Nursing Care Plan for Hemorrhoids

Hemorrhoids, also called "'piles," are swollen tissues that contain veins. They are located in the wall of the rectum and anus and may cause minor bleeding or develop small blood clots. Hemorrhoids occur when the tissues enlarge, weaken, and come free of their supporting structure. This results in a sac-like bulge that extends into the anal area.

Hemorrhoids are unique to humans - no other animal develops them. They are very common - up to 86% of people will report they have had hemorrhoids at some time in their life, though people often use this as a catch-all label for any ano-rectal problem including itching. They can occur at any age but are more common as people get older. Among younger people, they are most common in women who are pregnant.

Although they can be embarrassing to talk about, anyone can get hemorrhoids, even healthy young people in good shape. They can be painful and annoying but aren't usually serious. Hemorrhoids differ depending on their location and the amount of pain, discomfort, or aggravation they cause.

Internal hemorrhoids are located up inside the rectum. They rarely cause any pain, as this tissue doesn't have any sensory nerves. These hemorrhoids are graded for severity according to how far and how often they protrude into the anal passage or protrude out of the anus (prolapse):

• Grade I is small without protrusion. Painless, minor bleeding occurs from time to time after a bowel movement.
• A grade II hemorrhoid may protrude during a bowel movement but returns spontaneously to its place afterwards.
• In grade III, the hemorrhoid must be replaced manually.
• A grade IV hemorrhoid has prolapsed - it protrudes constantly and will fall out again if pushed back into the rectum. There may or may not be bleeding. Prolapsed hemorrhoids can be painful if they are strangled by the anus or if a clot develops.

External hemorrhoids develop under the skin just inside the opening of the anus. The hemorrhoids may swell and the area around it may become firm and sore, turning blue or purple in colour when they get thrombosed. A thrombosed hemorrhoid is one that has formed a clot inside. This clot is not dangerous and will not spread through the body, but does cause pain and should be drained. External hemorrhoids may itch and can be very painful, especially during a bowel movement. They can also prolapse. (bodyandhealth.canada.com)
hemorrhoids

Nursing Assessment for Hemorrhoids

1. The identity of patients


2. The main complaint
   Patients came with complaints of continuous bleeding during defecation. There was a lump in the anus or pain during defecation.


3. History of disease
   • History of present illness
     Patients were found in a few weeks there was only a bump coming out and a few days after defecation there is blood dripping out.
   • Past history of disease
     Have there been previous hemorrhoidal disease, heal / reoccur. In patients with hemorrhoids when not in doing the surgery will be back.
   • Family history of disease
     Are there family members who suffer from the disease
   • Social History
     Disease in question to be asked.

Pre-operative and Post-operative Nursing Diagnosis Nursing Care Plan for Hemorrhoids

Pre-operative Nursing Diagnosis and Nursing Interventions

Impaired sense of comfort: acute pain related to the mass of the anal or anus, anal area marked lumps, pain and itching in the anal region

PURPOSE:
To fulfill the criteria of comfort with reduced pain itching reduced mass decreases.

INTERVENTION:

1. Give soak seat
Rationalization: Reduce local discomfort, reduce edema and promote healing.

2. Give lubricant during defecation would

Rationalization: Assist in the conduct of defecation so it does not need straining.

3. Give a diet low in residual
Rationalization: Reduce stimulation of the anus and weaken the feces.

4. Instruct the patient to do a lot of standing or sitting (must be in balance).
Rationalization: The force of gravity will affect the incidence of hemorrhoids and sitting can increase intra-abdominal pressure.

5. Observation of patient complaints
Rationalization: It helps to evaluate the degree of discomfort and lack of effectiveness of actions or states of complications.

6. Provide an explanation of the emergence of pain and explain briefly
Rationalization: Education about it helps in patient participation to prevent / reduce pain.

7. Give the patient suppository
Rationalization: It can soften the stool and can reduce the patient to avoid straining during defecation.

Post-operative Nursing Diagnosis and Nursing Interventions

Impaired sense of comfort: acute pain related to the sutures in surgical wound

PURPOSE:
Fulfillment of comfort with the criteria there is no pain, and patients can perform light activity.

INTERVENTION:

1. Give the patient a pleasant sleeping position.
Rationalization: May decrease the voltage of the abdomen and increase the sense of control.

2. Change the bandage every morning according to aseptic techniques
Rationalization: Protecting the patient from cross contamination during replacement of bandages. Wet bandage acts as an absorber of external contamination and cause discomfort.

3. Exercise road as early as possible
Rationalization: It can reduce the problems that occur due to immobilization.

4. Observation of the rectal area if there is bleeding
Rationalization: Bleeding on the network, local imflamasi or the occurrence of infection may increase the pain.

5. Chimney anus is released according to physician advice (orders)
Rationalisation: Improve physiological functions anus and gives comfort to the patient's anal region because there is no blockage.

6. Provide an explanation of the purpose of installation of flue-anus (anus to funnel to drain the remnants of bleeding that occurs in order to get out).
Rationalization: Knowledge of the benefits of the chimney can make the patient understand the anus to funnel anus to cure the wound.

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