LESSON PLAN

ON
CERVICAL CANCER

PRESENTED BY:-
NEHA KHANAM
[M.Sc. NURSING IIndyear]

IDENTIFICATION DATA
NAME OF EVALUATOR : MRS. S. BIRJENI
NAME OF THE STUDENT : NEHA KHANAM
COURSE OF STUDY : MSC NURSING 2ND YEAR
SUBJECT : OBSTETRICS AND GYNAECOLIGY
TOPIC : CERVICAL CANCER
VENUE : ROHILKHAND MEDICAL COLLEGE AND HOSPITAL
DURATION : 1 HOUR
DATE : 16-06-2021
METHOD OF TEACHING : LECTURE CUM DISCUSSION
A.V AIDS : PPT, HANDOUTS, PAMPLET, LEAFLETS

GENERAL OBJECTIVES
 At the end of this presentation should able to learn about the cervical cancer.

SPECIFIC OBJECTIVES
To introduce about the cervical cancer.
To discuss about the definition.
To explain about the etiology and risk factors.
To explain about the types of cervical cancer.
To discuss about the pathophysiology.
To explain about the sign and symptoms.
To describe about the stages of cervical cancer.
To explain about the diagnosis of cervical cancer.
To explain about the management of cervical cancer.
To discuss about the prevention of cervical cancer.
To explain about the nursing management.

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 CERVICAL CANCER
INTRODUCTION

Cervical cancer is the third most common cancer in women

Worldwide. Cervical is a disease that develops quite slowly What do you mean
and begins with a precancerous condition known as by cervical cancer?
dysplasia. The cervix is the lower portion of the uterus that
Lecture cum
connects the uterus to the vagina. The opening of the cervix
1. 2min To introduce discussion PPT
remains small expect during labor when it expands to allow
about the cervical
the baby to pass from the uterus to the vagina. Cervical
cancer
cancer occurs when cell in the cervix grow erratically and
multiple out of control.

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 Definition
To discuss about the Cervical cancer is a malignant tumor deriving from
2 definition Lecture cum Define of cervical
cells of the “cervix uteri”. It is due to the abnormal
2min discussion PPT cancer?
growth of cells that the ability to spread to other parts
of the body.

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ETIOLOGY AND RISK FACTORS

Human papilloma virus (HPV), which is transmitted

 by sexual contact, is the leading cause of cervical
cancer. Studies have documented clearly that cervical Explain about the
3. 5min To explain about the cancer is common among prostitutes. The other risk PPT etiology and risk
etiology and risk factors for cervical cancer are: Lecture cum factors?
factors discussion
 Multiple sexual partners, history of sexually
transmitted infections and prostitution
 Early age first intercourse
 Immunosuppression, poor socioeconomic
status
 Smoking
 Use of oral contraceptives
 Antioxidant vitamins deficiency
 Intrauterine exposure to DES
 Frequent douching or heavy use of talc
 Several pregnancies
 Family history

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TYPES OF CERVICAL CANCER

 Squamous cell carcinoma: The forms in the lining of your Explain about
4 5min To explain about cervix. It’s found in up to 90% of cases. Lecture cum Handout the types of
 the types of  Adenocarcinoma: The forms in the cells that produce discussion cervical cancer?
cervical cancer mucus.
 Mixed carcinoma. This has features of the two others
types.

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PATHOPHYSIOLOGY

Sexual activity
Lecture cum Discuss about the
Enter to HPV discussion pathophysiology
of cervical
5 2min To discuss about Pamplet cancer?
the Virus enter in the basal layer of Cervix
 pathophysiology
HPV infects the basal cells

Cell become pre-cancerous

Damage cells continue to multiply

Cervical cancer

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SIGN AND SYMPTOMS

Cervical cancer may be asympatomatic in early stages.
 Bleeding that occurs between regular menstrual periods.
Explain about
6 5min To explain about  Bleeding after sexual intercourse
sign and
the sign and  Menstrual periods that last longer and are heavier than Lecture cum symptoms of
symptoms before discussion PPT cervical cancer?
 Bleeding after going through menopause
 Metrorrhagia
 Increased vaginal discharge
  Pelvic pain
 Swollen legs
 Bone pain
 Weight loss and lack of appetite
 fatigue

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STAGES OF CERVICAL CANCER

 Stage I ; Cancer is confined to cervix
 Stage II; Cancer at this stage includes the cervix and uterus,
To describe
7 4min but has not spread to the pelvic wall or the lower portion of Describe about
about the stages
the vagina. Lecture cum the stages of
of cervical
cancer  Stage III; Cancer at this stage has moved beyond the cervix discussion PPT cervical cancer?
and uterus to the pelvic wall or the lower portion of the
vagina.
 Stage IV; At this stage ,cancer has spread to nearby
organ,sach as the bladder or rectum ,or it has spread to other
 areas of the body , such as the lungs, liver or bones.

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DIAGNOSIS AND INVESTIGATION

I. Pap smear; It is a screening test to detect cancer in

preinvasive phase. Annual Pap smears should be
encourage in all sexually active women, especially those
8 8min To explain about at high risk.
the diagnosis and II. Biopsy. A conical or punch biopsy is obtained during Explain about the
investigation the colposcopic examination and is considered adequate Lecture cum diagnosis and
for histopathology. investigation of
discussion PPT cervical cancer?
III. Occasionally excision biopsy by loop electrocautery
may be done under local anesthesia by a low – voltage
diathermy loop.
IV. Other investigation such as
 I.V.P (intravenous pyelogram)
  CT scan
 Cystoscopy
 Sigmoidoscopy
 Blood test
 MRI
 PET scan of lymph nodes

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 MANAGEMENT

Treatment depends on the stage of cancer. Chemotherapy has

played no significant role in cervical cancer. Squamous cell
carcinoma is relatively unresponsive to drug treatment.
10min To explain about Surgical treatment includes conization
9 the management Lecture cum Explain about the
 Loop electrocautery excision procedure (LEEP) for
of cervical discussion management of
the involve tissue , PPT
cancer cervical cancer?
 Cryosurgery or laser surgery for localized tumors
 Radical hysterectomy for invasive cancer
 Recent advances in HPV vaccines are offering hope
for use for HPV therapy and prophylaxis against
cervical cancer

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 PREVENTION OF CERVICAL CANCER

Cervical cancer can often be prevented by having regular screening

with Pap tests and HPV tests to find any precancers and treat them.
10 5min To discuss about
It can also be prevented by receiving the HPV vaccine. Lecture cum Leaflet What are the
the prevention of
 Delaying first sexual intercourse until the late teens or discussion prevention of
cervical cancer
older cervical cancer?
 Practicing safe sex by using condoms dental dams
 Avoiding sexual intercourse
 Quitting smoking

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 NURSING MANAGEMENT
A. Patient care
(a) Nursing care before implantation of radioactive Lecture cum
material discussion
Explain about the
11 10min To explain about  Empty the bowel with a cleansing enema. nursing
the nursing  Keep the bladder empty for Folley’s catheter for management of
management better penetration of radiation. PPT cervical cancer?
 Shave the pubic area, if necessary, and perform
betadine douche.
(b) Nursing care during 24-72 hours of implantation
 Keep the bladder and rectum separated from the
irradiated zone by a gause piece placed into the
vagina.
 Maintain strict bed rest. Make the patient lie flat or
head slightly
 Elevated. Help the client to turn from side to side.

(c) Use analgesic for pain relief.

(d) Avoid bowel distension by advising the patient to take
low-residue diet and antimotility drug, if needed.
(e) Perineal cleansing by aseptic method. For foul smelling
discharge, use deodorant.
(f) Advise minimal intake of fluid (2-2.5L/day).

B. Radiation precaution for the nurse and other staff involved

 Nurse or other staff should not spend much time (>30
min) at the bedside or near the client.
 Children and pregnant women are not allowed to visit
 the client.
 Staff members should wear a dosimeter during every
visit to the client to monitor the radiation exposure.
 Do not handle the implant with hands. Use a long
forcep. Keep a lead lined container ready in the room
in case the implant dislodges.
C. Advice to the patient at discharge.
 The women should be taught self-care skills home
management.
 The women must know the radiation hazard and its
signs and symptoms.
 Nurse should teach the technique of douche, use of
vaginal cream and regular vaginal dilator.
 Advise frequent sexual intercourse between regular
sexual partners.
 Others self-care measures includes:
- Liberal fluid intake
- Good diet
- Gradually increasing activity
- Instruct the client to report in case of complication
- Stress on regular follow- up visits

SUMMARY
Today summaries my topic, HPV infection is more than cervical
cancer. There is an increasing evidence strongly linking HPV DNA
with cancers of anus, vulva, vagina uterus. Although current
vaccines are highly effective in women, implementation of HPV
vaccination in developing countries remains a challenge.

CONCLUSION
HPV plus Pap co-testing is now strongly recommended for cervical
cancer screening in women ages 30-65
. Both tests are negative, the screening interval is very 5 years.
Cervical cancer remains as a leading cause of morbidity and
mortality for women worldwide.
 SEPCIFIC TEACHING A.V
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BIBLIOGRAPHY

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