Nursing 211

N211: Health Differences Across the Lifespan I Cervical Cancer is unregulated growth of abnormal cells in the female cervix. This is the most common reproductive system cancer; often seen between the ages of 30 and 50. It may become invasive and spread to tissues outside cervix, uterine fundus, and the lymph glands. Some cervical cancers are directly linked to the human papillomavirus (HPV). 95% of the cancers are squamous cell in origin. Young women between the ages of 9 and 30 years of age are encouraged to be immunized with an intramuscular injection of recombinant vaccine (Gardasil). Cancer of the cervix is easily detected early with a PAP test. Cancer of the cervix is divided into three stages: 1. Early dysplasia can be treated with cryosurgery, electrocautery, laser, Conization, or hysterectomy. Laser therapy and Cryosurgery can be used when the lesion is small and localized. 2. Early carcinoma can be treated with hysterectomy and intracavity radiation 3. Late carcinoma is treated with external beam radiation along with hysterectomy; antineoplastic chemotherapy and pelvic exenteration. Pelvic exenteration involves the removal of the uterus, ovaries, fallopian tubes, vagina, rectum and bladder. Nursing Assessment Includes no symptoms in the early stages of the disease. Symptoms include post-coital bleeding, irregular vaginal spotting or bleeding in between periods or after menopause, a watery, dark, foul smelling discharge may be present. Later bleeding becomes constant and accompanied by pain, which radiates to the buttocks and legs. Cervical Pap test if abnormal calls for a repeat test, colposcopy exam of the cervix, tissue biopsy and diagnosis is based on biopsy results. Nursing Diagnosis • Pain related to tumor growth and treatments • Activity intolerance related to fatigue secondary to anemia and effects of radiation therapy and chemotherapy • Anxiety and knowledge deficit related to diagnosis of cancer • Body image disturbance related to diagnosis and possible surgery that will make conception impossible. Medical Interventions Include Conization or laser therapy to remove localized lesions if the patient is of childbearing age. Hysterectomy with radiation therapy for more extensive disease. Pelvic exenteration for advanced disease. Nursing Interventions Include assisting client with psychological effects of illness; provide emotional support and information. Develop strategies for pain control. Maintain skin and tissue integrity during radiation therapy and following surgery. Observe for fistula formation between vagina and rectum, a possible

©2012

Page 106

of 148

Achieve