Hemorrhoids are varicosities in the superior or inferior hemorrhoidal venous plexus. Internal hemorrhoids result from the dilation and enlargement of the superior plexus while external hemorrhoids result from the enlargement and dilation of the inferior plexus. Hemorrhoids are considered to be caused by increased venous pressure in the hemorrhoidal plexus.
- First-degree hemorrhoids may itch because of poor anal hygiene.
- Second-degree hemorrhoids are usually painless and spontaneously return to the anal canal following defecation.
- Third-degree hemorrhoids cause constant discomfort and prolapse in response to an increase in intra-abdominal pressure. They must be manually reduced.
Nursing Care Plans
Nursing management of hemorrhoids depends on the type and severity of hemorrhoid and on the patient’s overall condition. Treatment includes measures to ease pain, combat swelling and congestion, and regulation of the patient’s bowel habits. Patient care includes preoperative and postoperative support.
Here are three (3) nursing care plans (NCP) and nursing diagnosis for patients with hemorrhoids:
Acute Pain
Nursing Diagnosis
- Acute Pain
May be related to
- Hemorrhoidal pain
- GI bleeding
- Gastric mucosal irritation
- Inflammation
- Infection
- Constipation
- Spasm
- Surgery
Possibly evidenced by
- Verbalization of pain
- Fever
- Malaise
- Rectal pain
- Elevated WBC
- Surgical wounds
- Drains
- Tachycardia
- Hypertension
- Tachypnea
- Facial grimacing
- Crying
- Moaning
- Rectal bleeding
- Rectal pruritus
- Rectal burning
Desired Outcomes
- Patient will achieve relief from aches and pain
- Patient will report pain is controlled or eliminated
| Nursing Interventions | Rationale |
|---|---|
| Assess patient for complaints of headaches, sore throat, general malaise or body weakness, muscle aches, and pain. | Caused by inflammation or elevated temperature. |
| Assess VS for changes from baselines | VS are usually increased as result of autonomic response to pain. |
| Administer analgesics as ordered. | Pharmacologic therapy to control pain and aches by inhibiting brain prostaglandin synthesis. |
| Provide restful, quiet environment. | Reduces stimuli that may increase pain. |
| Provide warm baths or heating pad to aching muscles. | Warmth causes vasodilation and decreases discomfort. |
| Provide cool compress to head prn. | Promotes comfort and treats headache. |
| Provide backrubs prn. | Promotes relaxation and relieves aches. |
| Encourage gargling with warm water; provide throat lozenges as necessary. | Reduces throat discomfort. |
| Instruct patient or SO in deep breathing, relaxation techniques, guided imagery, massage and other nonpharmacologic aids. | Helps patient to focus less on pain, and may improve efficacy of analgesics by decreasing muscle tension. |
| Instruct patient or SO regarding use of acetaminophen and to avoid the use of aspirin. | Acetaminophen may relieve pain and headache, but should be used cautiously in patients with liver dysfunction because of acetaminophen metabolism in the liver. Aspirin can potentially cause hemorrhage and ulceration, therefore, must be avoided. |
See Also
You may also like the following posts and care plans:
- Nursing Care Plan: The Ultimate Guide and Database – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
Gastrointestinal Care Plans
Care plans covering the disorders of the gastrointestinal and digestive system:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans
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