NCM 112 Cervical Cancer PDF

NCM 112: CERVICAL CANCER ASSESSMENT 1. Painless vaginal postmenstrual and postcoital bleeding 2.Foul-smelling or...

NCM 112: CERVICAL CANCER ASSESSMENT 1. Painless vaginal postmenstrual and postcoital bleeding 2.Foul-smelling or serosanguineous (PINK) vaginal discharge 3. Pelvic, lower back, leg, or groin pain 4. Anorexia and weight loss 5. Leakage of urine and feces from the vagina (fistula or opening is created between bladder and vaginal canal) 6. Dysuria (PAINFUL URINATION) 7. Hematuria (BLOOD IN URINE) 8. Cytological changes on Pap test - The cervix is the opening to the uterus. - Women get Pap Smear tests (ONLY FOR CERVICAL CANCER) to watch out for cancer in the cells of the cervix. - Cervical cancer is rare but curable when caught early. Cervix viewed through speculum with patient in lithotomy position. It shows a rough lesion on the cervix. DIAGNOSIS 1. Preinvasive cancer is limited to the cervix 2. Invasive cancer is in the cervix and other pelvic structures. 3. Metastasis usually is confined to the pelvis, but distant metastasis occurs through lymphatic spread. 4. Premalignant changes are described on a continuum from dysplasia, which is the earliest premalignancy change, to carcinoma in situ, the most advanced premalignant change. RISK FACTORS Smoking HPV infection Weak immune system Family history Long-term use of birth control pills Multiple sexual partners MRPP © 2022 l NOTES BY: BRYLE JUSTIN L. MAMON 90 1st SEMESTER l ENDTERM SIDE SURGICAL visualizing cancer cannot diagnosed Conization - remove cancer and surrounding who can undergo HIV testing? As long as menstruation tissues has started (15 years old and above). Hysterectomy - removal of uterus including the Punch biopsy - needle punch in your cervix to obtain cervix tissue Pelvic exenteration - remove uterus, cervix, Cone biopsy - removal of tissue and lesion fallopian tube, colon, ovary and bladder LEEP - similar to cone biopsy, but you obtain dome shape using heat and electricity to cut through the tissue. TREATMENT NON-SURGICAL Chemotherapy Cryosurgery - external surgical procedure using freezing probe to freeze cancer cells so it will die. External radiation Internal radiation implants (intracavitary) - probe is inserted intravaginally where radio isotopes are found. All bodily fluids of woman are considered radioactive. Laser therapy SIDE TIME - stay with the patient for 30 mins within 8-hour shift SHIELDING - use LED apron DISTANCE - Maximum distance is 3 ft away from the pt. Instruct pt to flush toilet twice. PELVIC EXENTERATION (PE) - is ultraradical surgery pioneered first in gynecological oncology in 1948 by Brunschwig for advanced cancer. This surgery removes basically all the pelvic organs including not only the uterus, ovaries, and vagina, but also the adjacent organs, which are bladder and rectosigmoid colon. MRPP © 2022 l NOTES BY: BRYLE JUSTIN L. MAMON 10 1st SEMESTER l ENDTERM 0 TOTAL PERVIC EXENTRATION SURGERY (organ removed in blue) POSTOPERATIVE INTERVENTIONS a. Monitor vital signs – Calcium leaked causes hypercalcemia and results to weakness and heart is irritable – Hypocalcemia causes tetany b. Assist with coughing and deep-breathing exercises. c. Assist with range-of-motion exercises and provide early ambulation. d. Apply antiembolism stockings or sequential compression devices as prescribed. – because if there is emboli it could lead to stroke and pulmonary embolism which is fatal e. Monitor intake and output, Foley catheter drainage, and hydration status. f. Monitor bowel sounds. – Bowel sounds indicate peristalsis g. Assess incision site for signs of infection. – Infection leads to fever, redness, swelling or edema and pain h. Administer pain medication as prescribed. i. Instruct the client to limit stair climbing for 1 month as prescribed and to avoid tub baths and sitting for long periods. j. Avoid strenuous activity or lifting anything weighing more than 20 pounds. k. Instruct the client to consume foods that promote tissue healing. l. Instruct the client to avoid sexual intercourse for 3 to 6 weeks as prescribed. m. Instruct the client in the signs associated with complications. MRPP © 2022 l NOTES BY: BRYLE JUSTIN L. MAMON 11 1st SEMESTER l ENDTERM 0