CT scan: A 3-dimensional image of the uterus is taken using x-rays through different angles. The computer then combines the images where a tumour and its size can be seen to confirm the diagnosis.
Hallo Maria, the female reproductive system is responsible for conception. At the external genital area, there lies a vulva that contains various organs like the clitoris, the urethral orifice, the labia majora and minora and the introitus (Martini and Bartholomew, 2017). The introitus opens into the vagina. Then the vagina into the uterus, which houses a fetus after conception and is in the lower abdomen. The uterus is connected to the ovaries by fallopian tubes. The ovaries eject a mature ovum to the fallopian tubes, and in a region called the isthmus, this ovum is fertilised after coitus (Alessandria et al., 2015). Then it moves to the uterus where it develops until one gives birth. Now, the uterus has various layers on its wall, and the innermost is known as the endometrium. This is the centre of our focus. The individual cells that form your endometrium always divide in a normal and controlled process known as mitosis. However, some factors may make these cells to divide at an uncontrollable rate, a condition we are calling endometrial uterine cancer. As the cells divide uncontrollably, the endometrial wall grows, a reason you presented with abdominal swelling. Moreover, the growth also exerts pressure on capillaries, which eventually rupture (Martini and Bartholomew, 2017). Also, the growth itself may produce more hormones that cause discomfort and eventual bleeding. This is the reason you presented with per vaginal bleeding. Stage 2 cancer stage means that the cancerous cells have covered the main uterine body and the lower uterine segment called the cervix (Alessandria et al., 2015).
Treatment option: One of the treatment options for stage 2 cancer is surgery that involves a hysterectomy, bilateral salpingo-oophorectomy and the removal of para-aortic and pelvic lymph nodes (Mayo Clinic, 2017). The lymph nodes can then be examined for further signs of metastases through biopsy.
Nursing issue: The priority nursing issue that arises from this form of treatment is acute pain related to a surgical incision.
Goal: Maria will describe a satisfying control of pain at levels below three on a scale rating of 0 to 10 after surgery (Mayo Clinic, 2017). She will also record an improvement in her well being especially the baseline vital signs like pulse rate, respirations, temperature and blood pressure. Additionally, she will have a relaxed posture and a normal tone of the muscles. Another goal is that Maria will utilise non-pharmacological and pharmacological forms of pain management (Rosenfeld and Loose, 2014). Furthermore, she will display an improved mood and coping postoperatively.
Administer a non-opioid agent like acetaminophen or a nonsteroidal anti-inflammatory drug. NSAIDS are active in the peripheral tissues by blocking the prostaglandin synthesis that enhances nociception (Lippincott, 2013).
Administer an opioid analgesic if the pain is not relieved by NSAIDS. The opioid to be administered is morphine.
Report any unsuccessful measures undertaken to the oncologist and the physician (Lippincott, 2013).
Reassure Maria that pain is limited and it is manageable mostly by patient factors such as a positive image of herself (Rosenfeld and Loose, 2014).
Alessandria, S., Norese, G., Gorosito, F., Lange, M., Nölting, M. and Bermudez, A. (2015). Early stage endometrial cancer: laparoscopy vs. laparotomy. International Journal of Gynecological Cancer, 25, p.70.
Charles, P. (2017). Cancer of the Uterus (Uterine Cancer or Endometrial Cancer). Journal of Medicine, [online] pp.1-6. Available at: https://www.medicinenet.com/uterine_cancer/article.htm [Accessed 27 Apr. 2017].
Lippincott, W. (2013). Brunner and suddarth's textbook of medical -surgical nursing 12th ed. + nursing diagnosis, ... 1st ed. [Place of publication not identified]: Wolters Kluwer Health.
Martini, F. and Bartholomew, E. (2017). Essentials of anatomy & physiology. 1st ed. Harlow, Essex: Pearson Education.
Mayo Clinic. (2017). Overview - Mayo Clinic. [online] Available at: https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/home/ovc-20205704 [Accessed 27 Apr. 2017].
Rosenfeld, G. and Loose, D. (2014). Pharmacology. 1st ed. Baltimore, MD: Lippincott Williams & Wilkins.
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