Nursing Diagnosis Plan

 When women are diagnosed with Ovarian Cancer, there are many nursing diagnoses to think about. Some of the most significant ones are:

1. Disturbed body image r/t removal of reproductive organs, or hair loss
2. Acute pain r/t gynecologic surgery 
3. Ineffective sexuality pattern r/t physiologic limitations and mood 
4. Risk for infection r/t immuno-suppressed status in chemo

Scars from traditional "bikini-cut" hysterectomy surgery.  Women may have concerns about body image after a surgery.

Here, I address the different elements of nursing care for a woman with disturbed body image r/t surgery scars and removal of reproductive organs. 
Pt goal: Patient will verbalize positive body image statements, and is able to look at, touch, and talk about the surgery and scars in a comfortable manner.
Nursing Plan: teach patient about the normalcy of grief and the grieving process; help patient identify coping mechanisms that have been useful in the past; introduce patient to support groups for patients experiencing similar struggles; incorporate motivational interviewing into patient interactions

For more information on nursing care for patients with disturbed body image, see these websites:
http://www1.us.elsevierhealth.com/SIMON/Ulrich/Constructor/diagnoses.cfm?did=74
http://medsurggroup6.wikispaces.com/6.+Nursing+Management

Picture from: http://www.healthychief.com/health-news/what-is-ovarian-cancer

 

Nursing Care

Nursing Care for Women with Ovarian Cancer

Women who are being treated for Ovarian Cancer may be undergoing chemotherapy and major surgery, often at the same time. Along with these massive medical treatments, they may be dealing with severe psychological stress and self-image issues because of the effects of the treatment on their bodies. Some common nursing diagnoses for patients with ovarian cancer include:

1. Disturbed body image r/t removal of reproductive organs, or hair loss
2. Acute pain r/t gynecologic surgery 
3. Ineffective sexuality pattern r/t physiologic limitations and mood 
4. Risk for infection r/t immuno-suppressed status in chemo 

Nursing care related to the first diagnosis would include: therapeutic listening, providing information on recovery groups, help patient identify positive changes, teach patient adaptive behavior

Nursing care related to acute pain would include: frequent pain assessment, utilization of pharmacolical and non-pharmacological pain management techniques

Nursing care for ineffective sexuality pattern would include: access to resources, using a relaxed, accepting normalizing approach to talking about sexuality, assisting patient and significant other in exploring and verbalizing fears, thoughts, preferences surrounding sexuality

Nursing care for infection includes: monitoring WBCs, temperature, BP and HR, maintaining sterile technique in administering chemo medications,  scrupulous hand washing, educating on importance of no sick visitors coming to visit

Treatment for Ovarian Cancer

Treatment for Ovarian Cancer

When you first get a diagnosis of Ovarian Cancer, your first question might be, "So what do I do to get rid of it?" There are several different types of treatment for ovarian cancer-- your doctor will recommend one or several, depending on several different factors, including: the type and stage of cancer, possible side effects, the patient’s preferences and overall health, and personal considerations, such as the woman's age and if she is planning to have children. Sometimes, multiple treatments will be used in combination, namely chemotherapy and surgery. Before starting any treatment, it is important to know about side effects, effect on reproductive ability, pain management, and other issues.

Surgery: This is one of the most common treatments for ovarian cancer. The extent of the surgery will depend on the type of cancer, and how far it has spread. Depending on these factors, the surgeon may perform one of several types of hysterectomy. To the right,  you can see that different organs are removed in different situations. The lymph nodes or omentum may also be removed.

Chemotherapy:  Chemo for ovarian cancer is most often a combination of 2 or more drugs, given IV every 3- to 4-weeks. Giving combinations of drugs rather than just one drug alone seems to be more effective in the initial treatment of ovarian cancer. The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule planned for your chemo.


Here you can see how intraperitoneal chemotherapy is administered. Administering chemo directly into the pelvic area ensures that the most concentrated chemo meds come into direct contact with the infected organs (the ovaries, fallopian tubes, uterus, etc). While this type of chemo works very well, the side effects are more severe than that of chemo administered through a different IV site). 

 Hormone Treatment: There are several different types of hormone treatments for ovarian cancer.

1. Luteinizing-hormone-releasing hormone (LHRH) agonists

2. Tamoxifen

3. Aromatase Inhibitors

Common side effects of these hormones include hot flashes, joint pain, bone loss, and osteoporosis. 

For more information on ovarian cancer treatments, research the American Cancer Society's ovarian cancer section, as well as the American Coalition for Ovarian Cancer. 

Photos from Medline Plus.