[Exam 1] Chapter 57: Management of Patients with Female Reproductive Disorders

Question 1

Ovary Cancer: Why is this difficult to find?

Answer 1

They are usually deep in the pelvis and no early screening mechanism exists.

Question 2

Ovary Cancer - Epidemiology: Median age for this?

Answer 2

Most cases diagnosed by 60.

Question 3

Ovary Cancer - Epidemiology: Most significant risk factor?

Answer 3

Family history.

Question 4

Ovary Cancer - Epidemiology: Mutation occurs on wha gene?

Answer 4

GRCA1 and sometimes BRCA2 gene.

Question 5

Ovary Cancer - Epidemiology: Lifetime risk of developing ovarian cancer has been shown to be derecrease by one half with what

Answer 5

long-term suppression (>5 years) of ovulation through use of oral contraceptives

Question 6

Ovary Cancer - Patho: What are germ cell tumors?

Answer 6

Germ cell tumors, which arise from cells that produce eggs and are the most common in those younger than 20.

Question 7

Ovary Cancer - Patho: What are stromal; cell tumors?

Answer 7

Arise in CT cells that produce hormones

Question 8

Ovary Cancer - Patho: What are epithelial tumors?

Answer 8

It originates from the outer surface of the ovary.

Question 9

Ovary Cancer - Patho: Most ovarian cancers are of what origin?

Answer 9

Epithelial.

Question 10

Ovary Cancer - Patho: What is closely related to this ?

Answer 10

Primary peritoneal carcinoma.

Question 11

Ovary Cancer - Patho: What is extraovarian primary peritoneal carcinoma?

Answer 11

Resembles ovarian cancer histologically and can occur in women with/without ovaries.

Question 12

Ovary Cancer - CMs: Symptoms of this include?

Answer 12

Increased abdominal girth, pelvic pressure, bloating, back pain, constipation, abdominal pain, urinary urgency, flatulence, and increased waist size.

Question 13

Ovary Cancer - CMs: Most common sign?

Answer 13

Enlargement of the abdomen from an accumulation of fluid

Question 14

Ovary Cancer - CMs: What would alert nurse to possibility of early ovarian malignancy?

Answer 14

Vague, undiagnosed persistent GI symptoms

Question 15

Ovary Cancer - CMs: Palpable ovary in woman who has gone through menopause must do what

Answer 15

must be evaluated because they are normally smaller and less palpable after menopause

Question 16

Ovary Cancer - Assessment/Diagnostic: Which diagnostic tests are not definitivve?

Answer 16

Pelvic Exam, and Pelvic Imaging

Question 17

Ovary Cancer - Assessment/Diagnostic: Classified as benign when

Answer 17

There is no proliferation or invasion,

Question 18

Ovary Cancer - Assessment/Diagnostic: Classified as borderline when

Answer 18

if there is proliferation but no invasion

Question 19

Ovary Cancer - Assessment/Diagnostic: classified as malignant when

Answer 19

if there is invasion

Question 20

Ovary Cancer - Assessment/Diagnostic: Diagnostic tests may include what

Answer 20

MRI scan, transvaginal and pelvic ultrasound, chest x-rays, and blood test for CA-125

Question 21

Ovary Cancer - Surgical Mx: What is the basis of treatment?

Answer 21

Surgical staging, exploration, and reduction of tumor mass. Surgical removal best choice.

Question 22

Ovary Cancer - Surgical Mx: Treatment likely involves what

Answer 22

total abdominal hysterectomy with removal of fallopian tubes and ovarianes and possibly the omentum , tumor debulking, and pelic lymph node sampling.

Question 23

Ovary Cancer - Surgical Mx: Postop management includes

Answer 23

taxanes or platinum-based chemotherapy

Question 24

Ovary Cancer - Surgical Mx: Treatment forr someone with a borderline tumor?

Answer 24

Younger, and conseravitive approach used. Affected ovary removed but uterus and other ovary may remain in place

Question 25

Ovary Cancer - Pharmacologic Therapy: Chemo is usually administered using which type?

Answer 25

Combo of platinum and taxane agents. Paclitaxel and Carboplatin are most often used bc of manageable toxicity.

Question 26

Ovary Cancer - Pharmacologic Therapy: What SE may occur with Paclitaxel and Carboplatin?

Answer 26

Leukopenia, neurotoxicity, and fever.

Question 27

Ovary Cancer - Pharmacologic Therapy: What do patients taking Paclitaxel with leukopenia need to take

Answer 27

granulocyte colony-stimulating factors.

Question 28

Ovary Cancer - Pharmacologic Therapy: What are some severe cardiac reactions of paclitaxel?

Answer 28

Hypotension, dyspnea, and angioedema and urticaria.

Question 29

Ovary Cancer - Pharmacologic Therapy: Carboplatin may be used in initial tx but used in caution with what patient

Answer 29

those with renal impairment. Six cycles are given.

Question 30

Ovary Cancer - Pharmacologic Therapy: Positive clinical response to carboplatin

Answer 30

Normalization of tumor marker CA-125. negative CT results and a normal physical and gynecologic exam

Question 31

Ovary Cancer - Pharmacologic Therapy: What does Liposomal therapy allow for?

Answer 31

Delivery of chemo in a liposome, which allows highest dose of chemotherapy to tumor target with a reduction in adverse effects. Are nontoxic, biodegrable, easily available and inexpensive.

Question 32

Ovary Cancer - Pharmacologic Therapy: What drug used with liposomal therapy?

Answer 32

Doxorubicin (Doxil) lessens incidence of N/V, and Alopecia. Must b monitored for bone marrow suppression.

Question 33

Ovary Cancer - Pharmacologic Therapy: Intraperitoneal chemotherapy is reserved for who

Answer 33

women with good kidney function because its more toxic and side effects are more severe

Question 34

Ovary Cancer - Pharmacologic Therapy: For those with recurrence, treatment is directed toward?

Answer 34

Control of cancer, maintenance of quality of life, and palliation.

Question 35

Ovary Cancer - Nursing Mx: Those involves what

Answer 35

Those related to patients tx plan, which may include suergery, chemotherapy, palliative care or combo of them.

Question 36

Ovary Cancer - Nursing Mx: Nursing interventions are pelvic surgery?

Answer 36

Similar to those after other abdominal surgeries.

Question 37

Ovary Cancer - Nursing Mx: When is the tumor removed?

Answer 37

If ovarian cancer occurs in young woman and tumor is unilateral.

Question 38

Ovary Cancer - Nursing Mx: What may be done after childbirth?

Answer 38

Surgical reexploration may be performed, and remaining ovary removed.

Question 39

Ovary Cancer - Nursing Mx: What is done if both ovaries are involved?

Answer 39

bilateral oophorectomy performed and chemo follows.

Question 40

Ovary Cancer - Nursing Mx: Pts with advanced ovarian cancer may develop what

Answer 40

ascites and pleural effusion. We would then need to give IV fluids to fix electrolyte imabalcne, administer parenteral nutrition, provide post op care and controlling pain

Question 41

Ovary Cancer - Nursing Mx: Comfort measurs for women with ascites?

Answer 41

Providing small frequent meals, decreasing fluid intake, administering diuretic agents and providing rest.

Question 42

Ovary Cancer - Nursing Mx: Those with pleural effusion may expeirnce what?

Answer 42

SOB, hypoxia, pleuritic chest pain and cough. Thoracentesis performed to relieve this.