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BENIGN GYNAECOLOGICAL CONDITIONS (OVARIAN TUMOURS (Care plan (Monitor for…
BENIGN GYNAECOLOGICAL CONDITIONS
OVARIAN TUMOURS
Signs and Symptoms
Discomfort in the pelvic area
Changes in bowel habits e.g constipation
Abdominal swelling or bloating
Frequent need to urinate
Quickly feeling full after eating a small amount of food
Unexplained weight loss
Pathophysiology
In the ovaries first and then invades other normal tissues
The cells then metastasizes across the pelvic floor as well as other body parts
Abnormal cells grow and multiplies creating a tumour in the
Errors occur in the cell's DNA mutation
Risk factors
Family history
Old age
Inherited gene mutation
Never having been pregnant
Early age of menarche
Estrogen hormone replacement therapy
Management
Surgical removal is the treatment of choice.
Preoperative can include a colonoscopy, MRI, ultrasound and CT scan.
Tumour debulking and biopsies
Likely treatment involves a total abdominal hysterectomy
Chemotherapy, including liposomal and intraperitoneal delivery, (eg, cisplatin)
Gene therapy is a future possibility
Causes
Its not clear as to what causes it
However like any other cancer
Its said that errors in mutation in the cells DNA
Definition
Malignant cancer of the ovaries
Essential information
Hormonal birth control pill may help prevent ovarian tumours
Tell the patient to find someone they trust that they can talk to
NSAID and opiods analgesia may help to minimize pain
Help them set reasonable goals and offer hope
Assessment and findings
No screening mechanism exists tumor markers are being explored
Biannual pelvic examinations are recommended for at-risk women
Any enlarged ovary must be investigated
pelvic examination does not detect early ovarian cancer, and pelvic imaging techniques are not always definitive
Transvaginal ultrasound and CA125 antigen testing are helpful for high-risk women
Care plan
Monitor for complications of therapy and abdominal surgery
Report manifestations of complications to physician.
Perform nursing measures, including treatments related to surgery, radiation, chemotherapy, and palliation.
Preoperative and Postoperative Nursing Management
Determine patient’s emotional needs, including desire for childbearing.
Allow patient to express feelings about condition and risk for death.
Provide emotional support by giving comfort, showing attentiveness and caring
Vaginal Fistula
Pathophysiology
Like primary pathology causing a fistula such as malignancy tissue irritation
By the flow of the intestinal content in the vagina resulting in an infection
Acute inflammatory is caused by a combination of factors
Management
Patient will be initiated on antibiotics
Abdominal surgery may be performed if it unable to heal on it own
Foley catheter may be inserted to allow the fistula to heal on it own
Laparoscopy, endoscope and CT scan may be done to see depth of the tract opening
A special glue made up of natural protein may be used
if the opening resembles a laceration a suture may be done
Biopsy must be taken
Signs and symptoms
Bleeding or painful movement
Bleeding or painful micturition
Pain, redness and swelling around the anus
A foul smelling liquid oozing from the vagina or anus
Fever
Assessment and findings
Some fistulas may not be visible on the skin's surface. In this case, your physician may need to perform additional tests:
An anoscopy is a procedure in which a special instrument is used to see inside your anus and rectum.
Physician may also order an ultrasound or MRI
Surgeon may need to examine in the operating room under anesthesia
Blood can be taken and they will show a sign of a certain infection
Physical exam can be done focusing on the recto-vaginal region and an abnormal opening may be noted
Risk factors
Systemic disease e.g HIV, TB and Diabetes
History of pelvic trauma
Crohn's disease
Ulcerative colitis
Inflammatory bowel disorder
Previous radiation therapy
Essential information
Adherence to the completion of antibiotics
Importance of protecting linen and avoiding complications
Promote personal hygiene and sitz bath
Venting out in order to prevent depression
Causes
Bowel disorders e.g diverticulitis
Infection after an episiotomy
Pelvic, cervical or colonal cancer
Traumatic injury
Abdominal surgery e.g hysterectomy or c-section
Care plan
Monitor for signs of complication
Determine the patient's emotional needs
Pre and post operative nursing care
Allow patient to express feelings about the condition and allay anxiety by giving assurance.
Nurse in a comfortable position
Definition
An abnormal opening that develops between a vagina and either a bladder or rectum