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Adult Medical-Surgical Nursing

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Presentation on theme: "Adult Medical-Surgical Nursing"— Presentation transcript:

1 Adult Medical-Surgical Nursing
Reproductive Health Module: Cervical Cancer

2 Cervical Cancer: Description
Carcinoma of the cervix of the uterus is mainly squamous cell Classification: CIN I and II (Cervical Intra-epithelial Neoplasia): mild to moderate dysplasia CIN III: severe dysplasia (carcinoma in situ). Still pre-invasive Invasive carcinoma

3 Cervical Cancer: Aetiology
Mainly occurs in younger women (child-bearing age) Multiple sex partners and unprotected sex Smoking; malnutrition; drug abuse *Chronic genital infection especially HPV: Human Papilloma Virus (genital wart virus) Other sexually transmitted diseases (STD) as genital herpes, chlamydia, gonorrhoea, HIV

4 Cervical Cancer: Clinical Manifestations
Intermenstrual bleeding per vagina Bleeding after intercourse Watery or foul-smelling vaginal discharge (advanced) Possibly post-menopausal bleeding

5 Cervical Cancer: Diagnosis/ Screening for Early Detection
Papanicolau cervical smear (Pap smear): cells scraped from inside the cervical canal. Yearly screening advised If abnormal Pap smear: Cone biopsy (wide wedge of surrounding tissue excised for examination/ staging) Colposcopy (examination of the uterus) If invasive: further tests to assess extent

6 Invasive Cervical Cancer: Further Tests to Assess Extent of Disease
D&C (Dilatation and Curettage) MRI CT scan IVP Barium studies (bowel) Bone scan

7 Cervical Cancer: Prevention
Health Education: Avoid multiple partners/ unprotected sex Seek optimum health and nutritional status ↓ smoking ↓ drug and alcohol abuse Annual screening through Pap Smear Vaccination for HPV now being used as public health measure

8 Cervical Cancer: Management
CIN I and II (pre-invasive): Cryotherapy (nitrous oxide freezing) or laser to remove Regular follow-up with Pap smear CIN III (also pre-invasive): Cone biopsy, colposcopy, laser or cryotherapy Careful regular follow-up Post-childbearing, hysterectomy an option

9 Invasive Cervical Cancer: Management
Further tests to assess extent of disease Staging (TNM): Tumour, Nodes, Metastases Radical surgery: Total Hysterectomy and Bilateral Salpingo-oophrectomy Radiation therapy: external beam and brachytherapy (internal pack) Chemotherapy

10 Cervical Cancer: Nursing Considerations
Clear health education related to: Lifestyle measures Regular Pap smear Vaccination for HPV Emotional and psychological support to patient and family involved in treatment


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