Davao Doctors College, Inc.

College of Allied Health Sciences

Nursing Program

NRG 301: CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID AND

ELECTROLYTES, INFECTIOUS, INFLAMMATORY AND IMMUNOLOGIC RESPONSE,
CELLULAR ABERRATIONS, ACUTE AND CHRONIC
All a Nurse Needs to Know about Medical-Surgical Nursing

Message from your Instructor

Hello future nurses! I am Dr. Karl Nazanzien L. Chavez, a

faculty member of the Nursing Program of Davao Doctors
College, Incorporated, and I will be your instructor for NRG
301: CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION,
FLUID AND ELECTROLYTES, INFECTIOUS, INFLAMMATORY
AND IMMUNOLOGIC RESPONSE, CELLULAR ABERRATIONS,
ACUTE AND CHRONIC. I garnered my BS Nursing degree
from San Pedro College, Davao City last March 2009 and
immediately took the Nursing Licensure Exam by November
2009. In 2010, I volunteered as a nurse in Samal District
Hospital. In July 2011, I got hired as a staff nurse at San Pedro
Hospital where I worked until 2016. I decided to pursue my dream of becoming a medical doctor,
so I resigned on the same year and began my medical studies at Davao Medical School Foundation.
Just this year, I was able to finish my studies and earned my degree in Doctor of Medicine. I’m
currently having my post-graduate internship program at the Department of Health – Philippine
Centers for Specialized Healthcare in Manila.

Currently, I am affiliated with Davao Doctors’ College as a Part-time Clinical Instructor and tasked
to teach: Human Anatomy and Physiology Laboratory.

For this semester, I will be your instructor for NRG 301: CARE OF CLIENTS WITH PROBLEMS IN
OXYGENATION, FLUID AND ELECTROLYTES, INFECTIOUS, INFLAMMATORY AND
IMMUNOLOGIC RESPONSE, CELLULAR ABERRATIONS, ACUTE AND CHRONIC. I am looking
forward to guiding you in learning this course well. If you want to reach me for any academic-
related concerns, you may reach through the following:

Contact number: 0917-717-7462

E-mail address: karlnazanzienchavez@davaodoctors.edu.ph
Consultation hours: 8am-5pm

The course NRG301: Care of Clients with Problems in Cellular Aberration deals with
concepts, principles, theories and techniques of nursing care management of at risk and sick adult
clients in any setting with alterations/ problems in cellular aberration. In this course, you are
expected to provide nursing care to at risk and sick adult clients utilizing the nursing process.
Presented below are the specific details of this course:

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Course Number: NRG 301

Course Credits 14 units (8 units Lecture, 6 units RLE)

306 hours (25.5 hours/week for 12 weeks)

No of Hours (Lab):
If with NRG302 (51 hrs) = 357 hrs (29.75 hours/week for 12 weeks)

Placement: Third year, First Semester

Prerequisite: NRG 204

Schedule: MTW 8-4

GOOGLE CLASSROOM: 13E NRG 301 RLE

Classroom:
CLASS CODE: km5rgkq

Requirements in Completing the RLE Activities

Since most of our sessions for this semester will be delivered through distance/blended learning
activities, the submissions will also be done online. To do this, you need to have access to the
following applications:
1. Microsoft Office/Google Docs
2. Google Classroom
3. Google Meet (or any other teleconferencing app, duly agreed by the whole class)
4. Internet connectivity

Access to a printer and/or scanner is also a plus, but not a requirement.

Daily Activities
Every week, you are expected to follow through the following deliverables:
Wednesday Thursday Friday Saturday
Completion of Module, Discussion of: Discussion of: Assignment of
to be submitted within 1. Stepping In 1. Deep Dive Reflection Time
the day 2. Deep Dive ❖ NCP (Readings)
❖ History taking ❖ DAR Charting
❖ Physical ❖ Clinical Weekly Quiz
Assessment Reasoning
❖ Concept Map Questions Preparation for next
❖ Drug Study week’s activity
❖ IVF 2. Destination Check

Now that you are done acquainting yourself with the instructor and the course itself, please proceed
to Module 11: Care of Clients with Problems in Cellular Aberration.

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

MODULE 11:
CARE OF CLIENTS WITH CELLULAR ABERRATION

Term: Third Term, First Semester S.Y. 2020-2021

Dates: Week 17: November 23-26, 2020
Class Schedule: 8:00 am - 4:00 pm
No. of Hours: 8 hours/meeting

Instructions
Print this worksheet to answer or write your answers on clean white bond papers. Answers must
be handwritten. Do not forget to write your name, year level and section, and course name on
the upper part of all your submissions. Observe pagination. Once done, take clear pictures of your
written outputs, compile them (in WORD or PDF), and send the compilation to your instructor.

Learning Outcomes
At the end of this module, you are expected to:
1. Utilize the nursing process in the care of a client with problems in cellular aberration.
2. Perform a holistic health assessment based on the case scenario presented.
3. Utilize assessment information to formulate a patient-centered plan of care.
4. Explain appropriate nursing interventions per problems identified.
5. Apply bioethical concepts/principles, core values, and nursing standards in the care of
clients.
6. Document the care rendered to assigned patient in the simulated health care record
accurately.

As you start with this module, you are free to consult and coordinate with your assigned clinical
instructor. Be sure to get his/her email address and contact number for collaboration and
assistance. Just keep going, you can do it!

STEPPING IN

Hello, future nurse!

Welcome to your Module 11. You had your discussion on the process of cellular aberration from
your concepts in Anatomy & Physiology, and to nursing procedures addressing cancer concerns. In
this module, you will learn the pathophysiology, diagnostics, medical and nursing management of
patients with breast, ovarian and cervical CA. Let us have a review of these concepts and see how
much you recall.

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College of Allied Health Sciences
Nursing Program

Review on the Anatomy & Physiology:

Cell Cycle
A cell cycle is a series of events that takes place
in a cell as it grows and divides. Understanding
this concept is essential in learning the
management of cancers because, at its core,
cancer cells are the result of cell cycle gone
wrong.

Answer the following:

Narrate the process that is taking place in the
figure shown here
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Why is learning the cell cycle important in understanding the how cancer cells exist and how cancer
therapy is prescribed for clients with cellular aberration problems? Discuss in not less than 5
sentences.
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Nursing Program

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Histology
1. Draw and then compare and contrast normal cells from hypoplasia, hyperplasia, neoplasia,
dysplasia, metaplasia, and anaplasia in terms of their etymology, definitions, and significant
characteristics.
2. Compare and contrast invasion and metastasis.

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College of Allied Health Sciences
Nursing Program

Cancer’s Classic Warning Signs

In one of your seminars about oncology, you
were asked by one of your attendees about
what are the warning (or danger) signs of
cancer. You correctly answer this question by
stating that the warning (or danger) signs of
cancer are:

Compare and contrast a benign from a malignant tumor in terms of differentiation,

encapsulation, metastasis, prognosis, and treatment modalities. Write your answers in a table.

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Nursing Program

Draw an infographic that you can use to educate the public about the various ways to detect
cancers early [cite the different health assessment procedures and/or diagnostic procedures,
including their definitions and brief description of the procedure, that the public must know for the
early detection of cancers, esp. for skin, breast, testicular, colon, and cervical/ovarian cancer]. You
may use additional sheets for this activity.

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Grading and Staging of Cancers

A relative of a patient who has been recently diagnosed with breast cancer asks you about how
cancers are graded and staged. You correctly reply to this question by stating that the cancer
grading and staging are done through:

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Cancer Treatment
Compare and contrast the surgery, radiation therapy, chemotherapy, hormonal therapy, and
biological therapy in terms of indication, types, examples, side effects, and nursing considerations
in managing patients with CA problems. Write your answers in a table.

Compare and contrast the nursing considerations and precautions observed for patients
receiving teletherapy from a patient receiving brachytherapy.

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College of Allied Health Sciences
Nursing Program

Test Your Knowledge! [Multiple Choice]

Directions: Select the best answer by highlighting the answer of your choice (write
your answers in full if you cannot print the module).

1. Which is the most common type of cervical cancer?

A. Adenocarcinoma
B. Squamous cell carcinoma
C. Adenosquamous carcinoma

2. Which one of the following is true about the epidemiology of cervical cancer?
A. Most cases occur in the developing world
B. Worldwide it is the most common malignancy in women
C. It is most commonly diagnosed in the third decade of life

3. Which one of the following is not a risk factor for cervical cancer?
A. Smoking
B. History of genital warts
C. High socioeconomic status
D. Micronutrient deficiency
E. HIV infection

4. Which one of the following is true about HPV infection in women?

A. Peak prevalence is in women aged 20–30 years
B. Infection is usually persistent
C. HPV DNA is found in about half of squamous cervical cancers

5. The FIGO (Federation of Gynecology and Obstetrics) staging of cervical cancer, which is the
internationally accepted classification, is based on which of the following?
A. Clinical examination with cystoscopy and proctoscopy
B. Radiological examination with computed tomography (CT) and magnetic resonance imaging
(MRI)
C. Surgical examination

6. Which of the following best reflects the evidence on conization of the cervix (removing the
abnormal portion using a diathermy loop or scalpel) for treating microinvasive carcinoma (stage
Ia1)?
A. Several randomized controlled trials (RCTs) have shown that conization of the cervix is superior
to simple hysterectomy (removal of the cervix and uterus)
B. Consensus opinion, based on observational studies, is that conization of the cervix is effective
for treating microinvasive carcinoma (stage Ia1)
C. Conization of the cervix is not suitable for women who wish to preserve their fertility

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College of Allied Health Sciences
Nursing Program

7. Which of the following best reflects the evidence on radical trachelectomy (removal of the cervix
and parametrium) plus lymph node removal for treating early-stage cervical cancer?
A. Several RCTs have shown that the rate of recurrence free survival is lower with this treatment
than with radical hysterectomy (removal of the cervix, uterus, vaginal cuff, pelvic lymph nodes,
obturator lymph nodes, paracervical tissue, and parametrial tissue)
B. The rate of operative complications is the same as with radical hysterectomy
C. Unlike radical hysterectomy, radical trachelectomy plus lymph node removal can preserve
fertility

8. Which of the following best reflects the evidence on radiotherapy versus surgery (i.e. radical
hysterectomy plus lymph node removal) for early stage cervical cancer?
A. There is overwhelming evidence that surgery is associated with higher rates of overall survival
and disease-free survival
B. There is overwhelming evidence that radiotherapy is associated with higher rates of overall
survival and disease-free survival
C. One RCT found no significant difference in overall survival or disease-free survival and consensus
regards both treatments as likely to be beneficial

9. Which of the following best reflects the evidence on chemoradiotherapy (chemotherapy and
radiotherapy given simultaneously for a short duration of time) for treating bulky early-stage
cervical cancer?
A. There is no evidence of any survival benefit from adding chemotherapy to radiotherapy alone
B. Several RCTs have found that chemoradiotherapy improves overall survival and progression-free
survival compared with radiotherapy, when used either with or after hysterectomy
C. Several RCTs have found that chemoradiotherapy improves progression-free survival but not
overall survival compared with radiotherapy, when used either with or after hysterectomy

10. Approximately what proportion of women with stage IVb disease will survive for over two years?
A. 20%
B. 50%
C. 70%

Are you done answering the questions above? Great!

You are now ready to meet your patient for this clinical experience.

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

DEEP DIVE

Case Scenario: A Patient with Ovarian Cancer

History of Present Illness: Patient A.B, 63-year-old
female patient, married with 4 kids, came in due to a
severe irritating cough and chest tightness yesterday,
Nov. 22, 2020. Preliminary chest x-ray revealed
mediastinal lymphadenopathy with pleural effusion,
right lung. After focused assessment and history taking
at the emergency room and negative RT-PCR test, A.B
was determined to be a non-COVID patient but was
suspected to have TB, thus she admitted at the
pulmonary unit of the hospital under the service of Dr.
Lim with the admitting diagnosis, to consider
tuberculous pleurisy.

Baseline vital signs were BP: 148/89 mmHg, HR: 112

bpm, RR: 36cpm, temp: 37.2℃, SpO2: 88%. Oxygen
support at 3L/min via nasal cannula which afforded some relief to the patient. She was placed in
airborne precaution, on diet as tolerated, bed rest with bathroom privileges and she was started
with intravenous therapy of Normal Saline Solution at 120cc/hr at right metacarpal vein.

Prior to transfer to a private room at the pulmonary unit, A.B. underwent chest CT-scan which later
revealed pleural effusion in the right lung, pericardial effusion with mild ascites. Considering the
result, a thoracentesis was done which yielded 500mL of yellow serous exudate. Abdominal
paracentesis was also done and about 300mL of fluid was removed. The removal of fluid via
thoracentesis and paracentesis improved A.B.’s respiratory status. Conservative therapy was
planned for the patient.

The patient was then wheeled to the pulmonary unit, Room 301, a private room. The receiving
ward nurse welcomed Patient A.B and oriented her in the unit as well as the guidelines of the
hospital in relation to Covid-19. While explaining the Covid-19-related guideline of the hospital,
patient A.B was lying on bed, awake, alert, coherent with some signs of respiratory distress.
Labored breathing was noted with use of accessory muscles, SpO2: 90-94%. She weighs 42 kgs
and stands on a 5’5’’ frame. She appeared weak, tired, and underweight. During interview, A.B.
revealed her irritating cough has started two weeks ago while the chest tightness three days ago.
Both became progressively severe thus she sought for consultation.

A.B. claimed she leads a healthy lifestyle. After being obese in her early adolescent years until her
early thirties, she pursued various diets and exercises to reduce weight. She also stopped smoking
and drinking when she became pregnant with her first child at the age of 33. A.B. mentioned she

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College of Allied Health Sciences
Nursing Program

is not hypertensive or diabetic. She claims her father’s side has hypertension in the lineage while
asthma runs in her mother’s family. Her hypertensive father died of heart attack and her mother
of acute respiratory distress. Also, she added she had relatives that died of from cancer (colorectal,
lung and breast). Her daughter recently has pulmonary tuberculosis and has been receiving
treatment in the past two months. Being health-conscious, she regularly submitted herself for flu
and pneumococcal vaccine. She also claimed she had HPV vaccine at her forties. She had
appendectomy 20 years ago and her last baby was delivered via caesarean section. She had her
menopause when she was 55 years old and took hormonal pills to manage the symptoms of
menopause for about three years. She worked as a day-care teacher for the children of coal
workers. The school was strategically located near the coal mining facility.

During the interview, the nurse noticed A.B.’s pale and dry skin. She has a senile skin turgor with
seborrheic keratoses, warm to touch but with localized hypothermia at toes of both feet. Her hair
was gray in color, appropriately distributed for her age and gender. Fingernails were pinkish,
toenails were pale. Both have convex curvature. Capillary refill time is 3 seconds. Her head was
normocephalic with symmetrical facial features. Presbyopia and presbycusis was noted. Upon
auscultation, muffled breath sounds can still be heard. Symmetrical chest wall expansion was noted.
In inspecting the client’s precordium, lifts and heaves were not noted. Heart sounds exhibited
normal heartbeat and rhythm. Breast appeared atrophied. Skin over the chest appeared uniform in
color. Areola is oval and symmetrical; the nipples were round and everted. Upon palpation, client
complained of tenderness at right supraclavicular, mid-axillary and brachial lymph node. The nurse
palpated about 2x1cm of nodal swelling at different sites. The patient was asked to lie supine.
Client’s abdomen was protuberant and nontender. Abdominal girth measured 28cm post
paracentesis. Baseline was 36cm. Hypoactive bowel sounds were auscultated. Stretch marks and
shifting dullness were noted. A tender umbilical nodule was also felt. Movement of a fluid wave
against the resting hand was also observed. Costovertebral angle (CVA) tenderness was noted A.B
mentioned she had been experiencing nagging pain at her lower back and at hypogastric area
(graded with 6-7 out of 10) and that she has been constipated for quite a time already with feelings
of being bloated and indigestion. She reports she had “accidents” in controlling her urine because
she had been experiencing increased urinary frequency and occasional pelvic pain. She also stated
that she experienced having alternating episodes of diarrhea and constipation before but regarded
that it was may just because of the food that she eats. Concerned with these symptoms, the nurse
performed bimanual palpation at A.B.’s genital area. Assessment revealed the vaginal wall felt
smooth and nontender. The cervix felt firm and soft. The fundus, the large, upper end of the uterus
was round, firm, and smooth. Ovaries were palpable and approximately measures 4x3x2 cm. A
mass in the recto-uterine pouch was also palpated.

The assessment findings prompted for transvaginal ultrasound which revealed a 3 cm cystic mass
in the left ovary with relatively clear margins and an irregular solid portion partially observed within
the mass. At the same time, pleural fluid analysis demonstrated an exudative effusion and cytology
revealed atypical cells from an ovarian tumor. Chest CT scan with contrast showed a number of
enlarged lymph nodes surrounding the right side of the thoracic entrance to the mediastinum,
multiple swollen cervical lymph nodes on the right side and right internal jugular vein embolus,

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College of Allied Health Sciences
Nursing Program

with bilateral pleural effusion and ascites. She subsequently underwent staging CT, which showed
multiple bilateral ovarian cystic lesions consistent with Stage IVB ovarian carcinoma.
Histopathological examination confirmed the diagnosis. Patient A.B. was transferred to Dr.
Barinaga, an OB-Gyne physician, for better treatment.

As the patient was not able to tolerate surgery, neoadjuvant chemotherapy was considered. Six
cycles of Paclitaxel 135mg/m2 IV over 3 hours or IV continuous infusion over 24 hours, Cisplatin
80mg/m2 intraperitoneal (IP) infused as rapidly as possible via IP port then Paclitaxel 60mg/m2 IP
infused as rapidly as possible via IP port. The first cycle was done during this admission. Patient
A.B was advised to return for the succeeding cycles of chemotherapy. Throughout the course, A.B.
experienced loss of hair, fatigue, arthralgia and myalgia, nausea and vomiting, anorexia, sore
throat, xerostomia, and mouth ulcers. A decrease in hemoglobin, hematocrit, neutrophils, and
lymphocytes were observed. Thus, patient was placed in neutropenic diet and advised to prepare
packed RBCs or whole blood as stand-by for the continuity of chemotherapy. Ondansetron 8mg
IVTT 1 hour prior to chemotherapy, Rebamipide 100mg/tab 1 tab twice a day, and Ketorolac 1
ampule IVTT as needed for pain was also prescribed for the patient.

On the sixth cycle, A.B expressed to the nurse her fears, she said she is not ready to die. She
wishes to enjoy her retirement years. She also shared that the chemotherapy has made her weaker
and uglier. She gets tired easily. She has no appetite. She cannot even bathe herself and do simple
house chores. She feels like a liability to her family. She mentioned she had refused looking at
herself in the mirror. She often cries herself to sleep fearing she might never wake up but she does
not want her family to see how miserable she feels and so she puts on a positive attitude whenever
her family is with her. Understanding the fears of the A.B., the nurse planned to check with A.B.’s
family members and discuss A.B.’s condition.

Despite treatment, A.B.’s condition persisted. She developed abdominal distention, dry and moist
rales in both lungs, shifting dullness in the abdomen and a CA-125 level of 1,030 U/ml.
Pancytopenia was noted on CBC. Patient became too weak and was confined to bed with full
assistance for self-care. Liposomal doxorubicin dosed at 60 mg/m2 followed by Trabectedin dosed
at 1.1 mg/m² on day 1 and Pegfilgrastim on day 2 every 3 weeks for up to six cycles. The patient’s
condition continued to decline with the development of severe abdominal distension (abdominal
girth 42cm), breathing difficulties (RR: 34cpm, SpO2: 80-86%) and an inability to eat. Patient also
complained of abdominal pain, black tarry stools and decreased urine output were observed. The
patient underwent thoracentesis and abdominocentesis, during which 1,000 ml clear yellow ascitic
fluid was extracted, and 300 mg Carboplatin was injected intraperitoneally into the abdominal
cavity. Kabiven (1440mL) infusion at 60cc/hr was also started for parenteral nutrition. In addition,
Omeprazole drip of 80mg incorporated in PNSS 100mL to run at 40cc/hr was also ordered.

Following therapy, a gradual improvement was observed in the patient’s condition. Dyspnea,
abdominal distension, and abdominal pain were significantly reduced, the patient had a significant
improvement in appetite and urine and feces had returned to normal. Interval cytoreductive surgery
was performed. Routine postoperative pathological examination identified undifferentiated

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College of Allied Health Sciences
Nursing Program

carcinoma on the left ovary with right ovary metastasis, without any metastasis to the pelvic lymph
nodes. Postoperative docetaxel plus carboplatin chemotherapy was administered for 3 cycles and
serum cancer antigen 125 (CA125) level returned to normal.

A.B’s condition continued to improve and felt she can fight off cancer. She expressed her desire to
know what she can do to increase her chances of winning over cancer and what she should do to
prevent recurrence. “Maningkamot ko, Nurse. Even at 60, I still have a lot to live for. I cancervive
my condition.”

To immerse yourself in the care management of your patient, let us do some detailed description
of your patient care tasks. Using the Case Scenario assigned to you, you are expected to perform
the following:

1. Fill-up the needed data based on the given scenario/case. Note: Assessment findings of all
other areas must be filled up using fictional data BUT should be within the scope of the case
scenario given.
2. Conduct a history taking and physical assessment of your patient. Use BLUE pen for
normal findings and RED for abnormal findings under Review of Systems (ROS).
3. Develop a Concept Map of your patient’s condition using the Concept Map Format.
4. Present your drug study and IVF data.
5. Prior to administering a patient’s medications, you are required to make a drug study of
all medications required by your patient in oral or parenteral form and document it. Select
one drug. No duplications of selected drugs for study should be made.
6. Formulate a 3 patient-centered care plan for your patient.
7. Clinical Reasoning Questions - Collaboration:

When A.B. was admitted, you, were also taking care of another cancer patient who had
been diagnosed of having cervical cancer. The patient was receiving brachytherapy. In one
shift, you noticed that one of your co-nurses have been staying for hours with the patient
while receiving the treatment. You also noticed that some of her visitors brough fresh
flowers and fruits in one of their hospital visits.

Knowing that this is a safety concern, how would you “stop the line” in this scenario? Follow
the CUS method.

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Nursing Program

8. Clinical Reasoning Questions - Ethico-Moral-Legal: A surgeon’s waiting list includes

one patient who has severe pain from gall stones that require removing surgically. This
patient also has severe asthma and will require hospital admission for his surgery. His
operation has already been postponed three times. The ward is full of patients who are
recovering from major surgery and none are yet ready to go home. However, there is one
patient who had surgery a year ago for testicular cancer and was admitted yesterday in
severe pain from the spread of his disease which is, now, responding to strong analgesics.
He is now in the terminal phase of his disease. His elderly wife is very frightened about her
husband’s death and feels unable to cope at home with him. Her husband would dearly like
to go home.

What ethico-moral consideration apply in this scenario? Do you persuade the cancer
patient’s wife to take him home so that the patient with gall stones can be relieved of his
pain? Why or why not? Discuss with an ethico-moral standpoint.

DESTINATION CHECK

You are nearly done with your module!

Before we end, let us check what you have learned so far and touch the topics which have been
discussed earlier but may not have been covered in the questions asked so far.

Listed below are questions that are frequently asked by cancer patients. As an
oncologic nurse, what will be your best response to these questions?

1. What is the goal of chemotherapy treatment? Is it to eliminate the cancer, help me feel better,
or both?
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2. If have a strong family history of cancer, what is my chance of getting another cancer?

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Nursing Program

________________________________________________________________________
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3. After mastectomy, is reconstruction (plastic surgery) an option for me? What are the advantages
and disadvantages?

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4. How long will my total mastectomy surgery take? What type of anesthesia will I need for this
operation?

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5. What kind of pain will I be in afterwards? Can you help me manage my pain?

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6. I am diagnosed with Ovarian cancer, what are stages of this disease? What do these mean?
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________________________________________________________________________
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7. When will I be able to work and/or return to my normal routine? Are there any activities I
should avoid?
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8. What is my HER2 status? What does this mean?

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9. What is chemotherapy and its difference with hormonal (endocrine) therapy?

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10. Will I lose my hair after chemotherapy and can I do anything to prevent hair loss?
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Test Your Knowledge! [Multiple Choice]

Directions: Select the best answer by highlighting the answer of your choice (write
your answers in full if you cannot print the module).

1.Which one of the following statements regarding screening for ovarian cancer is correct?
a. Screening using CA-125 is offered to all women between the ages of 50 and 75
years in the UK
b. Studies have shown an approximate 40% reduction in mortality with screening
c. Serum CA-125 has a sensitivity of 50% and a specificity of 20%
d. Trials of potential screening methods for ovarian cancer are ongoing

2. Risk factors for ovarian cancer include which of the following?

a. young age
b. nulliparity
c. multiple pregnancies
d. Prolonged use of oral contraceptive pill

3. Which of the following is true of ovarian cancer?

a. It is the second commonest cancer in females
b. Approximately 10% are familial
c. Median age of diagnosis is 53 years
d. none of the above

4. Which of the following is true of treatment for relapsed epithelial ovarian cancer?
a. Platinum chemotherapy is the optimum therapy for patients who relapse less than
6 months after completion of platinum-based chemotherapy
b. The response rate to platinum chemotherapy is approximately 60% in those who
relapse more than 2 years after completion of platinum based first line
chemotherapy
c. Most patients can be cured with further chemotherapy
d. Most patients can be cured with further surgery

5. In metastatic epithelial ovarian cancer:

a. ascities usually responds well to diuretics
b. bowel obstruction is common and is usually managed medically using subcutaneous
medication given via a syringe driver
c. opioid analgesics should be avoided
d. lymphoedema is rare and treatment of it is generally ineffective\

6. What is the cardinal sign of the ovarian cancer?

a. abdominal enlargement
b. lymphoma
c. enlarge spleen

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d. dysuria

7. What is the chemotherapy drugs used in ovarian cancer patient?

a. Cisplatin
b. Taxol
c. 5 FU
d. none of the above

8. Which of the following statements is true regarding prognosis of ovarian cancer?

a. Stage I disease has a median 5-year survival of 70 %
b. Stage II disease has a median 5-year survival of 60%
c. Stage III disease has a median 5-year survival of 20%
d. Stage IV disease has a median 5-year survival of 10%

9. Which one of the following symptoms is an uncommon presentation of ovarian cancer?

a. abdominal pain
b. chest pain
c. weight loss
d. abdominal distension

10. Which of the following is not a risk factors in ovarian cancer?

a. Nulliparity
b. vaginal use of talcum powder
c. obesity
d. multiple pregnancies

Have you answered all of the questions above? Great! You are now ready to proceed to
the next part of the module

REFLECTION TIME

Things to Ponder: The management of the patient with breast, ovarian and cervical cancers is a
challenge to us health care practitioners. Foremost is the need to educate the patient about self-
examination and our role in providing a thorough clinical evaluation and nursing interventions.
Finally, once a diagnosis is established, the patient requires counselling and referral to the needed
specialists.

Today, there are more breast, ovarian and cervical cancer survivors than any other group of cancer
survivors. This means that these types of cancers have probably touched the lives of your family
members or other couple of people that you know. On the plus side, this also means that more
and more people are benefiting from early detection and advances in treatment. These days, these

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Nursing Program

3 types of cancer survivors often live long, satisfying, and happy lives. As a future nurse, what are
your recommendations for these survivors to help them embrace the life after cancer?
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Congratulations! You have completed this module. You may now proceed to the weekly quiz.
Please wait for further instructions from you instructor

References:

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb’s fundamentals of nursing: Concepts,
process, and practice (10th ed.). Pearson Education, Inc.

Hinkle, J. & Cheever, K. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing (14th
ed.). Wolters Kluwer

Marieb, E., & Keller, S. (2017). Essentials of human anatomy & physiology (12th ed.). Retrieved
from https://bok.asia/book/5010929/ac07d2

Quigley, B., Palm, M.L., & Bickley, L. (2012). Bates’ nursing guide to physical examination and
history taking (1st ed.). Wolters Kluwer Health

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Nursing Program

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Davao Doctors College, Inc.
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Nursing Program

Use the DDC form for drug studies. Drugs will be assigned by the clinical instructor
according to the concept of the rotation
Must contain the following:
o Generic Name
o Brand Name
o Classification
o Mode of Action
o Indications
o Contraindications

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College of Allied Health Sciences
Nursing Program

o Side Effects (organized per system; cephalocaudal)

o Adverse Effects (per system; cephalocaudal)
o Dosage
o Nursing considerations
o Reference(s) – Follow APA 7e format.

Create 1 NCP appropriate for the patient.

Please follow the DDC NCP template.

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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program

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