant pain in the lower part of the stomach during your periods.

• Are tired, lack energy, or are short of breath

INVESTIGATION

1.History Taking & Physical Examination

2.Blood Test: Full Blood Count

3.Radiology & Imaging: Ultrasound

Other: Pap test, Endometrial biopsy, o Dilation and Curettage (D&C)

DIFFEREANTIAL DIAGNOSIS

1.Adnexal Tumors

2.Cervicititis

3.Endometritis

4.Hyperprolactinemia

5.Hypothyroidism

6.Vaginitis

MANAGEMENT

1.Medication

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-NSAIDs – Ibuprofen, naproxen sodium

-Tranexamic acid

-Oral Contraceptives

-Oral progesterone

-Hormonal IUD

2.Procedure

1.Dilation and Curettage (D&C)

2.Uterine artery embolization

3.Myomectomy

4.Hysterectomy

3.Nursing Care

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  1. Rest in bed according to supine or recumbent, semi flower and flower position.
  1. Taking and monitoring vital sign such blood pressure, pulse rate, respiration rate,

temperature and pain score for show progress toward recovery.

  1. Insert and monitoring intravenous normal saline drip to avoid electrolyte imbalance.
  1. Administration medication according to prescription such as right patient, right medication,

right dosage, right route, right time, right documentation, right refuse.

  1. Taking blood specimen and labeling sample for investigation purpose.
  1. Record tracking and saving documentation for support diagnosis and as proof of activities.

7.Give health advice or health education.

8.Record and document input and output chart.

9.Assess for sign of bleeding

4.Health Education

-

1.Attending follow up treatment according to the time and date given by doctor.

2.Take the medication with correct dosage and timing according to doctor prescription such as 2 time per day (BD), 3 time per day (TDS), 4 time per day (QID), Immediately (Stat) and when necessary (PRN).

3.Consume a balance diet based on the food pyramid such as intake of high protein food, carbohydrate food, vegetables and fruits.

4.Encourage drinking 8 glasses of boiled water a day to prevent dehydration in the body. Avoid drinking alcohol and smoking cigarettes because it can affect the health.

5.practice a healthy and active lifestyle by doing light exercise such as jogging, walking, yoga and so on for a speedy recovery capabilities.

COMPLICATION

1.Anemia

2.Severe pain

PROGNOSIS

•Can cure with early treatment
•Cannot cure if late or no treatment, can leads to severe complication

REFERENCES

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• Centers for Disease Control and Prevention (CDC). (n.d.). Menorrhagia. Retrieved from https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html

• Columbia University Department of Obstetrics and Gynecology. (n.d.). Menorrhagia. Retrieved from https://www.columbiadoctors.org/treatments-conditions/menorrhagia

• Mayo Clinic Staff. (n.d.). Menorrhagia - Diagnosis and treatment. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/drc-20352834

• Medscape. (n.d.). Menorrhagia Differential Diagnoses. Retrieved from https://emedicine.medscape.com/article/255540-differential#1

• Nurseslabs. (n.d.). Risk for Bleeding (Nursing Care Plan) & Management. Retrieved from https://nurseslabs.com/risk-for-bleeding/#google_vignette