INTRODUCTION

General Objectives
The purpose of the presentation is to know related information and knowledge about the patients case/ condition and disease. This presentation will serve as guidelines for us student nurses in assessing and providing proper nursing care to our patient with the same problem or disease.

Specific Objectives
To understand condition of disease and associate it with the patient through the introduction of the case To know the nursing history, personal data, health history and physical assessment of the patient To illustrate the anatomy and physiology and pathophysiology of the affected organ. To discuss and determine manifestation and complications To develop an effective skill on how to manage care in patient with the disease To formulate a drug study with regards to the patients condition and correlate lab results to its normal values. To provide the client a nursing care plan and discharge plan to assure for clients total wellness during her hospitalization up to the time of her hospital discharge.

Overview of the disease

Ovarian cysts are small fluid-filled sacs that develop in a woman's ovaries. Most cysts are harmless, but some may cause problems such as rupturing, bleeding, or pain; and surgery may be required to remove the cyst(s). It is important to understand how these cysts may form. Women normally have two ovaries that store and release eggs. Each ovary is about the size of a walnut, and one ovary is located on each side of the uterus. One ovary produces one egg each month, and this process starts a woman's monthly menstrual cycle. The egg is enclosed in a sac called a follicle. An egg grows inside the ovary until estrogen (a hormone), signals the uterus to prepare itself for the egg. In turn, the uterus begins to thicken itself and prepare for pregnancy. This cycle occurs each month and usually ends when the egg is not fertilized. All contents of the uterus are then expelled if the egg is not fertilized. This is called a menstrual period. Ovarian cysts affect women of all ages. The vast majority of ovarian cysts are considered functional (or physiologic). In other words, they have nothing to do with disease. Most ovarian cysts are benign, meaning they are not cancerous, and many disappear on their own in a matter of weeks without treatment. Cysts occur most often during a woman's childbearing years. Ovarian cysts can be categorized as noncancerous or cancerous growths. While cysts may be found in ovarian cancer, ovarian cysts typically represent a normal process or harmless (benign) condition.

Types of Cysts
Graafian follicle cysts
These are the most common type, and are most likely to develop when an egg does not release properly during ovulation. Generally, the cyst will gradually be reabsorbed into the system over the course of several menstrual cysts and cause no problems whatsoever.

Corpus Luteum cysts

These also develop during the menstrual cycle when an egg fails to release. With this type of cyst, the thin wall containing the fluid may rupture. This in turn releases fluid back into the ovary. Like the Graafian follicle cyst, the corpus luteum cyst will reabsorb into the system over the course of three or so periods.

Hemorrhagic cysts
These types of cyst are capable of inflicting a great deal of pain. Sometimes referred to as blood cysts, hemorrhagic cysts undergo small ruptures in one of the blood vessels in the cyst wall. This releases blood back into the ovary and can be extremely painful. While surgery is sometimes necessary, many women can take medication and rest for several days as the body heals.

Pathological and Endometrioid cysts

Both of these have the potential to create severe health issues for women. Should the development of a pathological cyst take place, it can lead to Polycystic Ovarian Syndrome, a condition that increases the chances of pregnancy loss, affects fertility, and can produce an unusual amount of bleeding during menstruation.

Signs and Symptoms

Oral contraceptive/birth control pill use decreases the risk of developing ovarian cysts because they prevent the ovaries from producing eggs during ovulation. The following are possible risk factors for developing ovarian cysts: History of previous ovarian cysts Irregular menstrual cycles Increased upper body fat distribution Early menstruation (11 years or younger) Infertility Hypothyroidism or hormonal imbalance Tamoxifen therapy for breast cancer

Ovarian Cysts Symptoms

Usually ovarian cysts do not produce symptoms and are found during a routine physical exam or are seen by chance on an ultrasound performed for other reasons. However, the following symptoms may be present: Lower abdominal or pelvic pain, which may start and stop and may be severe, sudden, and sharp. Irregular menstrual periods Feeling of lower abdominal or pelvic pressure or fullness Long-term pelvic pain during menstrual period that may also be felt in the lower back Pelvic pain after strenuous exercise or sexual intercourse Pain or pressure with urination or bowel movements Nausea and vomiting Vaginal pain or spots of blood from vagina Infertility

OVARIAN CYST TREATMENT

Physicians will employ different types of ovarian cysts treatment, depending on several key factors. Fortunately, the vast majority of cysts of this type are benign. As a result, the treatment strategy is usually focused more on alleviating the pain and discomfort associated with the symptoms while continuing to monitor the status of the cyst itself.

For many women, the use of over the counter pain relievers is effective with many of the aches and pains associated with an ovarian cyst. Ibuprofen and acetaminophen are commonly recommended to help women deal with aching in the joints, headaches, and general body aches. Some women also find some relief with aspirin and may prefer this type of medication to the others. If any one of these pain relievers causes a negative reaction, trying one of the others will usually bring about the relief that is desired. In addition to over the counter medications, there are other forms of ovarian cysts treatmentthat can also be made from everyday things around the house. Applying cold to the lower back or abdomen can sometimes help to dull pain in those areas. Placing chipped ice into a zipper style storage bag, then wrapping the bag in a kitchen towel can quickly create a homemade cold pack. The chipped ice will conform easily to the contours of the body, making it much easier to get the most benefit from the treatment.

Some women find that the application of heat does more good than using cold. A heating pad placed on the thighs, abdomen, or lower back may help to pull some of the soreness and aching that can sometime develop as a sign of the presence of an ovarian cyst. If no heating pad is available, warming salt in a microwave oven, then placing the salt into an old sock will work very well. Heat pads can be applied on an as-needed basis, or used at specific times of day, whichever seems to provide the most relief. Other options for applying heat include enjoying a soak in a hot bath, or using a hot water bottle to concentrate heat on the area where the pain is present. Even using a shower massage to direct a steady stream of hot water onto the stomach or lower back can help bring some degree of relief.

Pain Relief for Ovarian Cysts Treatment

When these elementary forms of ovarian cysts treatment are not successful, a physician may prescribe a stronger pain reliever to help with cramps, dull aches, or shooting pains. Use of prescription narcotics should include following the physicians orders for dosage levels and frequency to the letter. If the medication is not providing relief, dont try taking more on your own. Consult with your physician first; it may be that switching to a different medication will bring about relief from your symptoms. Even while treating the pain, doctors will want to watch the status of the cyst closely. Since most cysts will simply break down over the course of two or three periods, there is usually no cause for alarm. However, if the physician notices that the cyst is growing rather than shrinking, he or she may choose to undertake ovarian cyst removal. Keep in mind that surgically removing a cyst does not automatically mean that a malignancy is present. At times, ovarian cysts treatment like this is more to prevent a benign cyst from developing into a malignant one. The doctor may also order ovarian cyst surgery if there are indications that the cyst is about to or has already damaged the ovary beyond repair. Depending on when the surgery takes place, it may be possible to save the ovary. However, it is not unusual for an ovary containing a cyst of significant size to be removed altogether.

OVARIAN CYST REMOVAL

Theres a good chance you will never have to deal with the issue of ovarian cyst removal. The cysts often form, grow for a short period of time, then simply reabsorb into the body. However, there are a few situations that will prompt your doctor to recommend surgical removal of an ovarian cyst, such as signs that the cyst is malignant or it has grown to a size that threatens the health of your ovaries. When this happens, you do have a couple of options that merit consideration.

What Are Your Options for Ovarian Cyst Removal?

The first option for ovarian cyst removal is known as open surgery. This approach is the oldest method, and is a fully invasive procedure. With open surgery, you will check into the hospital, and go through all the preparation that is necessary for any type of operation. In the operating room, the surgeon will open your abdominal cavity. This allows the surgeon to have a clear view of the cyst and the surrounding organs and tissue. The blood vessels that feed your ovaries are clamped, and then the cyst is removed carefully. If there is any sign of a rupture, the surgeon will also remove any deposits from the cyst that have collected in the abdomen. A biopsy will be conducted on the extracted cyst, just to make sure there is no sign of cancer, and to make sure that no metastasis (spreading of cancer cells to other organs) has taken place.

What To Expect After Ovarian Cyst Removal via Open Surgery?

With open surgery, you can expect your recovery time to be up to six weeks, although many women find that a month is sufficient when no complications arise during the procedure or at any point during the healing process. This type of surgery involves all the usual risks for infection, but with proper care there is a good chance you will not have any problems, other than soreness and bruising from the cutting of the skin and the muscles of the abdomen.

A second option for ovarian cyst removal is known as laparoscopic surgery. Much less invasive than open surgery, this approach makes use of a device known as a laparoscope. Essentially, this is a small device that has a tiny camera at one end. The surgeon makes a small incision, usually just below the navel. The laparoscope is inserted and routed gently to the area around the ovaries. Once the surgeon has a clear view of the location of the cyst, he or she can make a couple of additional incisions, and use small surgical tools to sever and remove the cyst. One of the benefits of using laparoscopic surgery as your ovarian cyst removal method is that there are fewer traumas to your body. The smaller incisions take less time to heal than with open surgery. In addition, while your abdominal muscles may be bruised and sore for some time, they will also recover at a faster rate. You will also find the chance for infection is reduced, which also speeds your recovery along. Depending on how the surgery goes, and if there are any complications arising from the procedure or during the recovery period, you may be healed enough to resume normal activities in two to three weeks. Your doctor can advise you of what to expect in your specific situation. The choice of which procedure to use for ovarian cyst removal depends a great deal on what is happening with your cysts. Today, many physicians will go with the laparoscopy if at all possible; open surgery is only used if there are compelling reasons to do so. In either case, your physician will make sure you understand how to prepare for the surgery, what to expect in the way of pain afterwards, and provide instructions on what you can do to speed along your recovery.

Bilateral Oophorectomy
A bilateral oophorectomy is a medical procedure in which both ovaries are surgically removed. This procedure often is carried out in conjunction with a hysterectomy, in which the uterus is removed. A woman who has had a bilateral oophorectomy loses the ability to produce hormones such as progesterone and estrogen, and she will no longer have menstrual periods. The effect of the procedure is similar to what happens when a woman goes through menopause, except that after this surgery, these effects occur rapidly rather than over a period of several years. An oophorectomy can be performed for a number of reasons. These include to treat endometriosis and to remove ovarian cysts, abscesses or malignant cancers. In addition, this procedure might be performed as a preventative treatment for women who have a high risk of developing ovarian cancer or estrogen-dependent breast cancer. This breast cancer is associated with mutations in genes called BRCA1 and BRCA2, and the risk of the cancer occurring in women with the genetic mutation is decreased significantly after bilateraloophorectomy. This is because this breast cancer is more likely to develop in the presence of estrogen, so removal of the ovaries reduces the cancer risk. Oophorectomy typically is carried out via an incision made in the abdomen. This procedure can be carried out laparoscopically, which leaves much smaller scars and has a shorter recovery time, but an abdominal incision is preferred by many surgeons because it provides a better overall view of the interior of the abdominal cavity. After surgery, recovery can take two to six weeks, depending on whether hysterectomy was performed in addition tooophorectomy and whether the procedure was carried out laparoscopically. After bilateral oophorectomy, the supply of estrogen in the body reduces almost immediately, leading to the development of menopausal symptoms that often are much more severe than would be experienced by a woman undergoing

natural, age-associated menopause. This so-called surgical menopause can include severe hot flashes, night sweatsand sleep disturbances. To counteract these effects, most women are prescribed hormonereplacement medications after undergoing bilateral oophorectomy. The value of bilateral oophorectomy for reducing the risk of ovarian and breast cancers is proven, but the overall desirability of the procedure is still under debate. This is because removal of the ovaries prior to menopause increases the risk of cardiovascular disease and osteoporosis because of the loss of estrogen. Women who have this procedure can use hormone replacement therapy until they reach natural menopause age, but the risk of cardiovascular disease and osteoporosis remains higher than normal.