RAFIN - Management of The Client With Cervical - Ovarian-Cancer and Hysterectomy
RAFIN - Management of The Client With Cervical - Ovarian-Cancer and Hysterectomy
PRETEST
SITUATION: Celia, a 33-year old woman underwent a loop electrosurgical excision procedure
(LEEP) for cervical cancer 1 week ago. Pathology reports confirmed the cancer was preinvasive
and due to dysplasia. The client is greatly relieved, but understands she will have to maintain
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Preinvasive and Invasive are both stages of cervical cancer. As the term implies, they differ
mainly according to the extent of invasion of carcinoma in the cervix. Preinvasive usually is at zero stage
where carcinoma is detected at the situ, technically classified as severe dysplasia, but is only limited to
the epithelial layer. In preinvasive, there’s no evidence of invasion. If the cancer progresses and
carcinoma is detected with little invasion, this stage is what we call then, invasive cervical cancer.
Invasive cervical cancer comprises 4 stages; 1 st stage with lesions identified at the cervix microscopically
using Pap smear; 2nd stage when carcinoma extends beyond the cervix but not unto the pelvic wall; 3 rd
stage, carcinoma extends to one or both pelvic walls, and; the 4 th stage where carcinoma extends beyond
the true pelvis, extending to the adjacent organs, and further extend to distant organs.
2. Cite three goals of collaboration care for the client with preinvasive cancer of the cervix.
First, on the detection of lesions or dysplasia by the use of colposcopy and biopsy, and
Second is on the treatment or removal of abnormal cells using conservative treatments such as
cryotherapy or laser therapy. A loop electrocautery excision procedure is used to cut away a thin layer of
cervical tissue and allows the pathologist to examine the removed tissue sample to determine if the
The nurse then should perform his/her responsibility by giving patient’s education, answering
questions and explaining every procedure that will be done to the patient. Relieving anxiety and coping
3. What can the nurse do to help the client with invasive cervical cancer cope with the situation
Patients diagnosed with invasive cervical cancer usually undergo procedures such as
hysterectomy. The nurse should help prepare the patient prior to the procedure. Patients during this
situation, they are high risk for anxiety and fear, therefore the nurse should first assess data which
includes psychosocial responses because the procedure may elicit strong emotional reactions and fears.
The nurse should allow the patient to ask questions, provide necessary information about the procedure
and assist the patient in expressing her feelings to relieve the patient’s anxiety and therefore establishing
the patient’s cooperation. Administering pain reliever prior to the surgery is administered as prescribed by
the doctor. Assessment of patient’s allergies is also a must to for the health care team to become
SITUATION: A 62-year old female client is being evaluated for possible ovarian cancer. She has
been experiencing vague GI symptoms and urinary urgency for several months. The primary care
provider has discovered a small pelvic mass and has ordered a group of diagnostic studies.
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PAP Test has of limited value in diagnosing ovarian cancer. This is due to the location and time
to when an ovulation occurs. PAP Test is usually used in the detection of the cervical cancer. This test is
done by gently scrapping the cervix to get a sample for the test. Ovarian cancer cells are located in the
ovaries. Ovaries releases an egg every month. This egg travels away from the ovaries through the
fallopian tubes and uterus to the area around the cervix. There is small chance that ovarian cancer cells
may come after as the egg travels. In this case, there is also a small chance that ovarian cancer cells are
collected during a PAP Test. These chances are very rare. One thing, studies reveal that there is no
extent of pathologic process and sometimes to confirm a diagnosis. Exploratory surgery is used with
cancer patients especially during staging to assess the extent of a cancerous growth.
The stages of ovarian cancer are determined by measuring the extent of the tumor. This is
The treatment of choice for clients with ovarian cancer is surgical removal. Procedures such as
abdominal hysterectomy with removal of the fallopian tubes, bilateral salpingo-oophorectomy and
omentectomy which is the removal of the omentum, are include for the standard procedure for early
disease.
Critical Thinking Exercise:
SITUATION: A 53-year old woman with dysfunctional uterine bleeding underwent an abdominal
hysterectomy and oophorectomy this morning. Her VS are stable and her dressing is dry and
intact. She is able to administer her own pain medication by means of PCA (Patient-controlled
analgesia).
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Other assessments should include patient’s psychological responses, because the patient
undergoing hysterectomy may elicit strong emotional reaction. Patient is also at high risk for anxiety
related to fear of cancer and its possible consequences may contribute to stress of the patient and her
family. Women who have had a hysterectomy may be at risk for psychological and physical symptoms.
Alternatively, women may note improved physical and mental health after hysterectomy as troublesome
2. How can a hysterectomy have both a negative and positive effect on a woman’s image?
Hysterectomy is a procedure where in the uterus is removed, and the removal of uterus means
women can no longer have period nor get pregnant. This could be positive in a sense that it is done to
treat cancer, dysfunctional uterine bleeding, endometriosis, nonmalignant growths, persistent pain, etc.
however even though there is no significant change in the women's appearances after a hysterectomy, the
feeling of insufficiency significantly affects body image especially the role of every women to conceive,
the feeling that they cannot fulfill that certain role of their gender.
3. Agree with or refute the idea that women undergoing a vaginal hysterectomy have fewer
laparoscopic hysterectomy, since vaginal hysterectomy usually is least invasive procedure thus this only
involves shorter stay in the hospital. However, the condition/disease of the patient should be considered in
choosing which hysterectomy is suitable for the patient to ensure the efficacy and safety of the operation,
the most minimally invasive surgery should be chosen and VH appears to have advantages over AH in the
Cancer, simply the word itself is sufficient to scare us and when it comes to dealing with
someone who is diagnosed with cancer, it turns into even more difficult one.
Cancer is an ailment which brings a variety of emotions and change normal life processes that
give adjustments hastily for a patient, the bodily remedy is taken care of by way of the medical doctors
however the mental health of the affected person have to be delicately dealt with through their friends and
family due to the fact that the pace of recuperation or the afterlife of the patient relies upon totally upon
love, care and help from their caregivers and family. There is no denying that it is difficult to start a
conversation with the person who has cancer, however staying in touch be preferred than staying away.
The first thing, we must put together ourselves emotionally before we deal with the person having
cancer. Know about what cancer the patient is diagnosed with, where he/she is being treated and what
kind of treatments the character is going through. It helps you to let you slip into their shoe and think
from their perspective. You are also ought to be honest with your feeling with them. From the topics that
we had been discussed, the following are the thoughts one must possess when dealing with a patient with
cancer:
Never pity them. That’s the last thing they deserve. Listen to them carefully and take a cue of
that. Choose your words carefully as they are very sensitive during cure and their emotional outburst is
Don’t compare one affected person with every other one even they share the same kind of cancer,
rather share motivating stories and books. Remember everyone’s sickness is distinct from another. You
can assist the patient with day by day activities, that’s one of the best helps you can ever do to them
Lastly, motivate them to stay positive. Help their family and caregivers. When a patient is aware
of that human beings are there to take of their cherished ones, it comforts them.