REPORT INTRODUCTION Nursing care TO PATIENTS WITH HEMORRHOIDS
A. Basic Concepts of Disease
Definition
Hemorrhoids are enlarged varicose veins of the segment / more hemorrhoidal veins (bacon) on the shaft intestine and anus are caused due to muscle and blood vessels around the anus / rectum less elastic so that the liquid is inhibited and enlarged.
Epidemiology
Hemorrhoids are common and occur in approximately 35% occupied more than 25 years old. This situation is not life-threatening but can cause very uncomfortable feeling.
The causes / predisposing
a. Hemorrhoidal plexus venous congestion b. Descent / genetic c. Excess abdominal pressure (Constipation, often straining, pregnancy) d. Sitting too long e. Rectal tumors f. Obesites g. Sexual relations through the anus
Pathophysiology
Hemorrhoids are caused due to the dam within the veins in the hemorrhoidal plexus caused by the triggering factors such as: hemorrhoidal plexus venous congestion, excessive abdominal pressure (constipation, often straining, pregnancy) sitting too long, director tumors, obesity, sexual relations through the anus, not the valve is structurally in hemorrhoidal veins. So that drainage of anorectal area disturbed by the increase in intra-abdominal pressure will also increase the pressure on the hemorrhoidal veins which pose a risk varices rupture and cause bleeding patients will complain bleeding from the anus, sometimes accompanied by pain and the most severe prolapse sometimes complain very painful because it happened thrombus and strangulation.
A. Basic Concepts of Disease
Definition
Hemorrhoids are enlarged varicose veins of the segment / more hemorrhoidal veins (bacon) on the shaft intestine and anus are caused due to muscle and blood vessels around the anus / rectum less elastic so that the liquid is inhibited and enlarged.
Epidemiology
Hemorrhoids are common and occur in approximately 35% occupied more than 25 years old. This situation is not life-threatening but can cause very uncomfortable feeling.
The causes / predisposing
a. Hemorrhoidal plexus venous congestion b. Descent / genetic c. Excess abdominal pressure (Constipation, often straining, pregnancy) d. Sitting too long e. Rectal tumors f. Obesites g. Sexual relations through the anus
Pathophysiology
Hemorrhoids are caused due to the dam within the veins in the hemorrhoidal plexus caused by the triggering factors such as: hemorrhoidal plexus venous congestion, excessive abdominal pressure (constipation, often straining, pregnancy) sitting too long, director tumors, obesity, sexual relations through the anus, not the valve is structurally in hemorrhoidal veins. So that drainage of anorectal area disturbed by the increase in intra-abdominal pressure will also increase the pressure on the hemorrhoidal veins which pose a risk varices rupture and cause bleeding patients will complain bleeding from the anus, sometimes accompanied by pain and the most severe prolapse sometimes complain very painful because it happened thrombus and strangulation.
Classification
Based origin / place causes hemorrhoids can be divided into two:a. Internal hemorrhoidsVarices on the superior hemorrhoidal plexus vein varices (hemorrhoids occur outside the anal sphincter muscle). Internal hemorrhoids are classified into 4:1) Level IVarices of the hemorrhoidal veins of one or more symptoms of bleeding.2) Level IIVarices of one or more of the hemorrhoidal veins on defecation out of the anus but still able to get back on its own.3) Level IIISuch as level II, but after defecation varices could not return spontaneously, should be encouraged.4) Level IVIt's happening thrombus & stangulasib. External hemorrhoidsVarices in the inferior hemorrhoidal plexus veins (hemorrhoids occur inside the anal sphincter muscles)
Clinical Symptoms
a. Internal hemorrhoidsClinical symptoms: bleeding without pain, bleeding fresh red during defecation, prolapse occurs.b. External hemorrhoidsClinical symptoms: pain, itching
Physical examination
In the physical examination found edema of the anus, prolapsed, visible blood out through the anus. In the event of heavy bleeding visible signs of anemia such as the patient looks pale, pale conjunctiva.
Diagnostic Examination
a. Laboratory examination- HB declined, BT / CT for surgical indicationsb. Sigmoidoscopy examination and inspection anaskopi Proctoscopy.c. Rectal touce
Diagnosis
Hemorrhoids Diagnosis is made based on the results of the examination of the anus and rectum area or if the situation is more serious, for example there is a tumor can be examined anaskopi / Proctoscopy.
Therapy / Treatment Measures
a. Medical1) Pharmacological- To soften stool / psilium which can reduce constipation laksansia given drug class.- To reduce / eliminate pain in the anal area used analgesic or group suposituria for internal hemorrhoids.- To stop the bleeding is given anti-coagulant.2) Non-Pharmacological- Improved lifestyle by suggesting multiply the consumption of foods that contain fiber that can soften the stool.- Reduce foods that are too spicy or acidic and alcoholic.- Fix defecation patterns replace closet squat into sitting- Keeping the local area, for example by soaking the anal anal advised not too much sitting / sleeping tired a lot of walking.3) ActionsIf treatment is pharmacological and non farmokologi unsuccessful, action- Skleroskopi hemorrhoids by injecting the drug directly to the bump / prolapse hemoroidnya.- Irrigation rubber band, conducted by binding haemorrhoids, prolapse will wilt and drop out without pain.- Irradiation laser beam- Illuminated by infrared rays- Electrified- Hemoroideolysis
B. Basic Concepts of Nursing Patient Hemorrhoids
Assessment
a. Objective DataIn the external hemorrhoids, most patients complain1) The existence of pain and discomfort in the anal region2) The presence of itching in the anal area3) The swelling on the edge of the anus (protrusion from the anus)4) The presence of excessive mucus in the anus.On the internal hemorrhoids, most patients complain:a) The presence of fresh blood dripping from the anusb) The presence of feces that came out mixed with fresh bloodIn addition, other subjective data that may arise include:a) Patient reveal patterns experienced sexualb) Patients say harsh chapter or said aqueous continuous chapter in a long timec) The patient expresses his diet pattern (less fibrous food) and the lack of drinking water.d) Patient reveal about everyday activities (whether the job requires patients to sit or stand much longer).e) The patient expresses disease history had ever experienced as an enlarged prostate for men and a history of labor in women.f) Patient reveals his ignorance of the disease being experienced.b. Objective data1) Looks for a lump / mass out at the anus (prolapse)2) Anus redness / irritation and looked for pruritus3) The presence of fresh blood dripping out of the anus4) Looks for mucus / mucus even pus coming out of the anus.5) The existence of strangulation in the anal region6) The patient was pale, pale conjunctiva7) Patients seem grimacing and difficult when walking or sitting8) The patient was restless and anxious
Nursing diagnoses
a. Intasi acute pain associated with skin / tissue anus area is characterized by redness of the anus, the patient seemed to grimace.b. Constipation associated with pain during defecationc. The risk of infection associated with rectal prolapse and strangulation aread. PK Anemiae. Damage to the integrity of the skin associated with the presence of edema and pruritus in anal area is characterized by the patient complained of itching and burning in the anal area.f. Activity intolerance related to their mass or prolapse of the rectum is characterized by difficult patients to walk or sit.g. Anxiety associated with psychological factors stimulation by the sympathetic because the inflammatory process is characterized by the patient looked scared.
Based origin / place causes hemorrhoids can be divided into two:a. Internal hemorrhoidsVarices on the superior hemorrhoidal plexus vein varices (hemorrhoids occur outside the anal sphincter muscle). Internal hemorrhoids are classified into 4:1) Level IVarices of the hemorrhoidal veins of one or more symptoms of bleeding.2) Level IIVarices of one or more of the hemorrhoidal veins on defecation out of the anus but still able to get back on its own.3) Level IIISuch as level II, but after defecation varices could not return spontaneously, should be encouraged.4) Level IVIt's happening thrombus & stangulasib. External hemorrhoidsVarices in the inferior hemorrhoidal plexus veins (hemorrhoids occur inside the anal sphincter muscles)
Clinical Symptoms
a. Internal hemorrhoidsClinical symptoms: bleeding without pain, bleeding fresh red during defecation, prolapse occurs.b. External hemorrhoidsClinical symptoms: pain, itching
Physical examination
In the physical examination found edema of the anus, prolapsed, visible blood out through the anus. In the event of heavy bleeding visible signs of anemia such as the patient looks pale, pale conjunctiva.
Diagnostic Examination
a. Laboratory examination- HB declined, BT / CT for surgical indicationsb. Sigmoidoscopy examination and inspection anaskopi Proctoscopy.c. Rectal touce
Diagnosis
Hemorrhoids Diagnosis is made based on the results of the examination of the anus and rectum area or if the situation is more serious, for example there is a tumor can be examined anaskopi / Proctoscopy.
Therapy / Treatment Measures
a. Medical1) Pharmacological- To soften stool / psilium which can reduce constipation laksansia given drug class.- To reduce / eliminate pain in the anal area used analgesic or group suposituria for internal hemorrhoids.- To stop the bleeding is given anti-coagulant.2) Non-Pharmacological- Improved lifestyle by suggesting multiply the consumption of foods that contain fiber that can soften the stool.- Reduce foods that are too spicy or acidic and alcoholic.- Fix defecation patterns replace closet squat into sitting- Keeping the local area, for example by soaking the anal anal advised not too much sitting / sleeping tired a lot of walking.3) ActionsIf treatment is pharmacological and non farmokologi unsuccessful, action- Skleroskopi hemorrhoids by injecting the drug directly to the bump / prolapse hemoroidnya.- Irrigation rubber band, conducted by binding haemorrhoids, prolapse will wilt and drop out without pain.- Irradiation laser beam- Illuminated by infrared rays- Electrified- Hemoroideolysis
B. Basic Concepts of Nursing Patient Hemorrhoids
Assessment
a. Objective DataIn the external hemorrhoids, most patients complain1) The existence of pain and discomfort in the anal region2) The presence of itching in the anal area3) The swelling on the edge of the anus (protrusion from the anus)4) The presence of excessive mucus in the anus.On the internal hemorrhoids, most patients complain:a) The presence of fresh blood dripping from the anusb) The presence of feces that came out mixed with fresh bloodIn addition, other subjective data that may arise include:a) Patient reveal patterns experienced sexualb) Patients say harsh chapter or said aqueous continuous chapter in a long timec) The patient expresses his diet pattern (less fibrous food) and the lack of drinking water.d) Patient reveal about everyday activities (whether the job requires patients to sit or stand much longer).e) The patient expresses disease history had ever experienced as an enlarged prostate for men and a history of labor in women.f) Patient reveals his ignorance of the disease being experienced.b. Objective data1) Looks for a lump / mass out at the anus (prolapse)2) Anus redness / irritation and looked for pruritus3) The presence of fresh blood dripping out of the anus4) Looks for mucus / mucus even pus coming out of the anus.5) The existence of strangulation in the anal region6) The patient was pale, pale conjunctiva7) Patients seem grimacing and difficult when walking or sitting8) The patient was restless and anxious
Nursing diagnoses
a. Intasi acute pain associated with skin / tissue anus area is characterized by redness of the anus, the patient seemed to grimace.b. Constipation associated with pain during defecationc. The risk of infection associated with rectal prolapse and strangulation aread. PK Anemiae. Damage to the integrity of the skin associated with the presence of edema and pruritus in anal area is characterized by the patient complained of itching and burning in the anal area.f. Activity intolerance related to their mass or prolapse of the rectum is characterized by difficult patients to walk or sit.g. Anxiety associated with psychological factors stimulation by the sympathetic because the inflammatory process is characterized by the patient looked scared.
