BSN 4

Sept. 18,2020

Cervical Cancer

1. Miss Q is 25-year old single woman who comes to the OB-Gyne clinic for the first time. She
works as a house help in the neighborhood. She tells the nurse she has regular monthly periods
but there are times that her monthly “’flow’ is moderate to heavy for the duration of her period.
The doctor writes on her record ”schedule for Pap Smear.” The recommendation of the doctor
is a big bang for Ms. Q since this is her first time to hear about this examination. She wanted to
refuse and tells the nurse of her feelings of anxiety and fear.

Consider yourself as the nurse in this situation. How should you start the health education activity. Give
a comprehensive health education plan stating the details of the procedure and the appropriate time for
the procedure.

Pap Smear also called Pap test is a screening procedure for cervical cancer, it test for the presence of
precancerous or cancerous cells in the cervix. As a nurse who have a patient wanting to refuse a pap
smear because of anxiety and fear, I would explain to her the importance of undergoing a pap smear
and and that pap smear may be mildly uncomfortable but doesn’t usually cause any long-term pain.

The best time to schedule the test is at least 5 days after the end of the menstrual period. To ensure that
the test result are as accurate as possible, do not have sexual intercourse for 2 to 3 days before the test.
Also to avoid washing away abnormal cells, do not use tampons, birth control foams, vaginal medicines
douches and vaginal creams or powders.

Pap smear can be a bit uncomfortable but the test is very quick. During the procedure, patient lie on her
back on an examination table with her legs spread and the feet resting in the stirrups (lithotomy
position). The doctor then will slowly insert a device called a speculum into the vagina that will keep the
vagina walls open and provide access to the cervix. The doctor will scrape a small sample of cells from
the cervix using a spatula, spatula and brush or a device called cytobrush (combination of spatula and
brush). Most patient feel a slight push and irritation during the brief scraping. The sample cells will then
be preserved and sent to a lab to be tested. After the test the patient might feel mild discomfort from
the scraping or a bit of cramping, and also light vaginal bleeding.

It is recommended to get pap smear at the age of 21 and then every 3 years for women in their 20s to 65
years old.
 2. Doreen is a 60 year old woman who has been diagnosed with ovarian cancer. She tells the nurse
a strong family history of cancer, her mother and her sister both died from breast cancer. She is
concerned with the health status of her 2 daughters - Nona and Wowie, 30 and 34 years old
respectively. Both her daughters are educated and are still single but contemplating to get
married next year while the younger daughter will also follow after a year.

Consider that you are the nurse in this situation. Doreen asks you to discuss the risk of cancer with
them. Explain what health counselling and education you will provide to Doreen and her daughters.
Explain the strength of the evidence.

-As defined by the National Cancer Institute , cancer is a genetic disease. Genes carry the
instructions to make proteins, which do much of the work in our cells. Certain gene changes can cause
cells to evade normal growth controls and become cancer.

Consider genetic testing that is a type of medical test that identifies changes in the chromosomes, genes,
or proteins. The result of genetic testing can confirm or rule out a suspected genetic condition or help
determine a person’s chance of developing or passing on a genetic disorder.

Consider living a healthy lifestyle. Eat a healthy diet, do not smoke, Maintain a healthy weight and be
physically active, procting oneself from the sun, avoid risky behaviors like unprotected sex, get
vaccinated, and get a regular medical care.

Be aware of the Symptoms and warning signs of cancer like; change in bowel or bladder habits, a sore
that does not heal, unusual bleeding and discharge, thickening or lump in the breast or else where,
indigestion or difficulty in swallowing, obvious change in a wart or mole and a nagging cough or
hoarseness.