Part Ovarian Cancer Question & Answer Guide (With Explanation)

This question focuses on applying theory to practical scenarios.

What This Question Is About

This question relates to part ovarian cancer and requires a structured academic response.

How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

This topic involves part ovarian cancer. A strong answer should include explanation, application, and examples.

Original Question

Part 1: Ovarian Cancer Evidence-based Practice, Patient-Centered Care Mrs. Rebecca Major is a 42-year-old woman with a history of stage IV ovarian carcinoma. She has previously been treated surgically with an exploratory laparotomy that included a total abdominal hysterectomy (TAH), an ileocecal resection and anastomosis, omentectomy, and peritoneal biopsies. She has received 3 courses of chemotherapy consisting of docetaxel and cisplatin. She is currently admitted with shortness of breath (SOB), complaints of (C/O) nausea, and early satiety with recent weight loss of 10 pounds. Her abdomen is distended and her SaO2 is 86% on room air. What is the most common reason ovarian cancer is usually stage III or stage IV when initially diagnosed? List three common presenting signs and symptoms of ovarian cancer. Mrs. Major’s chest x-ray (CXR) reveals bilateral pleural effusions. How do these relate to her underlying disease? How might they be treated? Mrs. Major has been prescribed Cisplatin (Platinol AQ) to be administered intravenously. Cisplatin can be very toxic to the __________. Damage can be lessened by . It can also cause severe ­­­­___________, which can last for many days. Surgical intervention at this time will include debulking of tumor and possible placement of a colostomy. Delineate four appropriate topics to be included in preoperative teaching. Mrs. Major is undergoing a palliative surgical intervention. How would the nurse explain this to the patient and family? Family history analysis reveals a strong positive occurrence of breast and ovarian cancer in Mrs. Major’s family. Her mother died of breast cancer at the age of 56, and a maternal aunt died of ovarian cancer at the age of 59. At the onset of her illness, the physician suggested the possibility of testing for the presence of the BRAC1 and BRAC2 genes. Describe the meaning of this test. PART 2: Breast Cancer Evidence-based Practice, Patient-Centered Care Answer True or False to the following questions regarding breast cancer ____ Breast cancer is the most commonly occurring cancer in women. ____ Breast cancer is the leading cause of death in women in the US. ____ Physical activity can help prevent breast cancer. ____ The most important risk factor for the development of breast cancer is heredity. ____ Oral contraceptives, hormone replacement therapy, alcohol, obesity, and inactivity can all increase the risk for this type of cancer. What are the most common sites for metastasis when a woman has breast cancer? Mary Willis has been diagnosed with breast cancer and the physician informed her that she had distant metastasis. What is Mary’s stage of cancer? Stage 1 Stage II Stage III Stage IV Why is staging the cancer important? “Breast conservation” surgery is gaining favor. This surgery is also called a: With this type of surgery, what is excised? PART 3: Case Study – Breast Cancer Evidence-based Practice, Patient-Centered Care Seventy-two year old Goldie Jackson discovers a hard, stony-like mass in the upper outer quadrant of her right breast one morning as she showers. After drying off from the shower, Mrs. Jackson notices that her right nipple deviates slightly to the left and that there is a small amount of discharge coming from that nipple. Her breast is not painful but she remembers a burning sensation in her breast at bedtime the previous evening when she removed her bra. She makes an appointment to be seen at the local women’s clinic. The nurse begins to gather a nursing history from Mrs. Jackson. Mrs. Jackson is a 5 foot 2 inch female who weighs 175 pounds. Mrs. Jackson states “this lump is probably nothing”, but she is somewhat concerned since her younger sister had a “breast taken off for a lump” three years ago. Mrs. Jackson takes no medication currently but does report taking “some kind of estrogen for severe hot flashes for about seven years” and that she stopped taking that medication last year. She states that she eats a fairly balanced diet but that she does like “sweets”. Mrs. Jackson report having “3 beers a day to keep the doctors away”. Mrs. Jackson is widowed and has one son whom she states she cherishes. She reports she had difficulty conceiving but finally became pregnant at the age of 34 years. When questioned about previous mammograms, Mrs. Jackson comments that she had one twenty years ago, but that it was uncomfortable so she never returned for another. What risk factors for breast cancer are present in Mrs. Jackson’s case? What clinical manifestations is Mrs. Jackson presenting which may indicate breast cancer? If a percutaneous biopsy is not possible for Mrs. Jackson, a surgical biopsy will be performed. After this procedure, what nursing care should be provided? Mrs. Jackson is diagnosed with infiltrating ductal carcinoma. She is started on an IV course of cyclophosphamide (Cytoxan). As a chemotherapeutic, what are its most common side effects? What interventions should be implemented to prevent the occurrence of hemorrhagic cystitis? Two other medications, anastrazole (Arimidex) and letrozole (Femara) are often given to treat breast cancer in post-menopausal women. These medications are ___________ inhibitors and are given for ________ ________ breast cancer. They block production of __________, depriving cancer cells of their means of growth. Two common side effects of these medications are _______________, and increased risk of _________. Unlike tamoxifen Novodex, they do not promote __________ __________. She is scheduled for a mastectomy with a sentinel node biopsy. Why is a sentinel node biopsy performed prior to an axillary node dissection? Describe how a sentinel node biopsy is conducted and what the results mean. Mrs. Jackson undergoes a right modified radical mastectomy. How does a modified radical mastectomy differ from a radical mastectomy, a total mastectomy, and a lumpectomy? Mrs. Jackson returns from surgery with a large pressure bandage over the right chest area. There is a wound drain in place. Why is there a pressure bandage over the surgical site? Describe the priorities in caring for this patient post-operatively on the medical surgical unit. Complete the following chart regarding post-operative nursing diagnoses for modified radical mastectomy Nursing Diagnosis Why is this diagnosis relevant? 3 Interventions Rationale Risk for Infection RC: Hemorrhage During the postop period Mrs. Jackson complains of “pins and needles” in the axillary area. How should the nurse respondPart 1: Ovarian Cancer Evidence-based Practice, Patient-Centered Care Mrs. Rebecca Major is a 42-year-old woman with a history of stage IV ovarian carcinoma. She has previously been treated surgically with an exploratory laparotomy that included a total abdominal hysterectomy (TAH), an ileocecal resection and anastomosis, omentectomy, and peritoneal biopsies. She has received 3 courses of chemotherapy consisting of docetaxel and cisplatin. She is currently admitted with shortness of breath (SOB), complaints of (C/O) nausea, and early satiety with recent weight loss of 10 pounds. Her abdomen is distended and her SaO2 is 86% on room air. What is the most common reason ovarian cancer is usually stage III or stage IV when initially diagnosed? List three common presenting signs and symptoms of ovarian cancer. Mrs. Major’s chest x-ray (CXR) reveals bilateral pleural effusions. How do these relate to her underlying disease? How might they be treated? Mrs. Major has been prescribed Cisplatin (Platinol AQ) to be administered intravenously. Cisplatin can be very toxic to the __________. Damage can be lessened by . It can also cause severe ­­­­___________, which can last for many days. Surgical intervention at this time will include debulking of tumor and possible placement of a colostomy. Delineate four appropriate topics to be included in preoperative teaching. Mrs. Major is undergoing a palliative surgical intervention. How would the nurse explain this to the patient and family? Family history analysis reveals a strong positive occurrence of breast and ovarian cancer in Mrs. Major’s family. Her mother died of breast cancer at the age of 56, and a maternal aunt died of ovarian cancer at the age of 59. At the onset of her illness, the physician suggested the possibility of testing for the presence of the BRAC1 and BRAC2 genes. Describe the meaning of this test. PART 2: Breast Cancer Evidence-based Practice, Patient-Centered Care Answer True or False to the following questions regarding breast cancer ____ Breast cancer is the most commonly occurring cancer in women. ____ Breast cancer is the leading cause of death in women in the US. ____ Physical activity can help prevent breast cancer. ____ The most important risk factor for the development of breast cancer is heredity. ____ Oral contraceptives, hormone replacement therapy, alcohol, obesity, and inactivity can all increase the risk for this type of cancer. What are the most common sites for metastasis when a woman has breast cancer? Mary Willis has been diagnosed with breast cancer and the physician informed her that she had distant metastasis. What is Mary’s stage of cancer? Stage 1 Stage II Stage III Stage IV Why is staging the cancer important? “Breast conservation” surgery is gaining favor. This surgery is also called a: With this type of surgery, what is excised? PART 3: Case Study – Breast Cancer Evidence-based Practice, Patient-Centered Care Seventy-two year old Goldie Jackson discovers a hard, stony-like mass in the upper outer quadrant of her right breast one morning as she showers. After drying off from the shower, Mrs. Jackson notices that her right nipple deviates slightly to the left and that there is a small amount of discharge coming from that nipple. Her breast is not painful but she remembers a burning sensation in her breast at bedtime the previous evening when she removed her bra. She makes an appointment to be seen at the local women’s clinic. The nurse begins to gather a nursing history from Mrs. Jackson. Mrs. Jackson is a 5 foot 2 inch female who weighs 175 pounds. Mrs. Jackson states “this lump is probably nothing”, but she is somewhat concerned since her younger sister had a “breast taken off for a lump” three years ago. Mrs. Jackson takes no medication currently but does report taking “some kind of estrogen for severe hot flashes for about seven years” and that she stopped taking that medication last year. She states that she eats a fairly balanced diet but that she does like “sweets”. Mrs. Jackson report having “3 beers a day to keep the doctors away”. Mrs. Jackson is widowed and has one son whom she states she cherishes. She reports she had difficulty conceiving but finally became pregnant at the age of 34 years. When questioned about previous mammograms, Mrs. Jackson comments that she had one twenty years ago, but that it was uncomfortable so she never returned for another. What risk factors for breast cancer are present in Mrs. Jackson’s case? What clinical manifestations is Mrs. Jackson presenting which may indicate breast cancer? If a percutaneous biopsy is not possible for Mrs. Jackson, a surgical biopsy will be performed. After this procedure, what nursing care should be provided? Mrs. Jackson is diagnosed with infiltrating ductal carcinoma. She is started on an IV course of cyclophosphamide (Cytoxan). As a chemotherapeutic, what are its most common side effects? What interventions should be implemented to prevent the occurrence of hemorrhagic cystitis? Two other medications, anastrazole (Arimidex) and letrozole (Femara) are often given to treat breast cancer in post-menopausal women. These medications are ___________ inhibitors and are given for ________ ________ breast cancer. They block production of __________, depriving cancer cells of their means of growth. Two common side effects of these medications are _______________, and increased risk of _________. Unlike tamoxifen Novodex, they do not promote __________ __________. She is scheduled for a mastectomy with a sentinel node biopsy. Why is a sentinel node biopsy performed prior to an axillary node dissection? Describe how a sentinel node biopsy is conducted and what the results mean. Mrs. Jackson undergoes a right modified radical mastectomy. How does a modified radical mastectomy differ from a radical mastectomy, a total mastectomy, and a lumpectomy? Mrs. Jackson returns from surgery with a large pressure bandage over the right chest area. There is a wound drain in place. Why is there a pressure bandage over the surgical site? Describe the priorities in caring for this patient post-operatively on the medical surgical unit. Complete the following chart regarding post-operative nursing diagnoses for modified radical mastectomy Nursing Diagnosis Why is this diagnosis relevant? 3 Interventions Rationale Risk for Infection RC: Hemorrhage During the postop period Mrs. Jackson complains of “pins and needles” in the axillary area. How should the nurse respond? Mrs. Jackson is to be started on tamoxifen (Novodex) postoperatively. Since this drug is to be given, Mrs. Jackson’s breast tumor is most likely: A) progesterone-receptor negative C) progesterone-receptor positive B) estrogen-receptor negative D) estrogen-receptor positive How does Tamoxifen work? What are some potential negative consequences of this drug? What are some side effects of this drug? Tamoxifen is used for both prevention and treatment of breast cancer. True/False Lymphedema can be a concern for patients after Axillary Lymph Node Dissection (ALND). What should the nurse teach the patient about prevention, management, and treatment? ? Mrs. Jackson is to be started on tamoxifen (Novodex) postoperatively. Since this drug is to be given, Mrs. Jackson’s breast tumor is most likely: A) progesterone-receptor negative C) progesterone-receptor positive B) estrogen-receptor negative D) estrogen-receptor positive How does Tamoxifen work? What are some potential negative consequences of this drug? What are some side effects of this drug? Tamoxifen is used for both prevention and treatment of breast cancer. True/False Lymphedema can be a concern for patients after Axillary Lymph Node Dissection (ALND). What should the nurse teach the patient about prevention, management, and treatment?

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