CERVICAL CANCER

PRETEST

Rafin, Marinel F. BSN III-D

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I. Read and analyze each question and encircle the best answer.
1. Which is the most common type of cervical cancer?
a. Adenocarcinoma
b. Squamous cell carcinoma
c. Adenoquamous carcinoma
d. All of the above
2. Which of the following is not a risk factor for cervical cancer?
a. Smoking
b. History of genital warts
c. High socio-economic status
d. Micronutrient deficiency
3. What remains the gold standard for determining ovarian cancer staging?
a. Blood tests
b. Imaging
c. Surgery
d. Palliation
4. Where does ovarian cancer occur?
a. On the tissue within the ovary
b. On the surface of the ovary
c. In egg-forming germ cells within the ovary
d. Any of these
5. Who is the most at risk for developing ovarian cancer?
a. A woman who has had multiple children
b. A woman who is underweight
 c. A woman over the age of 60
d. Any of the above
6. Which of the following is usually one of the earliest symptoms of uterine cancer?
a. Abnormal or excessive bleeding without pain
b. Excessive bleeding and pelvic pain
c. Abdominal pressure and watery discharge
d. Enlarged lymph nodes
7. Which treatment option/s are best while the cancer is still localized to the uterus?
a. Surgery
b. Hormone therapy
c. Surgery and chemotherapy
d. Surgery and hormone therapy
8. Which of the following is considered a main risk factor and a necessary cause of cervical
cancer?
a. Human Toro virus
b. Human papillomavirus
c. Rotavirus
d. Coronavirus
9. Which of the following tests can be used to detect precancerous stages of cervical cancer?
a. Mammography
b. Pap test
c. Blood test
d. Cone Biopsy
10. High fat diet may be factor in the development of certain cancer of the:
a. Breast and colon
b. Prostate
c. Uterine
d. All of the above

Critical Thinking Exercise:

 Nursing Management of the client with Cervical Cancer

Rafin, Marinel F. BSN III-D

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

close follow-up care for the next few years.

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1. How does preinvasive differ from invasive cervical cancer?

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

monitoring by the use of Pap smear.

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

borders of the tissue are disease free.

Lastly, if it occurs on a woman who has completed childbearing, a hysterectomy is usually

recommended, and if not, biopsy is recommended.

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

up of patient’s knowledge insufficiency is a prime duty.

3. What can the nurse do to help the client with invasive cervical cancer cope with the situation

while she is being prepared for a treatment such as hysterectomy.

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

precautions about drugs.

Critical Thinking Exercise:

Nursing Management of the client with Ovarian Cancer

Rafin, Marinel F. BSN III-D

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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1. Why is a PAP (Papanicolaou) Test of limited value in diagnosing ovarian cancer?

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

standard or routine screening test for ovarian cancer.

2. What is the purpose of exploratory surgery?

Exploratory surgery is a type of diagnostic procedure. It is frequently performed to determine the

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.

3. What are the stages of Ovarian Cancer?

The stages of ovarian cancer are determined by measuring the extent of the tumor. This is

important for direct treatment

 Stages of Ovarian Cancer
Stage I Growth limited to the ovaries
Stage II Growth involves one or both ovaries with pelvic extension
Growth involves one or both ovaries with pelvic extension
Stage III
or positive retroperitoneal or inguinal nodes
Growth involves one or both ovaries with distant
Stage IV
metastases.

4. What is the treatment of choice for clients with ovarian cancer?

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:

Nursing Management of the client with Hysterectomy

Rafin, Marinel F. BSN III-D

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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1. What other assessments need to be made by the nurse?

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

symptoms may be alleviated.

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

problems than women undergoing an abdominal hysterectomy?

Vaginal hysterectomy generally causes fewer complications than abdominal or

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

treatment of benign gynecological diseases.

 Reflection

Rafin, Marinel F. BSN III-D

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

unpredictable. Talk to them about things aside from cancer.

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.