Case Study

Ovarian
Cancer
History:
A Saudi female patient named sara aged 57 years, married ,
unemployed.
History of the present illness:

The pt. with a history of Ovarian Cancer since 9 months presents to the
Hospital for scheduled TAHBSO ( Total abdominal hysterectomy bilateral
salpingo oophorectomy ) After she finished 6 chemotherapy sessions.
Past history:
The patient had breast cancer 9 years ago, and she recovered with chemotherapy
sessions.
She was diagnosed with ovarian cancer 9 months ago in America, after she was
admitted to the hospital complaining of abdominal distention, vomiting and
diarrhea after doing CT scan, she was diagnosed with ovarian cancer.
Family history:
She has a family history of breast and ovarian cancer from both parents
Social history:
Average socioeconomic status
Patient assessment:
Physical assessment:
Head to toe examination was done:
Neurologic Oriented, conscious, GCS 15/15.
Integumentary Warm pale skin

No scar or edema
Cardiovascular BP: 139/79, Normal rate, regular rhythm, normal heart

sound.
Pulmonary Symmetrical chest expansion, breath sound clear and
equally in both lungs.
Gastrointestinal Soft, Normoactive bowel sound, surgical incision in lower
abdomen
Musculoskeletal Normal gait, no stiffness, deformity or tenderness
Lab Investigation:
WBC 18x10^9/L 4.0 – 10.0

Hgb 9 g/L 12 – 16
HCT 34 % 38 - 48
Platelet 637x10^9/L 150 - 450
RBCs 5.9x10^/L 4 – 5.4
Medical Management:
Done for my patient:
Chemotherapy: Chemotherapy is a very common method of ovarian

cancer treatment that helps in eliminating the cancerous cells that are
multiplying.
The patient completed 6 chemotherapy sessions that started in January

2022
Surgical Management:
Done for my patient:
Total abdominal hysterectomy bilateral salpingo oophorectomy
(TAHBSO) is the removal of entire uterus, the ovaries, fallopian tubes
and the cervix.
ovarian cancer
Ovarian cancer is a growth of cells that forms in the ovaries. The cells
multiply quickly and can invade and destroy healthy body tissue.
symptoms:
o Bloating; abdominal distention or discomfort

o Pressure effects on the bladder and rectum
o Constipation
o Vaginal bleeding
o Indigestion and acid reflux
o Shortness of breath
o Tiredness
o Weight loss
o Early satiety
Causes :
The precise cause of ovarian cancer is unknown, but several risk and
contributing factors have been identified.
The patient may have a higher chance of getting ovarian cancer if she:
o inherited a faulty gene, such as the BRCA genes or those linked to

Lynch syndrome
o had breast cancer or bowel cancer
o had radiotherapy treatment for a previous cancer
o have endometriosis or diabetes
o started her periods at a young age or went through the
menopause late (over 55), or have not had a baby – because these
things may mean she released more eggs (ovulated more)
o have never used any hormonal contraception, such as the pill or
an implant
o are taking hormone replacement therapy (HRT)
o are overweight
o smoke
Epidemiology:
International statistics:
Internationally, ovarian cancer is the eighth most common cancer in

women and the 18th most common cancer overall, with almost 300,000
new cases and almost 200,000 deaths in 2018. Age-standardized rates
per 100,000 ranged from 9.5 in Japan to 16.6 in Serbia.
Ovarian Cancer Management:
Ovarian cancer is more treatable if it’s diagnosed early.

The methods of ovarian cancer treatment often include several
procedures that the doctors use to remove cancer.
• Chemotherapy: Chemotherapy is a very common method of ovarian

cancer treatment that helps in eliminating the cancerous cells that are
multiplying
• Radiation: The therapy of radiation includes the pointing of the

radiation in the direction of cancer to remove it completely. Very often,
radiation is used as a follow up of chemotherapy
• Hormone Therapy: The estrogen in the body is prohibited to reach the

cancer-causing cells. This causes them to die and further treats the
ovarian cancer
• Surgery: In advanced cases, surgical procedures to remove the ovaries

is the only option that doctors can use
Nursing management ( NCP ):
Assessment Diagnosis Planning Intervention Rational Evaluation

Subjective Independent: After nursing
Cues: Acute Pain After 4 1- Note client’s 1- Impacts interventions,
"I have sever R/T surgical hours of age, ability to report the goal was
pain "as procedure nursing developmental pain Met as
verbalized by evidenced intervention level, and parameters. Evidenced by:
the patient by patient the patient current Report relief of
verbalization will Report condition pain and
and Facial pain is relaxed face
Objective grimacing relieved or 2- Assess pain 2- Assists in expression
Cues: controlled. reports, noting differentiating Pain scale:4/10
-Guarding location, cause of pain,
behaviour - characteristics, and provides
restlessness and severity (0 information
-facial to 10 [or about disease
grimacing of similar] scale). progression and
pain resolution,
-pain scale : development of
8/10 complications,
and
effectiveness of
interventions.
3- Note 3- Severe pain

response to not relieved by
medication, routine
and report to measures may
physician if indicate
pain is not developing
being relieved. complications
and the need
for further
intervention.
4-Monitor skin 4-May be

color and altered by
temperature, acute pain.
as well as vital
signs (e.g.,
heart rate,
blood pressure,
respirations).
5- Promote 5- Bedrest in
bedrest, low-Fowler’s
allowing client position
to assume reduces intra-
position of abdominal
comfort. pressure;
however, client
will naturally
assume least
painful
position.
6-Provide 6-To promote
comfort nonpharmacolo
measures (e.g., gical pain
touch, management.
repositioning,
quiet
environment,
focused
breathing).
Dependent:
- Administer - to relief pain.
analgesics as
ordered.
_____________________________
Patient and Family teaching:

Instruct pt. for:
• Don’t drive until the healthcare provider says it's OK.

• Don’t lift anything heavier than 10 pounds for 6 weeks.
• Don’t vacuum or do other strenuous activities until the healthcare provider
says it’s OK.
• Continue the coughing and deep breathing exercises
• Avoid constipation:
- Eat fruits, vegetables, and whole grains.
- Drink 6 to 8 glasses of water a day, unless directed otherwise.
• Don’t use oils, powders, or lotions on incision.

• Call the healthcare provider immediately if have any of the following:
Fever above 100.4°F ( 38°C), Chills, Bright red vaginal bleeding or vaginal bleeding
that soaks more than 1 pad per hour, smelly discharge from the vagina, Trouble
urinating or burning when you urinate, Severe pain or bloating in your abdomen,
Redness, swelling, or drainage at incision site, Shortness of breath or chest pain,
Nausea and vomiting.
Conclusion:
In such cases, women diagnosed with breast cancer are more likely to develop
ovarian cancer.
Also for those who have a family history of breast and ovarian cancer.
Routine screening is recommended for early detection of cancer.
Ovarian cancer is more treatable if it’s diagnosed early.
References:
• https://emedicine.medscape.com/article/255771-overview
• https://alraziuni.edu.ye/uploads/pdf/Nursing-Care-Plans-Edition-9-Murr-Alice-Doenges-
Marilynn-Moorehouse-Mary.pdf
• https://fairviewmnhs.org/Patient-
Education/Articles/English/d/i/s/c/h/Discharge_Instructions_for_Abdominal_Hysterectomy_86260

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Ovarian

History of the present illness:

Neurologic Oriented, conscious, GCS 15/15.

Integumentary Warm pale skin

Cardiovascular BP: 139/79, Normal rate, regular rhythm, normal heart

WBC 18x10^9/L 4.0 – 10.0

Chemotherapy: Chemotherapy is a very common method of ovarian

The patient completed 6 chemotherapy sessions that started in January

o Bloating; abdominal distention or discomfort

o inherited a faulty gene, such as the BRCA genes or those linked to

Internationally, ovarian cancer is the eighth most common cancer in

Ovarian cancer is more treatable if it’s diagnosed early.

• Chemotherapy: Chemotherapy is a very common method of ovarian

• Radiation: The therapy of radiation includes the pointing of the

• Hormone Therapy: The estrogen in the body is prohibited to reach the

• Surgery: In advanced cases, surgical procedures to remove the ovaries

Nursing management ( NCP ):

Assessment Diagnosis Planning Intervention Rational Evaluation

3- Note 3- Severe pain

4-Monitor skin 4-May be

Patient and Family teaching:

• Don’t drive until the healthcare provider says it's OK.

• Don’t use oils, powders, or lotions on incision.

Ovarian cancer is more treatable if it’s diagnosed early.

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