ABCs  A - airway  B - breathing  C – circulation Uterine Leiomyoma  Benign, slow growing solid tumors of the muscle layer of the uterus (fibroids)  Excessive local growth of smooth muscle tissues o Growth may be stimulated by estrogen, progesterone, and growth hormone Assessment: asymptomatic or symptomatic (heavy prolonged vaginal bleeding)**  Assess pelvic pressure, elimination pattern, abdomen size, dyspareunia, infertility  Painful menses  Elimination patterns (due to enlarged fibroid pressing on organs)  Ask how many pads/tampons used in a day S/S: Heavy periods or periods that last a long time & abd distention, urinary frequency Psychosocial assessment:  Quality of life from dyspareunia  Fear that symptoms could be cancerous  Anxiety  Significance of loss of uterus for patient and partner if want to conceive Diagnostic assessment:  CBC – iron deficiency anemia from heavy bleeding  WBC would be normal  HGB and HCT – low  Pregnancy test to rule out uterine enlargement  Transvaginal US – able to see if fibroid is protruding into uterine cavity  Biopsy: gold standard Pelvic exam Planning and Implementation  Manage bleeding o Non-surgical management: oral contraceptive** o Surgical management:  MRI focused ultrasound-heat to tumor  Uterine artery embolization – starves tumor of circulation allowing it to shrink