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OVARIAN

CANCER
Gynecologic malignancy,
with high mortality
because of advanced
disease by time of
diagnosis. It is the
leading cause of
morbidity of gynecologic
Signs and Symptoms:
Bloating; abdominal
distention or discomfort
Pressure effects on the
bladder and rectum
Constipation
Vaginal bleeding
Signs and Symptoms:
Indigestion and acid
reflux
Shortness of breath
Tiredness
Weight loss

Signs and Symptoms:


Indigestion and acid
reflux
Shortness of breath
Tiredness
Weight loss

Diagnostic Evaluation
Pelvic Examination to detect
enlargement, nodulity,
immobility of the ovaries.
Pelvic sonography and
computed tomography(CT)scan
not help for early detection
Paracentesis or thoracentesis if
ascites or pleural effusion is
Diagnostic Evaluation
Laporotomy to stage the
disease and determine
effectiveness of treatment.
Increase of CA125 signifies
progression, but not useful as
diagnostic or screening tool.
Diagnostic Evaluation
Laporotomy to stage the
disease and determine
effectiveness of treatment.
Increase of CA125 signifies
progression, but not useful as
diagnostic or screening tool.
Management
Chemotherapy is more
effective if tumor is
optimally debulked;
usually follows surgery
because of frequency of
advanced disease;may
be given IV or
Management
Radiation therapy is not
often valuable
Hormonal therapy with
Tamoxifen(tamofen), an
antiestrogen agent, may
be used
Complication
Direct intra-abdominal or
lymphatic spread.
Patient
s
Name: J. M
Age: 45 years old
Gender: Female
Date of Birth: June 19, 1970
Civil Status: Married
Address: Bangag, Solana, Cagayan
Nationality : Filipino
Dialect Spoken: Iloco, Ibanag
Religion: Roman Catholic
Educational Attainment : Under graduate
in Elementary (Grade One)
Occupation: Vendor
Date of Admission : Feb. 28, 2016
Time of Admission : 2:15pm
Mode of Arrival : via Wheelchair
Chief Complaint: Enlarging
abdomen
Ward: OB
Admitting Diagnosis: Ovarian New
Growth
Final Diagnosis : G4P4(4003) Ovarian
New Growth related to probably
malignant, Cystoadenocarcinoma
ruptured.
Date of Interview : March 06, 2016
Time of Interview : 11:30 am
Attending physician: Dr.M. L
Date of Discharge : March 4, 2016
Time of Discharge : 5:10 pm
Source of Information : Patient, SO, and
Chart
NURSIN
G
PAST HEALTH HISTORY
Patient J.M. was fully immunized, she had
her BCG as evidenced by the BCG scar in
her right deltoid muscle. She didnt
experience any childhood illnesses such
as chicken pox, measles, and mumps but
she experienced symptoms such as
cough, colds, and fever. Her mothers
initial management was by taking OTC
drugs such as neozep and biogesic. She
has no allergic to any food and
medication drugs even when she got
PAST HEALTH HISTORY
Her Ligation was on 1997and she was
diagnosed with ovarian on 2014.
PRESENT HEALTH HISTORY
May 2014, patient J.M.
noticed that her menstrual
cycle stopped and during that
month she experienced
enlarging abdomen, however,
patient J.M. did not
experience any pain on her
enlarging abdomen.
PRESENT HEALTH HISTORY
She refused to have her check up
because of financial constrict. Last
year she decided to have medical
consultation and her physician
advised to schedule operation but
she postponed it. On February 28,
2016 she decided to continue her
operation and undergone test like CT-
scan, MRI, and X-ray.

SOCIAL HEALT H ISTORY


PatientJ.M. is a resident of
Bangag, Solana, Cagayan.
She is the second daughter
among seven siblings. She
working as a fish vendor and
she smoke 2 packs per day
but she never drink alcohol.
FAMILY HEALTH HISTORY
No noted family history of
hypertension, diabetes
mellitus, cancer, asthma,
tuberculosis, heart
disease, stroke and kidney
failure on both paternal
and maternal sides.
GORDONS
11
FUNCTIONAL
HEALTH
HEALTH
PERCEPTION
/HEALTH
MANAGEMENT
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
Ang kalusugan para sakin Ang kalusugan para sakin
ay ang malusog ako at ang ngayon ay kayamanan na
aking pamilya as verbalized dapat kong alagaan para sa
by the patient. According to magandang kinabukasan ko
the patient she already had at ang aking pamilya as
numerous experienced of verbalized by the patient.
fever she usually takes OTC She managed her health right
during like paracetamol now by following the
500mg every 4 hours until doctors order to her. And
the fever subside. And when willing to accept and listen
she have cough and colds, to health teachings.
she usually drink a lot of
warm water.
NUTRITION
AL
METABOLIC
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
Patient J.M. usually eats 3 Before the operation, patient
times a day, every meal she eats her meals 3x a day with
eat 2-3 cups of rice, more on 1 cup of rice in every meal.
meat and fish and often on She also drinks 6-8 glasses
vegetables. She drinks 10-12 of water a day.
glasses of water a day, every Approximately 250 per
glass of water contains glass. But she was on NPO
250ml. she does not have 12 hours before the surgery.
any allergies reaction to any And her weight is 48kg.
food and medication. And
according to her, her weight
is 79kg.
ELIMINATI
ON
PATTERN
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
According to patient J.M. According to patient J.M.
she voids 8-10 times a day she voids 9-11 times and
with yellowish in color of defecates 1-2 times a day but
urine. She also defecates lessen in amount. She does
once or twice times every not experience pain during
after two days. Stool is urination and defecation. Her
brown in color and semi urine color is light yellow.
formed. She does not take Her stool is watery because
any laxatives. Patient J.M. she take laxative as prescribe
does not have painful by her doctor (Bisacodyl)
sensation during urination
and defecation.
ACTIVITY
EXCERSIZE
PATTERN
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
According to patient J.M., She was able to ambulate,
she does household chores lay down herself in bed,
and goes to work. She was bathe herself, and have her
able to bathe herself and meal without assisting before
have her exercise sometimes her operation. After the
by stretching and walking. operation the patient cannot
She does not take energy easily ambulate because of
vitamins. She feels uneasy her surgical incision but we
when she does not take a told her that she must move
bath. Patient J.M. can her body so that she can
ambulate and perform easily to recover to the
activities of daily living surgery.
without assistance
SLEEP
REST
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
According to patient J.M., There is a change in
she sleeps for 7-8 hours in patient J.M. sleeping
a day. She usually wakes pattern. She usually sleeps
up at night to urinate. She 6-7 hours and she has her
does not take medication siesta. Nakakatulog
for inducing sleep. Her naman ako ng mabuti kaso
usual routine before sa tuwing may magbibigay
sleeping is taking a bath to sa akin ng gamot at
feel more comfortable kumukuha ng bp ko ay
when sleeping. hindi ko na makuha ulit
ang matulog. as
verbalized by the patient.
COGNITIVE
CONCEPTUA
L PATTERN
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
According to patient J.M. she is a The patient properly responds to
grade 1 undergraduate of the questions being asked. She
elementary. She knows how to was able to answer open-ended
speak tagalong, Iloko and Ibanag question concisely. Patient J.M. is
as verbalized by the patient. She oriented of time, place, and
has no hearing deficit, have a person. There are no changes
good vision, she can see without noted on his senses.
eye glass. According to patient
J.M., she usually recalls events
easily from the past. She can
respond to stimuli verbally and
physically oriented and have her
husband beside her in decision-
making.
SELF
PERCEPTIO
N/ SELF
CONCEPT
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION
Patient J.M., describe herself as a According to patient J.M., she
silent type in terms of she do not was scared for the scheduled
make chika to the other people operation. She perceived if her
life, she is happy, tall, and operation was done theres
skinny., she hates when nothing to think about and can
somebody is making chismis to focus herself doing things that
her. Her emotions affect her way matters to her. She was still
of communicating with others. hopeful to have positive operation
According to her, she limits although she was worried but she
herself towards things she wants was trying herself to be calm.
to provide more for her family.
She easily accepts changes in her
life. maging positibo lang tayo
lagi sa buhay as verbalized by
the patient.
ROLE
RELATIONS
HIP
PATTERN
BEFORE HOSPITALIZATION DURING
HOSPITALIZATION
According to patient J.M., she is Her relationship with her
married and has children. Living with family during
her family and described it as a solid hospitalization remains the
family. She managed with her husband same. She maintains
for their family. Patient J.M. does not communication with her
avoid responsibilities given to her. husband and children
When we ask if she is disturbed by her because she feels more
relationship, she verbalized hindi relieved when talking to her
naman madalas, may araw din na hindi husband and children.
kame nagkakaintindihan. She does not
have multiple relationships. When
confronted with misunderstanding with
a family member or anyone else, he
verbalized, dapat inaayos kaagad ang
problema para hindi lumala at
magkaroon ng alitan sa bawat isa.
SEXUALITY
REPRODUCT
IVE
PATTERN
BEFORE HOSPITALIZATION DURING
HOSPITALIZATION

Patient J.M. had her menarche According to patient


when she was 13y/o. her usual J.M she has no sexual
menstruation lasts for 3-5 days activity and he also
with no pain and consumes 1-2 stated that she is happy
pads of napkin a day and fully to have four children
soaked. Her menstruation is and her husband in her
regular. She menopause at the age life.
of 43 years old and also that age
she experience enlarging
abdomen. She also stated that her
first coital with his husband
happened when she was 17y/o.
They have sex 2 times a week.
COPING
STRESS
TOLERANCE
PATTERN
BEFORE HOSPITALIZATION DURING
HOSPITALIZATION

Patient J.M. copes up with Usually, patient J.M.


stress by managing to pray prays and takes a
and relax. When it comes to nap and rest. She
financial problems and others, talks to her family
her husband is beside her and and when she is
they both handle it helping tense she alleviates
each other to resolve it. herself that
everything will be
fine. Also, she tries
to be optimistic.
VALUES
BELIEF
PATTERN
BEFORE DURING
HOSPITALIZATION HOSPITALIZATION

According patient J.M., she According to patient


is a Roman Catholic but she J.M. her faith did not
doesnt attend mass change and remains
regularly. Sometimes she to be strong. Patient
believes in superstitious believes to have a
belief. And according to her, successful operation
having faith in God is the because she believed
most important and God is that God is always
always there from the trials there to help and also
they encounter until they she asks for the
surpassed it. guidance of the Lord.
PHYSICAL
ASSESSMENT
Date and time assessed: March 6, 2016
11:30am
General appearance: Pt. Mrs. JM was
clean and tidy during the interview. She
was conscious, coherent not in
cardiorespiratory distress and was
oriented to time, date, place and persons.
Also, she is weak looking and cachetic She
was sitting on her bed.
VITAL SIGN:
BODY TEMPERATURE: 36.4 C
PULSE RATE: 82bpm
RESPIRATORY RATE 18cpm
BLOODPRESSURE:
120/80mmHg