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, anastomosis, omentectomy, and peritoneal biopsies. Mrs. Rebecca Major 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.
- Her chest x-ray (CXR) reveals bilateral pleural effusions. How do these relate to her underlying disease? How might they be treated?
- She 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.