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Hemorrhoids

NANDA HemorrhoidsHemorrhoids are massive clumps or cushions of tissue caused by swollen veins in the anal canal. Most people think this condition is abnormal but it is actually very common among men and women. This problem is most often not life threatening but can be painful.

Hemorrhoids are a very common health problem. Hemorrhoids cause serious problems in about 4% (over 10 million) of people in the United States. Prevalence of hemorrhoidal disease increases with age until the seventh decade and then diminishes slightly. Hemorrhoids also increase in pregnancy due to direct pressure on the rectal veins.

The anal canal contains a rich network of arteries that give it a constant supply of blood. This explains why bleeding from hemorrhoids is bright red rather than dark red, and why bleeding from hemorrhoids sometimes can be severe.

Causes

Most common causes of hemorrhoids:
  • straining with bowel movements (from constipation or hard stools)
  • diarrhea
  • constant sitting
  • sitting on the toilet for a long time
  • childbirth
  • pressure of the fetus in pregnant women
  • heavy lifting
  • familial tendency
  • obesity

Types

If the hemorrhoid occurs inside the rectum, it is referred to as an internal hemorrhoid. If it originates at the lower end of the anal canal near the anus, it is referred to as an external hemorrhoid.

Most people do not know they have internal hemorrhoids since they are painless and cannot be seen. External hemorrhoids however can get irritated and clot under the skin, causing a pain.

Symptoms

Symptoms of hemorrhoids include:
  • rectal bleeding
  • pain around the anus and rectum
  • irritation and itching
  • bulge or lump at the anus

Physicians use a grading system to describe the severity of hemorrhoids:

1st degree - Hemorrhoids that bleed but do not prolapse.

2nd degree - Hemorrhoids that prolapse and retract on their own (with or without bleeding).

3rd degree - Hemorrhoids that prolapse but must be pushed back in by a finger.

4th degree - Hemorrhoids that prolapse and cannot be pushed back in.




Nursing Diagnosis for Hemorrhoids Before Surgery

1. Acute Pain

2. Risk for Constipation


Nursing Diagnosis for Hemorrhoids After Surgery

1. Acute pain: the surgical wound

2. Activity intolerance

3. Knowledge Deficit

4. Risk for Infection

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