METRO COLLEGE OF NURSING

Lesson plan
NAME: MR.AVADHESH KUMAR

GROUP: GNM II YEAR

VENUE: 403, 4TH FLOOR

DATE: 27/03/2018

TOPIC: OVARIAN CANCER

SUBJECT: MEDICAL SURGICAL NURSING 2ND

PREVIOUS KNOWLEDGE: students have previous knowledge about the ovarian cancer

OBJECTIVES:

GENERAL OBJECTIVE:

The students will be able to understand about ovarian cancer and its meaning, risk factors, clinical
manifestations, stages, types ,diagnostic methods, management including nursing management.

SPECIFIC OBJECTIVES:

The students will be able to:

 Define ovarian cancer and its meaning.

 Explain its Risk factors and clinical manifestations.
 Explain types of ovarian cancer.
 Explain stages of ovarian cancer.
 Explain about the various diagnostic methods.
 Explain the management including nursing management.
SPECIFIC CONTENT TEACHING/
OBJECTIVES LEARNING
ACTIVITIES
To Define Ovarian cancer is a cancer that forms in or on an ovary. It results in Lecture cum
Ovarian cancer abnormal cells that have the ability to invade or spread to other parts of the discussion
and its meaning. body. Symptoms may include bloating, pelvic pain, abdominal swelling,
and loss of appetite, among others. Common areas to which the cancer may
spread include the lining of the abdomen, lymph nodes, lungs, and liver.
To Explain risk Risk factors :- Lecture cum
factors Hormones :- discussion
 Polycystic ovary syndrome (androgens)
 Endometriosis
 Postmenopausal hormone replacement therapy (HRT)
 family history of ovarian cancer
Genetic :-
 Hereditary nonpolyposis colorectal cancer
 BRCA1 or BRCA2 gene mutation
 first-degree relative
 Icelandic descent, European Jewish descent/Ashkenazi Jewish
descent, and Hungarian descent
 Peutz–Jeghers syndrome
 Sex cord /gonadal tumour

Other factor

 Smocking
 Low level of Vitamin D in blood
 human papilloma virus
 Sitting

To explain Clinical manifestations :- Lecture cum

clinical discussion
manifestations Early symptoms:- It includes bloating ,irritable bowel syndrome,
abdominal or pelvic pain or discomfort, back pain, irregular menstruation
or postmenopausal vaginal bleeding, pain or bleeding after or during
sexual intercourse, loss of appetite, fatigue, diarrhea, indigestion,
heartburn, constipation, nausea, feeling full, and possibly urinary
symptoms (including frequent urination and urgent urination).

Later symptoms:- it includes Sister Mary Joseph nodule, growing

teratoma syndrome, Menometrorrhagia, abnormal vaginal bleeding after
menopause, Hirsutism, Virilization or masculinization, adnexal mass

Children
Severe abdominal pain, irritation of the peritoneum, or bleeding,
Secondary sex characteristics, Amenorrhea.
To explain the Stages of stomach cancer Lecture cum
stages of  Stage I:- Cancer is confined to one or both ovaries, discussion
ovarian cancer  Stage II. Cancer is found in one or both ovaries, the fallopian tube
& womb. It may spread to other organs in the pelvis such as
bladder, rectum, and vagina.
 Stage III. Cancer has spread outside the pelvis to other organs in
the abdomen such as bowels, the liver, the diaphragm and lymph
nodes.
 Stage IV. Cancer is found in one or both ovaries, has spread to
other organs in the abdomen, and has spread to other areas of body
beyond the abdomen, such as chest.
To explain Types:-
types of ovarian  Epithelial carcinoma
cancer  Serous carcinoma
 Small-cell carcinoma
 Primary peritoneal carcinoma
 Clear-cell carcinoma
 Sex cord-stromal tumor
To explain Diagnosis: Lecture cum
various  History collection with gynecological examination ( abdominal discussion
diagnostic discomfort/ pain, increasing girth, ascites,
methods  Serum tumor marker:- ( CA125, CA19-9)
 Imaging studies:-
 Transvaginal ultrasound ( TVU)
 CT/ MRI:- Abdomen/ pelvis
 PET scan
 Laproscopy.
 Mammography
 Endometrial biopsy
To Explain the Management ;- Lecture cum
management Pharmacological : discussion
Chemotherapy:-
 Carboplatin.
 Avastin,
 Taxol,
 Paclitaxel,
Radiation therapy:-
 External beam radiotherapy (EBRT)
 Brachytherapy
 Radioactive phosphorus
Hormonal therapy:-
 Luteinizing-hormone-releasing hormone (LHRH) agonists
(goserelin (Zoladex) and leuprolide (Lupron)
 Tamoxifen (anti-estrogen)
 Aromatase inhibitors
Immunotherapy
 Bevacizumab, (Avastin, )
Surgical management:-
  Unilateral oophorectomy,
 Bilateral oophorectomy ,
 Salpingectomy,
 Hysterectomy,
 Omentectomy.
To explain the Nursing management :- Lecture cum
Nursing Nursing Assessment discussion
management
1. Leukorrhea
2. Irregular vaginal bleeding and vaginal discharge
3. Increase in abdominal pain and pressure
4. Bowel and bladder dysfunction
5. Vulvar itching and burning

Nursing Diagnosis
1. Anxiety related to threat of a malignancy and lack of knowledge
about the disease process, and prognosis.
2. Acute pain related to pressure secondary to an enlarging tumor.
3. Disturbed body image related to loss of body part and loss of good
health.
4. Ineffective sexuality pattern related to physiologic limitations and
fatigue
5. Ineffective breathing pattern related to presence of ascites and
effusions
6. Grieving related to poor prognosis of advanced disease.
7. Imbalance nutrition: Less than body requirement

Patient Goals
1. Patient will actively participate in in treatment decisions
2. Patient will achieve satisfactory pain and symptom management
3. Patient will recognize and report problems promptly.
4. Patient will maintain preferred lifestyle as long as possible
5. Patient will continue to practice cancer detection strategies
6. Patient will appear relaxed and report anxiety is to a manageable
level.
7. Patient will use resources/support systems effectively.
8. Patient will verbalize understanding of adequate nutrition and
controlling nausea.

Nursing Interventions
1. Teach women the importance of having routine screenings for
cancer of the reproductive system.
2. Teach women about the risk factors of the reproductive system
3. Teach women about menopause signs and symptoms after bilateral
oophrectomy.
4. Teach women about hormone replacement therapy and the side
effects.
5. Manage client's pain related to chemotherapy
6. Monitor for infection
7. Teach client to prevent DVTs after surgery, i.e. frequent changes in
positions, leg exercises to promote circulation.
8. Offer encouragement and allow the patient to discuss her fears
regarding ovarian cancer.
9. Provide additional education and help the patient find a support
group.
10. Explain the need for increased intake of fruits, vegetables, and
whole grains. Also, a decreased fat intake of <30% of calories.
11. Administer anti nausea (antiemetic) medications as needed.
12. Assess patient for body image changes as a result of disfiguring
treatment.