10 Exemplars 231
4
The Effectiveness of Sennosides to Decrease
Constipation Post Uterine Artery Embolization
Dana Triplett, BSN, RN, CCRN
Deborah Phillips, RN, CRN
Suzanne Stiffler, BSN, RN, RN-BC
Jane Hauhn, RN, CCRN
Theresa Neskow-Logan, RN
Andrea Staiti, BSN, RN
Brad Cogan, MD
Robert Liddell, MD
David Sill, MD
Mercy Medical Center
Baltimore, Maryland, USA
Practice Question
In interventional radiology, all outpatients receive a follow-up phone call post-
procedure from the interventional nurse coordinator. From these calls, an adverse
trend was noticed with the population of patients who had undergone uterine
artery embolizations (UAE) to treat uterine fibroids. These patients reported hav-
ing difficulty with constipation that sometimes continued for five to ten days. Fi-
broids can press on the outside of the colon, impeding motility, and cause heavy
menstruation requiring iron supplements. These factors alone put women at
risk for chronic constipation. Additionally, opioids are commonly used to man-
age post-procedure cramping and discomfort; and patients often have limited
mobility and minimal oral intake, which can further contribute to constipation.
A retrospective data audit of 25 patients was done, and all 25 reported consti-
pation with no bowel movements for six to ten days post-procedure. Unit staff
discussed this trend at a unit shared governance meeting and agreed to initiate an
