Nursing Diagnosis

 

Today we are going to talk about nursing diagnosis for individuals with cervical cancer. I nursing diagnosis is part of the nursing process and is clinical judgment about a patient and the experiences/responses to actual or potential health problems.

Some examples of nursing diagnosis for those with cervical cancer include

• Chronic and acute pain r/t metastasis and surgery
• Risk for impaired skin integrity r/t radiation
• Fear r/t cancer diagnosis
• Anticipatory grieving r/t potential loss of life
• Decisional conflict r/t treatment options
• r/t = related to

I am going to expand a little further on the diagnosis regarding pain...

Diagnosis & definition:	Acute and chronic pain Pain is defined as an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage
Actual or Potential?	Actual
Related to:	Metastasis of cancer to other areas of the body and/or possible surgeries and treatment methods (chemotherapy, radiation, etc.) to remove tumors
Plan & outcome:	Assess pain and treat pain as needed Patient will be pain free or have pain managed to where they are able to function
Nursing intervention:	Provide pain medication as ordered, provide distractions, provide heat or cool, use alternative techniques such as guided imagery,

Works:
http://wps.prenhall.com/wps/media/objects/737/755395/cervical_cancer.pdf

Nursing & Cervical Cancer

Cancer can be a very scary and emotionally turbulent event for patients. Cancer can cause pain, side effects from treatment and fear of the unknown. I am going to describe a possible nursing care plan for an individual with cervical cancer.

Nursing Diagnosis:

• Chronic and acute pain r/t surgery and metastasis
• Impaired skin integrity r/t radiation 
• Risk for fear r/t diagnosis
• Risk for decisional conflict r/t treatment options
• Risk for anticipatory grieving r/t potential loss of life

Outcomes:

• Develop strategies for pain control
• Maintain skin integrity
• Gain knowledge regarding treatment options
• Express feelings about cancer and possible fears of death

Planning & Implementing:

• Discuss treatments types and prognosis
• Asminister pain medications PRN 
• Inspect skin often
• Refer to cancer support groups
• Refer to social worker
• Provide emotional support 

Support for nurses:

A great tool for creating nursing care plans is nurselab: http://nurseslabs.com/6-hysterectomy-tahbso-nursing-care-plans/

Treatments

Today we are going to focus on treatment of cervical cancer. The national cancer institute is a great resource when looking to find more information on the treatment of cervical cancer

Several factors affect prognosis (chance of recovery). These include...

• Your age and general health
• The type of human papillomavirus (HPV) you have
• The stage of the cancer (I, II, III, IV)
• Whether or not your have HIV or other STIs (sexually transmitted infections)
• The type of cervical cancer
• Wether or not this is your first diagnosis or if the cancer is recurrent 

Treatment options differ depending on several factors as well, for example, treatment for an individual who still wants to have kids might differ from someone who doesn't. Other factors include age, stage of cancer and type of cancer. 

Cancer in situ, refers to the cancer being confined to the tissue it arose from. When a cancer is in situ, it means that it hasn't metastasized (spread to other areas of the body). The four stages of cervical cancer are as follows....

• Carcinoma in situ: abnormal cells are found confined to the innermost lining of the cervix
• Stage I: cancer is found in the cervix only
• Stage II: cancer has spread beyond the cervix but not to the pelvic wall or the lower third of the vagina 
• Stage III: cancer has spread to the lower third of the vagina, and/or pelvic wall, and/or is causing kidney problems 
• Stage IV: cancer has spread to the bladder, rectum or other areas in the body
• 
  

Treatment plans differ from patient to patient. Treatment can include surgery, radiation, chemotherapy and/or targeted therapy. 

• Surgery: cancer can be removed surgically. A total hysterectomy (removing the uterus) may be an option for those or no longer want children. 
• Radiation: this type of uses high energy x-rays to kill cancer cells
• Chemotherapy: when drugs are used to stop growth of cancer cells by either limiting division or killing the cells
• Target therapy: this is a type of treatment that uses drugs or other substances to directly harm the cancer cells without harming nearby cells. 

Works:

http://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq#section/all

Signs & Symptoms

It can sometimes be difficult to diagnose cervical cancer, due to the fact that many cancers go unnoticed. It is not unusual for a woman to have very few to no signs or symptoms in the early stages of the disease.

 

More advanced stages of cancer may produce signs and symptoms including the following...

• Vaginal bleeding after intercourse
• Vaginal bleeding outside of one's period or after menopause
• Vaginal discharge that may be bloody, watery and foul smelling
• Pelvic pain during vaginal intercourse

These symptoms can be a sign of things other than cancer, like infection, so it is important to be seen by a provider if they occur. For more information about cervical cancer, you can visit reliable websites such as the CDC, Mayo Clinic or American Cancer Society.

Works:
http://www.mayoclinic.org/diseases-conditions/cervical-cancer/basics/symptoms/