STATE COLLEGE OF NURSING, DEHRADUN

PRACTICE TEACHING
MEDICAL SERGICAL NURSING
LESSON PLAN
ON
CIRVIX CANCER
Submitted to: Submitted by:
Mr. MAYANK JAMINI MRS. ANITA BISHTANIYA
Assistant Professor I year M.Sc. Nursing
SCON Dehradun, Uttarakhand SCON, Dehradun,
Uttarakhand

Submitted on:
/ /2018
SUBJECT : MEDICAL SERGICAL NURSING

UNIT : ONCOLOGY

TOPIC : CERVIX CANCER

GROUP : B.Sc. NURSING IIIRD YEAR

PLACE : B.Sc. NURSING IIIRD YEAR CLASS ROOM

DATE :

TIME : 45 MINUTES

TEACHING METHOD : LECTURE CUM DISCUSSION

INSTRUCTIONAL AIDS
PREVIOUS KNOWLEDGE OF STUDENTS
STUDENT TEACHER
CHART, POWER POINT TILES, PAMPHLETS,
: HANDOUTS, VIDEO CLIP INCLUDING BLACK
BOARD AND CHALK
THE STUDENT SHOULD HAVE BASIC KNOWLEDGE
: REGARDING CANCER AND ALSO ANATOMY AND
PHYSIOLOGY OF REPRODUCTIVE SYSTEM.
: ANITA BISHTANIYA

EVALUATER : MR. MAYANK JAMINI (ASSISTANT PROFESSOR)

GENERAL OBJECTIVE:
At the end of the class students will acquire adequate knowledge regarding cervix cancer, its causes, types, pathophysiology,
clinical manifestation, diagnostic evaluation, management (medical, surgical, nursing). Cervical cancer is the third most common
cancer in the women worldwide therefore it is one of the most important topic to understand in the field of nursing in order to
reduce mortality rate and incidences among women. cervix cancer and their incidences. The students would be able to apply this
knowledge in clinical practice, hospitals, while providing health education and handling the clients with cervix cancer.

SPECIFIC OBJECTIVE:
At the end of the class students will be able to-
 Define cervix cancer
 Enlist the etiology and risk factors of cervix cancer.
 State down the pathophysiology of cervix cancer.
 Enumerate the clinical manifestation of cervix cancer.
 Classify the stages of cervix cancer.
 Elaborate the diagnostic evaluation of cervix cancer.
 Explain the management of cervix cancer.
 Enlist the nursing diagnosis of cervix cancer.
S.NO Time Specific Content Teaching learning Evaluation
objectives activity with Audio-
Visual Aids
1. 5min To define CERVIX CANCER: Teacher activity: What is cervix
cervix DEFINITION: “Cervix cancer is malignant tumor of To define cervix cancer with cancer?
cancer. the cervix. The tumor may develop from the the help of powerpoint.
surface epithelium of the cervix or from
Learner activity:
epithelium lining of the cervical canal.” Students are listing.

INCIDENCE:
 New cases - 130,000/year
 Died from cervical cancer - 20,ooo-
30,000/year
2. 5min To enlist the ETIOLOGY AND RISK FACTOR: Teacher activity: What are the
etiological Enlist the etiological and risk etiological and risk
factors of ETIOLOGY: factors of cervix cancer with factors of cervix
cervix Human papilloma virus- the help of handouts. cancer?
cancer. Infection with the common human papilloma virus
(HPV) is a cause of approximately 90% of all cervical Learner activity:
cancers. About half of the sexually transmitted HPV are Students are reading.
associated with cervical cancer.

RISK FACTOR:
 Early sexual activity
 Cigarette smoking
 Oral contraceptives
 Family history
 Nutritional deficiency
(folate, carotene, vit.c)
 Obesity
  Poor immune system (HIV)
 Age(30-39 & 60-69)
 Diethylstilbestrol
3. 5min To state PATHOPHYSIOLOGY: Teacher activity: What is the
down the State down the pathophysiology of
pathophysiol Due to etiological factors pathophysiology of cervix cervix cancer?
ogy of cervix cancer with the help of over
cancer. Entry of HPV head projector.

Virus enters in the basal layers of cervix Learner activity:

Students are watching.
HPV infects the basal cells

Damage the genetic material of the cells

Cells becomes pre cancerous

Damaged cells continue to multiply

Invasion to the near by tissues

Cervical cancer
4. 5min To enumerate CLINICAL MANIFESTATION: Teacher activity: What is the clinical
the clinical  Bleeding that occurs between regular menstrual Enumerate the clinical manifestation of
manifestation periods manifestation of cervix cancer cervix cancer?
of cervix  Bleeding after sexual intercourse, douching, or a with the help of pamphlets.
cancer. pelvic exam
 Menstrual periods that last longer and heavier Learner activity:
that before bleeding after going through Students are reading.
menopause
 Increased vaginal discharge
 Pelvic pain
5. 5min To classify STAGES OF CERVICAL CANCER: Teacher activity: What are the stages
the stages of  Stage I- Cancer is confined to the cervix. Classify the stages of cervix of cervix cancer?
cervix  Stage II- Cancer at this stage includes the cervix cancer with the help of chart
cancer. and uterus, but has not spread to the pelvic wall and powerpoint.
or the lower portion of the vagina.
 Stage III- Cancer at this stage has moved beyond Learner activity:
the cervix and uterus to the pelvic wall or the Students are watching.
lower portion of the vagina.
 Stage IV- At this stage, cancer has spread to
nearby organs, such as bladder to other areas of
the body, such as the lungs, liver or bones.
6. 5min To explain . DIAGNOSTIC EVALUATION: Teacher activity: What is PAP
the diagnostic  History collection Explain the diagnostic smear?
evaluation of  Physical examination evaluation with the help of
cervix  PAP smear-Routine screening for cervical powerpoint.
cancer. cancer abnormalities can detect early stage
cancer and precanceraous condition that could Learner activity:
progress to invasive disease. The processbegins Students are reading.
with a pap test, also known as a pap smear.
 HPV DNA test- Like the pap test, the HPV DNA
test involves collecting cells for lab testing.
 Colposcopy- It illuminates the cervix for biopsy.
 Cone biopsy- A large area of tissue around the
cervix excised for examination.
 Chest X- ray
 CT scan
 MRI scan
 Pelvic ultrasound
7. 10min To elaborate MANAGEMENT: Teacher activity: What is the
the MEDICAL MANAGEMENT: Elaborate the management of management of
management  Chemotherapy: cervix cancer with the help of cervix cancer?
of cervix  Chemotherapy is the use of chemicals powerpoint.
cancer. (medication) to destroy cancer cells. Cytotoxic
 medication prevents cancer cells from dividing Learner activity:
and growing. Students are reading.
 Chemotherapy for cervical cancer, as well as most
other cancer, is used to target cancers, is used to
target cancer that surgery cannot or did not
remove, or to help the advanced cancer.
 Cisplatin, a chemotherapy drug, is frequently used
in combination with radiotherapy.
 Radiotherapy:
 Radiotherapy is also known as radiation therapy.
Radiation works by damaging the DNA inside the
tumor cells, destroying their ability to reproduce.
For patient with advanced cervical cancer
radiation combined cisplatin based chemotherapy
is the most effective treatment.
 SURGICAL MANAGEMENT:

 LASER SURGERY: A narrow beam of intense light

destroys cancerous and precancerous cells.
 LEEP: Loop electro surgical excision procedure-a
wire loop has an electric current cuts through
tissue removing cells from the mouth of the
cervix.
 CRYOSURGERY: Compressed nitrogen gas flows
through a cryo-probe making the metal cold
enough to freeze and destroys the abnormal
cervical tissue.
 HYSTERECTOMY: Removal of the uterus.
 NUTRITIONAL MANAGEMENT:

 Flavinoids are chemical compounds in fruit and

vegetables that are thought to be leading source
protection against cancer. The falvinoids-rich
 foods are apples, black beans, broccoli, brussels
sprouts, cabbage, garlic, onions, soy, spinach.
 Folate ( a water soluble B vitamin) reduce the risk
of cervical cancer in people with HPV. Foods
include Avocades, Breades, Lentins, Orange juice
and Strawberries.
 Carotenoids, a source of vitamin A, are also
helpful in preventing cervical cancer risk. Foods
such as carrots sweet potatoes and pumpkin are
rich in vit.A

8. COMPLICATION:
 Low blood counts
 Uteric pain due to pyelonephritis
 Vesicovaginal fistula
 Menorrhagia
 Post-menopausal PV bleed
9. 5min To enlist the NURSING MANAGEMENT: Teacher activity: What are the
nursing Enlist the nursing management nursing
management NURSING DIAGNOSIS: of cervix cancer with the help intervantions of
of cervix  Pain related to cancer and treatment effect as of powerpoint. cervix cancer?
cancer. evidenced by pain scale and facial expression.
 Imbalanced nutrition less than body requirements
related to anorexia, vomting,as evidenced by Learner activity:
weight loss. Students are watching.
 Impaired tissue integrity related to treatment as
evidenced by mucocitis.
 Anxiety related to diagnosis of cancer as
evidenced by talking with family member.
 Risk for infection related to immune suppression.
 Impaired urinary elimination related to surgical
incision.
NURSING INTERVENTION:
 Assess patients condition
 Give careful attention to post opt. bleeding
 Providing close monitoring and care for the first
2-3 days
 Early ambulation
 Close monitoring the patient undergoing
cryosurgery for hemorrhage and hypothermia
 Instruct the patient to follow up visit.
PREVENTION:
 HPV (human papilloma virus vaccine)
If every female adheres to current HPV
vaccination programs the total number of female
deaths from cervical cancer globally will drop
by hundreds of thousands each year.
 Safe sex
 Cervical screening
 Have few sexual partners
 Delay first sexual intercourse
 Don’t smoke
 SUMMARY:
Cervical cancer is a cancer arising from the cervix it is due to the abnormal growth of cells that have the ability to invade or
spread to the other parts of the body its usual onset is over 10 to 20 years and caused by HPV infection, smoking, weak immune
system, birth control pills etc. Early on typically no symptoms are seen later symptoms may include abnormal vaginal bleeding, pelvic
pain, or pain during sexual intercourse.
Cervical screening followed by biopsy is the diagnostic method with regular cervical screening, HPV vaccine. As a risk of
cancer still exists, guide4lines recommend continuing regular PAP tests.

CONCLUSION:

Worldwide, cervical cancer is both the fourth most common cause of cancer and fourth most common cause of death
from cancer in women. PAP test screening every 3-5 years with appropriate follow-up can reduce the cervical cancer
incidence up to 80% and reduced the number of cases and mortality from cervical cancer.
As a nursing personnel, encouraging the women to get screened are effective at increasing the likelihood they will do
so. Educational material also help to increase awareness about cervical cancer.

ASSIGNMENT:

Assignment on radiation therapy.

EVALUATION:

Q1:- where is the cervix located in the body?

a) In the ovaries
b) The lower, narrow part of the uterus
c) In the chest
d) In the neck

Q2:- What is cervical cancer?

a) It is the cancer of female reproductive tract.
b) It is the cancer of brain.
c) It is a STD
d) None of the above

Q3:- which of these are risk factor for the cancer?

a) Smoking
b) Infection with a human papilloma virus
c) Infection with a virus that causes AIDS
d) All of the above

Q4:- which of these tests effectively screens for cervical cancer?

a) ECG
b) PAP test
c) Blood test
d) Cholesterol test

Q5:- when should women begin PAP test screening?

a) No later than age 12
b) At age 21
c) No later than age 30
d) None of the above.
REFERENCES:
 PHIPP’S, Medical Surgical Nursing, Health and Illness Perspective, 8th Edition, Page No.-1697-1707, Published by Elsevier.
 HAWKS, HOKANSON JANE, BLACK.M.JAYEE, Medical Surgical Nursing, Clinical Management For Positive Outcomes,
Page No.-927-928, 8th Edition, Published by Elsevier.
 MOSBY’S, Comprehensive Rreview of Nursing for the NCLEX-RN Examination,20th Edition, Published by Elsevier, Page
No.-527-528.
 SUDDARTH’S & BRUNNERS, Textbook of Medical Surgical Nursing, 13th Edition, Published by Wolters kluwer (INDIA)
Pvt Ltd, Page no.-1667-1652.
 CHINTAMANI,Levis’s Medical Surgical Nursing, Assessment and Management of Clinical Problems, Published by Elsevier,
Page no.-1367-1369.

BOOK:-

 PHIPP’S, Medical Surgical Nursing, Health and Illness Perspective, 8th Edition, Page No.-1697-1707, Published by
Elsevier.
 HAWKS, HOKANSON JANE, BLACK.M.JAYEE, Medical Surgical Nursing, Clinical Management For Positive
Outcomes, Page No.-927-928, 8th Edition, Published by Elsevier.
  MOSBY’S, Comprehensive Rreview of Nursing for the NCLEX-RN Examination, 20th Edition, Published by Elsevier,
Page No.-310-312.
 SUDDARTH’S & BRUNNERS, Textbook of Medical Surgical Nursing, 13th Edition, Published by Wolters kluwer
(INDIA) Pvt. Ltd, Page no.-1586-1588.
 CHINTAMANI, LEVI’S medical surgical nursing, assessment and management of clinical problems, published by
Elsevier, Page no.- 1367- 1369.

NET INFORMATICS:-
 https//www.slideshare.net/mobile/manalisolanki/cervical-cancer-ppt.
 http//www.slideshare.net/mobile/joyawale5/cervical-cancer-presentation-73217007.
 https//www.slideshare.net/mobile/tageyaja/cancer-of-cervix-29150685.
 https//www.webmd.com/cancer/cervical-cancer.
 https//en.m.wikipedia.org/wiki/cervical_cancer.

JOURNAL’S REFERENCES:-
 Oncology &Cancer Case Reports, Journal of Tumor Diagnostic and Reports.
 International journals of cancer research and prevention, oncology report, cancer cell.
 Journal of clinical & experimental oncology, chemotherapy of cancer.