OUR LADY OF FATIMA UNIVERSITY

VALENZUELA CITY
S.Y. 2022-2023

A CASE STUDY ON OVARIAN NEW GROWTH

IN PARTIAL FULFILLMENT OF
THE REQUIREMENTS FOR
RELATED LEARNING EXPERIENCE
NCMA 219

SUBMITTED BY:

BUGNON, JOHN MARK

CALBAY, LIANA MARNICA D.
CALIMAG. CHRISTIAN IMHEL G.
CALINGAY, SOPHIA CRIZELLE F.
CAPILI, LYNETTE M.
CAPILI, NICHOLE M.
CASTANEDA, TRISTAN S.
CASTRO, MARION JOHN A.
CHUA, SOPHIA MARIE YESHA R.
CLARETE, KASHMIR CARL A.
ERA, SHERILYN

19th of July 2023

 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

TABLE OF CONTENTS

I. Learning Objectives ……………………………………………………………………... 3

II. Introduction ……………………………………………………………………………… 4

III. Epidemiology …………………………………………………………………………….. 6

IV. Anatomy and Physiology ……..…………………………………………………………. 7

V. Pathophysiology ………………………………………………………………………..... 8

VI. Patient’s Profile ………………………..……………………………………………….... 9

VII. Present and Past Medical History …….………………………………………………... 9

VIII. Health Assessement …..………………………………………………………………..... 10

IX. Laboratory/Diagnostic Exams …………………………………………………………. 12

X. Drug Study ………………………………………………………………………………. 14

XI. Nursing Care Plan ……………………………………………………………………….. 22

XII. Recommendation Planning ……………………………………………………………… 29

XIII. References ………………………………………………………………………………… 30

XIV. Members and their Contributions ……………………………………………………… 31

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

I. LEARNING OBJECTIVES

General Objectives

The goal of this case analysis is for the students to have a more comprehensive understanding

about Ovarian New Growth in order to enhance their critical thinking and decision-making skills

in formulating the appropriate nursing interventions for the care of a patient having ovarian masses.

Specific Objectives

At the end of the case presentation, the students will be able to:

Knowledge:

● Define Ovarian new growth

● Identify the risk factors for ovarian cyst

● Review and discuss the anatomy and physiology related to Ovarian new growth

● Understand the pathophysiology of the case being presented

● Demonstrate how Ovarian new growth occurs

Skills:

● Systematically present the data relevant to the case

● Systematically present each medication through drug study

● Establish essential nursing intervention to be implemented for the patient’s wellness and

recovery

● Formulate appropriate nursing care plan and recommendation planning

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

II. INTRODUCTION

Ovary is a female paired organ that are small, oval-shaped glands located on either side of

your uterus and it produce and store egg cell. This is where menstruation happens and make

hormones that control your menstrual cycle and pregnancy. They also produce the

reproductive hormones, oestrogen, progesterone and androgens. Ovulation happens when the

ovary releases an egg each month.

Ovarian new growths also called ovarian cyst are abnormal growths in or on the ovaries

and a sac or pouch filled with fluid or other tissue that forms in or on an ovary. Most ovarian

growths are non-cancerous and benign and can removed without treatment but it has the

possibility of becoming cancerous if not monitored closely and this need a treatment. The

growth is a fluid-filled sac and is called a cyst. This cyst may or may not show symptoms. If

showing any symptoms, they may include pain in the belly or pelvis, pain during your period,

and abnormal bleeding. It causes with hormonal stimulation and/or ovulation when the stroma

of the uterine lining (endometrium) are found outside of the uterine cavity. Ovaries can

become enlarged due to cysts, masses, or neoplasms. The women may experience pain when

symptoms exist of ovulation pain the vary pain usually happens on only one side of the pelvis,

and can alternate sides and the pain can range in intensity from dull to sharp. When ovarian

new growth occurs and huge it can lead to a swollen tummy, a feeling of fullness and pressure,

pain when urinating, or constipation. Ovarian cysts can cause complications, it includes

rupture, haemorrhage, and torsion, which are considered gynecologically emergencies.

Ovarian cysts are sometimes found in the women for pelvic pain though the cysts. Ovarian

cyst is not much and low risk for developing cancer.

Ovarian neoplasms, commonly referred to as ovarian new growths or ovarian tumors,

encompass a diverse range of pathological conditions affecting the ovaries. These growths can

arise from various cellular origins, leading to a wide spectrum of clinical presentations and

outcomes. The study of ovarian new growths is of utmost importance in the field of

gynecology and oncology, as early detection and accurate diagnosis significantly influence

treatment strategies and patient outcomes.

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S.Y. 2022-2023

Ovarian new growths pose a significant medical challenge due to their heterogeneity and

potential for both benign and malignant outcomes. Benign ovarian tumors, ranging from

simple cysts to complex masses, present with different clinical features and treatment

considerations compared to their malignant counterparts. Malignant ovarian neoplasms,

including epithelial tumors, germ cell tumors, and stromal tumors, require efficient diagnostic

techniques and multidisciplinary management approaches for optimal patient care.

This case study aims to delve into the intricacies surrounding ovarian new growths,

shedding light on pertinent aspects such as risk factors, diagnostic approaches, and

management options. By examining a specific case, we aim to provide a comprehensive

understanding of the diagnostic journey, treatment decisions, and prognosis in the context of

ovarian neoplasms.

The case study will be conducted by reviewing the medical records, imaging reports,

histopathology results, and treatment plans of a patient diagnosed with an ovarian new growth.

We will present a detailed analysis of the patient's symptoms, diagnostic procedures

performed, and the subsequent therapeutic interventions implemented. Additionally, we will

explore the challenges encountered during diagnosis, the impact on the patient's quality of life,

and the overall prognosis.

By examining this case study on ovarian new growths, we aim to enhance the

understanding and management of these complex reproductive system pathologies. Through

an in-depth analysis of the diagnostic process, treatment decisions, and patient outcomes, we

hope to contribute to the growing body of knowledge surrounding ovarian neoplasms.

Ultimately, the insights gained from this case study will aid healthcare professionals in

improving patient care, refining treatment protocols, and advancing research in the field of

gynecologic oncology.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

III. EPIDEMIOLOGY

Ovarian new growth or ovarian tumor is an abnormal growth on the ovaries, located in the

female reproductive organ, which produce eggs. Ovarian tumors can be benign, an abnormal

mass of tissue that slowly grows and can develop into a malignant tumor. On the other hand,

malignant is made up of cancerous cells. These can be further divided into surface epithelial

tumors, stromal tumors, and germ cell tumors. Surface epithelial tumor is the most common

type that develops in cells that lines that ovarian surface. This tumor is common in women

over 50. Stromal tumors develops on reproductive producing hormones. It is a low grade

cancer that is rarely considered malignant. Lastly, germ cell tumor is most common in younger

women. This tumor develops in the cells that become eggs.

Ovarian cancer ranked 7th as the most common cancer. It also ranked 8th as the leading

cause of cancer mortality among women worldwide. The rate of ovarian cancer is highest in

women ages 55-64. There is also a high risks in women who conceived after the age of 35. In

2020, there is a total of 313,959 new cases of ovarian cancer were recorded globally. A total

of 207,252 new deaths, where Micronesia (ASR = 7.3) have the highest mortality rate, which

is followed by Polynesia (ASR = 6.6), Central and Eastern Europe (ASR = 5.6), South East

Asia (ASR = 5.2), and Melanesia (ASR = 5.2). On the other hand, Caribbean (ASR = 3.2),

East Asia (ASR = 3.3), and Southern Africa (ASR = 3.3) have the lowest mortality rate.

In 2020, it ranked 5th among female cancers with 5395 new cases in the Philippines. It

recorded 3379 cancer mortality over the years which made it as the 7th leading cause of all

cancer mortality in the country. In the present, there is no standard procedure for the screening

and early detection of ovarian cancer that can reduce the mortality of ovarian cancer. The use

of combined clinical assessment and ultrasound are the standard for preoperative diagnosis of

ovarian cancer and its referral to a gynecologic oncologist. Based on the Philippine General

Hospital’s 2016-2020 annual statistics, 15.4% of gynecologic patients had adrenexal mass and

74.1% of these masses were benign while 25.9% were malignant.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

IV. ANATOMY AND PHYSIOLOGY

Ovaries are paired female reproductive organs that are responsible for sex hormone

production. It houses the ova and is on either side of the uterus inside the broad ligament below

the uterine tubes. It is whitish and is located at the ovarian fossa, surrounded by the external iliac

artery, internal iliac artery, and front of the ureter. The average standard size of the ovary is

3.5cmx2.5cmx1.5cm. After menopause, the ovaries generally measure 2cmx1.5cmx1cm or less.

In between the ovaries and uterus is the fallopian tube. It is a pair of hollow, muscular ducts

that serves as a fertilization channel between the ovaries and uterus. The fallopian tube has a

significant role in conception and pregnancy. It is a holding place for the egg when the ovaries

release a mature egg during the menstrual period. Fimbriae, the finger-like structure located at the

end of the fallopian tube, sweeps the egg to the tube to wait for fertilization. It is also the site of

fertilization because this is where the egg and sperm meet. Lastly, it is an active passageway that

moves a fertilized egg to the uterus. The fertilized egg travels via the fallopian tube and is moved

by its muscle until it reaches the uterus, where the fetus grows.

When cells in or near the ovaries have undergone change or mutation happens in the DNA,

ovarian cancer develops. The DNA has instructions to make the cells grow and multiply quickly,

later turning into a mass or tumor of cancer cells. The cancer cell can metastasize to other body

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

parts and invade nearby tissues. The three types of ovarian cancer are epithelial ovarian cancer,

stromal tumors, and germ cell tumors. Moreover, fallopian tube cancer was once considered rare,

but evidence shows that most ovarian cancers originated in the fallopian tube. The cancer develops

when eggs enter from the ovary to the end of the fallopian tube. It then metastasizes to the surface

of the ovary. 70% of epithelial ovarian cancers are from fallopian tube cancers. The ovarian,

fallopian tube and peritoneum cancers are grouped for diagnosis, treatment, and management.

V. PATHOPHYSIOLOGY

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

VI. PATIENT’S PROFILE

Patient Name: Patient D.,A.

Age: 54 years old

Gender: Female

Nationality: Filipino

Occupation: Unemployed

Date of Admission: July 10, 2023

Admitting Diagnosis: G6P6, Negative vaginal bleeding, Negative vaginal discharge,

Negative N/V, positive dysuria

Final Diagnosis: G6P6, Ovarian New Growth.

VII. PRESENT AND PAST MEDICAL HISTORY

Chief of Complaints

The patient’s Chief of Complaint is Abdominal pain with a scale of 10/10.

Family History

The patient has a family history of hypertension from the father’s side.

Past Medical and Surgical History

The patient doesn’t have past medical history and hasn’t undergone any operation or surgery.

Obstetrical and Menstrual History

Obstetrical History

Year Type of Delivery AOG Date & Place of

Birth

G1 1986 NSD FT Home (Midwife)

G2 1989 NSD FT Home (Midwife)

G3 1992 NSD FT Home (Midwife)

G4 1995 NSD FT Home (Midwife)

G5 1998 NSD FT Home (Midwife)

G6 2000 NSD FT Fabella

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

Menstrual History

● Age of Menarche: 16 Years Old

● Menstrual Cycle: Regular, 4 days

● Menstrual Symptoms: (-)

● Last Menstrual Period: Menopause 2020

Gyne History

Patient D.,A., 54 years old, female, has a menarche at the age of 16 with a regular interval,

duration that lasts up to 4 days, amount of 5-6 PRD, (-) symptoms, has a sexual contact of 1 and

coitarche at 18, with no contraceptives and a last sexual contact at 2019.

History of Present Illness (HPI)

The patient, a G6P6 woman, is admitted to Quezon City General Hospital for a scheduled

surgery with a chief of complaint of Abdominal Pain. The patient has a history of six normal

spontaneous delivery from her previous pregnancies, and a diagnosis for New Ovarian Growth.

Personal and Social History

● The patient is a 54 years old woman, unemployed.

VIII. HEALTH ASSESSMENT

General Survey: The patient is alert and awake.

Date & Time: VITAL SIGNS REMARKS

07/12/23, 4:00pm

Temperature 37.3 °C - Axilla Normal

Respiratory Rate 19 bpm Normal

Heart/Pulse Rate 93 bpm Normal

O2 Saturation 98 % Normal

Blood Pressure 110/60 mmHg Low BP

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

ASSESSMENT IMPLICATIONS

Pain Scale 10/10 Abdominal Pain

General Appearance Patient has a medium body The patient has good hygiene,

frame, unsteady gait, bad posture because of the

appropriate clothes, good bloated abdomen, looks

odor, and has a quite tired fatigue and noted unsteady

expression. walking pattern.

Mental Status Patient is conscious, aware of Patient is conscious, alert and

the time, place and person, can respond to the nurse, but

cooperative and can feels anxiety for her upcoming

communicate with simple surgery.

words.

Skin Patient has pink, dry, fair skin. No abnormalities such as

lesions, scratches, and etc.

have been found within the

skin of the patient's body.

Head and Face Patient’s head is proportional The head is round and has

to body size, white scalp, even evenly distributed hair with no

thick hair and a weary look. depressions when palpated

which is normal but the

patient looks a little tired.

Eyes Her eyes are clear, thin The patient's eyes don't have a

eyebrows, positive blink discoloration or presence of

response, but with drooping discharge, and puffy circles

eyelids and dark circles under under the eyes.

the eyes.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

Ears and Nose Patient has symmetric and The patient can hear loud and

normal ears and nose clear, the nose is symmetrical

and can smell odors properly.

Chest, Breast, Lungs Symmetrical chest The patient doesn’t feel

expansions, and clear breath difficulty in breathing and no

sounds. abnormal chest & lung sounds

can be heard

Heart Normal rate, regular rhythm Normal heart rate and blood

pressure noted

Abdomen Round and bloated abdomen Round and bloated abdomen

is abnormal because the

patient is not pregnant.

Genitourinary No vaginal bleeding No bleeding was seen during

observation

Neurological Examination Essentially Normal No abnormalities found

during the examination

IX. LABORATORY/DIAGNOSTIC EXAMS

Complete Blood Count (CBC)

Examination Result Reference Value IMPLICATIONS
WBC 9.45 5.00 - 10.00 NORMAL
RBC 3.76 4.00 – 6.00 LOW
Hemoglobin 107 110 – 150 LOW
Hematocrit 31.0 35.0 – 45.0 LOW
MCV 82.3 86.0 – 110.0 LOW
MCH 28.5 26.0 – 38.0 NORMAL
MCHC 346 316 – 354 NORMAL
Platelet Count 438 150 - 400 HIGH
Differential Count
Neutrophils 73.6 55.0 – 65.0 HIGH
Lymphocytes 17.9 25.0 – 35.0 LOW
Monocytes 6.2 3.0 - 7.0 NORMAL
Eosinophils 1.2 0.4 – 8.0 NORMAL
Basophils 1.1 0.0 – 2.0 NORMAL
Protime

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

Patient 16.9 10.0 – 15.0 LOW

Control 14.5 RNF NORMAL
% Activity 58.81 RNF NORMAL
INR 1.36 RNF NORMAL
PTT
APTT 31.5 25.0 – 39.0 NORMAL

Clinical Chemistry
Examination Result Reference Value IMPLICATIONS
RBS 4.43 < 7.80 NORMAL
Sodium 134.9 135 – 155 LOW
Potassium 3.80 3.4 – 5.3 NORMAL
Ionized Calcium 1.18 1.13 – 1.32 NORMAL
(ISE)
ALT 9.08 0 – 33.0 NORMAL
AST 19.25 0 – 32.0 NORMAL
Magnesium 0.82 0.66 – 1.07 NORMAL

Urinalysis
Examination Result IMPLICATIONS
Color (Urine) Dark Yellow  Should be pale yellow to amber
 Can be a sign of dehydration
Transparency Slightly Hazy  Should be clear
Chemical Analysis
Blood Negative NORMAL
Bilirubin Negative NORMAL
Urobilinogen +1 HIGH
 May be a sign that the liver is
producing too much bilirubin
Ketones +3 HIGH
 May be a sign of too much acidity
Protein +1 HIGH
Nitrite Negative NORMAL
Glucose Negative NORMAL
pH 5.5 NORMAL
Specific Gravity 1.025 NORMAL
Leukocytes Negative NORMAL
Microscopic Analysis
Red Blood Cells 0-1/hpf NORMAL
White Blood Cells 0-2/hpf NORMAL
Epithelial Cells Moderate  Not in normal range
Bacteria Few NORMAL
Mucus Threads Many  Not in normal range

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

X. DRUG STUDY

SIDE EFFECTS SEEN /

DRUG INDICATION ADVERSE EFFECTS NURSING CONSIDERATION
POSSIBLE SIDE EFFECTS
Generic Name: Metronidazole It is given to individuals with  Dizziness or CNS: headache, seizures, fever,  Monitor LFT results
bacterial infection caused by lightheadedness vertigo, ataxia, dizziness, carefully in elderly
syncope, incoordination,
Brand Name: Flagyl R anaerobic microorganisms,  Feeling of constant confusion, irritability, depression, patient.
trichomoniasis and bacterial movement of self or weakness, insomnia, peripheral  Observe patient for edema
neuropathy
Classification: Antibiotic vaginosis for non-pregnant surroundings  Record number and
women.  Heartburn CV: flattened T wave, edema, character of stools when
Dosage and Frequency:  Sensation of spinning flushing drug is used to treat
500 mg, TID  Stomach cramps amebiasis. Give drug only
EENT: rhinitis, sinusitis,
 Trouble sleeping pharyngitis
after Trichomonas

 Weight loss vaginalis infection is

GI: nausea, abdominal pain, confirmed by wet smear
stomatitis, epigastric distress,
or culture or Entamoeba
vomiting, anorexia, diarrhea,
constipation, proctitis, dry mouth, histolytica is identified.
metallic taste

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

GU: vaginitis, darkened urine,  Sexual partners of patients

polyuria, dysuria, cystitis, being treated for T.
dyspareunia, dryness of vagina
and vulva, vaginal candidiasis, vaginalis infection, even if
genital pruritis, UTI, asymptomatic, must also
dysmennorhea be treated to avoid
reinfection.
Hematologic: transient
leukopenia, neutropenia  Don’t confuse
metronidazole with
Musculoskeletal: transient joint
metformin.
pains

Respiratory: URI

Skin: rash

Other: decreased libido,

overgrowth of nonsusceptible
organisms
Williams, L.,& Wilkins. (2022). Nursing 2022 Drug Handbook. 42nd edition. Philadelphia. Wolters Kluwer
Mayo Clinic. (n.d.). Metronidazole (Oral Route). https://www.mayoclinic.org/drugs-supplements/metronidazole-oral-route/side-effects/drg-20064745

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S.Y. 2022-2023

SIDE EFFECTS SEEN /

DRUG INDICATION ADVERSE EFFECTS NURSING CONSIDERATION
POSSIBLE SIDE EFFECTS
Generic Name: Lactulose It is given to patients with  Diarrhea All laxatives may cause  Monitor patient for
constipation, IBS and  Bloating flatulence, diarrhea, and abdominal distention,
Brand Name: Generlac diverticulosis.  Wind (farting and abdominal disturbances. presence of bowel sounds,
burping) Hyperosmolar laxatives may and normal pattern of
Classification: Laxatives  Nausea cause fluid and electrolyte bowel function.
(Hyperosmolar)  Vomiting imbalances.  Assess color, consistency

 Stomach pain and amount of stool.

Dosage and Frequency:  Monitor patient’s serum
30 cc, ODHS electrolytes as it may
cause diarrhea which can
result to hypokalemia and
hypernatremia.
Williams, L.,& Wilkins. (2022). Nursing 2022 Drug Handbook. 42nd edition. Philadelphia. Wolters Kluwer
NHS. (n.d). Side effects of Lactulose. https://www.nhs.uk/medicines/lactulose/side-effects-of-lactulose/
Nursing Central. (n.d.). Lactulose. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51431/all/lactulose

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

SIDE EFFECTS SEEN /

DRUG INDICATION ADVERSE EFFECTS NURSING CONSIDERATION
POSSIBLE SIDE EFFECTS
Generic Name: Cefazolin Infections of the lungs, skin, soft  Allergic reactions Many cephalosporins have  If CrCl falls below 55
tissue, bones, joints, urinary and  Confusion similar adverse effects. mL/minute in adults or 70
Brand Name: Kefzol respiratory tracts, blood,  Diarrhea Hypersensitivity reactions range mL/minute in children, adjust
abdomen, and heart; CNS  Drowsiness from mild rashes, fever, and dosage.
Classification: Cephalosporin infections caused by susceptible  Eosinophilia eosinophilia to fatal anaphylaxis  If large doses are given,
antibiotics strains of Neisseria meningitidis,  Fainting and are more common in patients therapy is prolonged, or
Haemophilus influenzae, and with penicillin allergy. Adverse patient is at high risk, monitor
 Fever
Dosage and Frequency: Streptococcus pneumoniae; Gl reactions includeabdominal patient for signs and
 Gas
2g (-) ANST IV prior to OR meningitis caused by Escherichia pain, diarrhea, dyspepsia, symptoms of superinfection.
 Headache
coli or Klebsiella; infections that glossitis, nausea, tenesmus, and  Monitor patient for diarrhea
 Heartburn
develop after surgical procedures vomiting. CDAD ranging in and treat appropriately.
 Hives
classifed as contaminated or severity from mild to fatal colitis  Look alike- sound alike:
 Lightheadedness
potentially contaminated; can occur during treatment or Don't confuse drug with other
 Loss of appetite
perioperative prophylaxis; after treatment ends. Hematologic cephalosporins that sound
 Low blood pressure
penicillinase-producing Neisseria reactions include positive direct alike.
(hypotension)
and indirect antiglobulin on

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S.Y. 2022-2023

gonorrhoeae; otitis media and  Low platelet count Coombs test, thromboc ytopenia
ampicillin resistant middle ear (thrombocytopenia) or thrombocythemia,
infections caused by  Low white blood cell transient neutropenia, and
H. influenzae count (leukopenia, reversible leukopenia.
neutropenia) Minimal elevation of LFT results
 Nausea and vomiting occurs occasionally. Adverse

 Oral thrush renal effects may occur with any

 Phlebitis cephalosporin; they are most

common in older patients, those
with decreased renal function,
and those taking other
nephrotoxic drugs.
Williams, L.,& Wilkins. (2022). Nursing 2022 Drug Handbook. 42nd edition. Philadelphia. Wolters Kluwer
Drugbank Online. (2023). https://go.drugbank.com/drugs/DB0327

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DRUG
Generic Name: Tranexamic Taken orally, tranexamic acid
Acid
Brand Name: Cyklokapron
Classification: Amino acid other instances of significant
antifibrinolytics
Dosage and Frequency:
1g TIV prior to OR
OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023
SIDE EFFECTS SEEN /
INDICATION ADVERSE EFFECTS NURSING CONSIDERATION
POSSIBLE SIDE EFFECTS
 Significant: Visual defects Adverse effects include  Monitor blood pressure, pulse, and
is indicated for the treatment of (e.g. changes in colour vision, seizures, headaches, respiratory status as indicated by
visual loss), retinal venous and
hereditary angioedema, cyclic backache, abdominal pain, severity of bleeding.
arterial occlusions, ligneous
heavy menstrual bleeding in conjunctivitis; convulsions nausea, vomiting, diarrhea,  Monitor for overt bleeding every
premenopausal females, and (particularly with high doses of fatigue, pulmonary 15–30 min.
IV inj), severe hypersensitivity
reactions (e.g. anaphylaxis or
embolism, deep vein  Monitor neurologic status (pupils,
bleeding in the context of anaphylactoid reaction), thrombosis, anaphylaxis, level of consciousness, motor
hyperfibrinolysis. Given venous and arterial thrombosis impaired color vision, and activity) in patients with
or thromboembolism; cerebral
intravenously, tranexamic acid other visual disturbances. subarachnoid hemorrhage.
oedema and infarction
is indicated for short-term use (particularly in women with  Assess for thromboembolic
(2-8 days) in patients with subarachnoid haemorrhage), complications.(especially in
hemophilia to prevent or reduce dizziness.
patients with history). Notify
 Blood and lymphatic system
bleeding following tooth physician of positive Homans’
disorders: Anaemia.
extraction.  Gastrointestinal disorders: sign, leg pain hemorrhage, edema,
Nausea, vomiting, diarrhea, hemoptysis, dyspnea, or chest
abdominal pain.
pain.
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S.Y. 2022-2023

 General disorders and  Monitor platelet count and clotting

administration site conditions: factors prior to and periodically
Fatigue.
throughout therapy in patients with
 Musculoskeletal and
connective tissue disorders: systemic fibrinolysis.
Musculoskeletal pain, back
pain, muscle cramps or spasm,
arthralgia.
 Nervous system disorders:
Headache, migraine.
 Respiratory, thoracic and
mediastinal disorders: Nasal
and sinus symptoms.
 Skin and subcutaneous tissue
disorders: Allergic dermatitis.
nd
Williams, L.,& Wilkins. (2022). Nursing 2022 Drug Handbook. 42 edition. Philadelphia. Wolters Kluwer
Drugbank Online. (2023). https://go.drugbank.com/drugs/DB00302
MIMS. (2022). Tranexamic Acid. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51431/all/lactulose
National Library of Medicine. (2022). Tranexamic Acid StatPearls.
https://www.ncbi.nlm.nih.gov/books/NBK532909/#:~:text=Adverse%20effects%20include%20seizures%2C%20headaches,vision%2C%20and%20other%20visual%20disturba
nces.

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S.Y. 2022-2023

SIDE EFFECTS SEEN /

DRUG INDICATION ADVERSE EFFECTS NURSING CONSIDERATION
POSSIBLE SIDE EFFECTS
Generic Name: Omeprazole  PPIs may cause abdominal  CNS: asthenia, dizziness,  Alert: May increase risk of
 Duodenal ulcers, gastric
pain, diarrhea, constipation, headache CDAD. Evaluate for CDAD
ulcers, erosive esophagitis,
Brand Name: Losec and GERD; hypersecretory flatulence, nausea, vomiting,  GI: abdominal pain, in patients who develop
conditions (Zollinger-Ellison
dizziness, arthralgia, fever. constipation, diarrhea, diarrhea that doesn’t
syndrome)
Classification: Antiulcer drugs Rash, dry mouth, headache, flatulence, nausea, vomiting, improve.
asthenia, URI, abnormal acid regurgitation.  Dosage adjustments may be
Dosage and Frequency: LFT results, and  Musculoskeletal: back pain, necessary in Asians and
40mg TIV OD once NPO hyperglycemia. weakness patients with hepatic
 Respiratory: cough, URI impairment.
 Skin: rash  Periodically assess patient
for osteoporosis.
 Monitor patient for signs
and symptoms of acute
interstitial nephritis.
Williams, L.,& Wilkins. (2022). Nursing 2022 Drug Handbook. 42nd edition. Philadelphia. Wolters Kluwer

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

XI. NURSING CARE PLAN

ASSESSMENT DIAGNOSIS BACKGROUND PLANNING NURSING INTERVENTION RATIONALE EVALUATION

KNOWLEDGE

1: Relaxation
Subjective Data: Risk for •Disturbed sleep The goal is to promote a 1. Anxiety reduction: 1. The patient reports
techniques
The patient's face Disturbed pattern refers to a restful and restorative •Implement relaxation techniques such improved sleep quality
promote
exhibited signs of Sleep Pattern disruption in the sleep pattern for the as deep breathing exercises, guided and duration, with
relaxation and
fatigue, such as related to quantity or quality of patient: imagery, or progressive muscle fewer sleep
reduce anxiety,
drooping eyelids or anxiety, pain, sleep. relaxation. disturbances.
preparing the
dark circles under or discomfort •Anxiety, pain, and •The patient will achieve •Encourage the patient to engage in
patient for
the eyes, indicating associated with discomfort can improved sleep quality and calming activities before bedtime,
restful sleep.
disrupted sleep the ovarian contribute to sleep duration. such as reading or listening to
patterns. neoplasm. disturbances. •The patient will report soothing music.
•Sleep deprivation feeling refreshed and rested
2. Sleep
can negatively upon waking. 2. Sleeping habit education: 2. The patient
hygiene
impact physical and •The nursing interventions demonstrates the
practices
mental well-being, will address anxiety, pain, ability to implement

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

including cognitive and discomfort to facilitate •Educate the patient about the promote relaxation techniques
function and a conducive sleep importance of maintaining a consistent healthy sleep and sleep hygiene
emotional stability. environment. sleep schedule. habits and practices.
•Encourage the patient to create a create an
conducive sleep environment, environment
including a comfortable mattress, conducive to
adequate room temperature, and restful sleep.
minimal noise and light.
•Discuss the importance of avoiding
stimulating activities, caffeine, and
electronics close to bedtime. 3.Collaborating 3. The patient reports
with the feeling refreshed and
3. Collaborate with the healthcare healthcare team well-rested upon
team: ensures waking.
•Collaborate with the healthcare team comprehensive
to assess the need for medications that care and
promote sleep or address specific maximizes the
sleep disturbances.

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OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

•Seek input from the healthcare team effectiveness of

regarding any underlying conditions or interventions.
medications that may contribute to
sleep disturbances.

24

BACKGROUND
ASSESSMENT DIAGNOSIS
KNOWLEDGE
Objective Data: Acute Pain Ovarian cysts are fluid-
(+) Facial related to filled sacs in the ovaries.
Grimace ovarian Some have tissue inside
enlargement them. The cysts are
and stretching surrounded by a capsule
of tissues. and usually about the
size of a cherry. Some
cysts cause dull pain in
the lower abdomen
(pelvic pain). If a cyst
ruptures (bursts), it can
be felt as a sudden pain
– but usually doesn’t
cause any other
problems. The weight of
the cyst can sometimes
OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023
PLANNING INTERVENTION RATIONALE EVALUATION
1.) Alleviate the patient's 1.) Regularly assess the 1.) Assessing pain helps 1.) Regularly
acute pain and provide patient's pain using a to determine the evaluate the
relief. numeric pain scale and a severity and nature patient's pain
pain assessment tool. of the pain, allowing level and pain
Document the location, for appropriate relief achieved
intensity, and interventions and through
characteristics of pain at evaluation of their interventions.
regular intervals. effectiveness.
2.) Offer non-pharmacologic 2.) Breathing can 2.) Assess the
interventions such as: actually help regulate patient's
 Breathing the heart rate and understanding
Techniques blood pressure, and utilization of
 Positioning which helps regulate pain management
 Distractions the pain response in techniques.
the brain.
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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

pull on the ovary and

cause it to become 3.) Encourage increase fluid 3.) Staying hydrated 3.) Adjust the care
twisted. This leads to intake. helps reduce plan as needed to
sudden, severe, inflammation, which meet the patient's
cramping pain on the can help manage changing needs
affected side of the pain. Drinking and response to
lower abdomen, as well enough water treatment.
as nausea, vomiting and decreases the
a high pulse rate. function of chemical
messengers that
typically contribute
to inflammation.

4.) Provide comfort 4.) Providing a clean

and comfortable
measurements.
environment for the
patient helps the
patient to calm and
recover easily.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

BACKGROUND
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
KNOWLEDGE

Subjective Data: Impaired Comfort Ovarian growths, such 1. Promote relaxation 1. Educate about deep 1. Deep breathing 1. Demonstrates
- The patient reports related to physical as ovarian cysts or and comfort. breathing exercises to help promotes relaxation, understanding and
difficulty in walking discomfort caused tumors, can occur due relax abdominal muscles decreases muscle tension, successfully
due to discomfort by ovarian new to various factors, and reduce pain. and distracts from the practices deep
associated with the growth. including hormonal discomfort. breathing exercises
ovarian new growth. imbalances, genetic and guided imagery,
predisposition, or reporting a decrease
Objective Data: underlying medical in pain intensity and
- Observation reveal conditions. These feeling more
slow and hesitant gait. growths may be benign relaxed.
- Limited range of or malignant. Common
motion and visible symptoms include 2. Assessed the
discomfort during abdominal pain, 2. Enhance comfort 2. Teach relaxation 2. Relaxation techniques patient's feedback
movement. bloating, and menstrual through non- techniques, such as guided can help reduce muscle on the effectiveness
irregularities. pharmacological pain tension, promote a sense of of non-

27
OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

management imagery or progressive calmness, and provide pharmacological

techniques. muscle relaxation distraction from pain. pain management
techniques. Found
that the patient
reported feeling
more comfortable,
with a decrease in
pain intensity and
an improved overall
sense of well-being.

3. Optimize physical 3. Assist the patient in 3. Proper positioning can 3. Evaluated the
comfort through finding comfortable alleviate pressure on the patient's overall
satisfaction with the
positioning and positions, such as using affected area, reduce
provided
support measures. pillows for support or discomfort, and enhance positioning and
elevation. relaxation. support
interventions

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

XII. RECOMMENDATION PLANNING

Medications

 Explain the medications that are needed to be administered for her treatment while the patient

is admitted in the hospital.

Exercise/Environment

 Provide a comfortable and safe environment for the mother including monitoring the room

temperature, noise level and lightning.

Treatment

 Instruct the patient to lightly massage the lower back, shoulder, thighs to help loosen tense

muscles and reduce discomfort.

 Assess the mother’s level of pain and provide appropriate interventions to manage discomfort.

Health Teachings

 Explain the need for laboratory exams to promote the patient’s compliance.

 Instruct patient on how to reduce anxiety by doing proper breathing exercises and by

expressing her fears and concerns on her upcoming procedure.

 Encourage patient to do activities that can promote proper sleep during her bedtime.

 Explain the importance of maintaining proper hygiene.

Observation

 Monitor the patient’s vital signs and assess physical condition regularly every rounds and as

per doctor’s order.

Diet

 Instruct and explain to the patient the need to follow her diet (NPO post-midnight) for her

upcoming procedure.

Spiritual

 Encourage patient to pray to promote awareness, understanding, and provide comfort.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

XIII. REFERENCES

Staff, H. (2021). Non-Cancerous Ovarian Growths: Care Instructions. Retrieved from:

https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ug6
384#:~:text=Ovarian%20growths%20are%20abnormal%20growths,and%20don%27t%2
0cause%20symptoms

Ovarian Masses and Tumors. (2023). NationwideChildrens. Retrieved from:

https://www.nationwidechildrens.org/conditions/ovarian-masses-and-
tumors#:~:text=What%20Causes%20Ovarian%20Masses%20and,outside%20of%20the
%20uterine%20cavity.
Nelson, L. (n.d.). Dignity Health. Retrieved from: https://www.dignityhealth.org/conditions-and-
treatments/womens-services/ovarian-tumors
Ovaries. (2022). Cleveland Clinic. Retrieved from:
https://my.clevelandclinic.org/health/body/22999-
ovaries#:~:text=The%20ovaries%20are%20small%2C%20oval,your%20ovaries%20relea
ses%20an%20egg

Dignity Health. (n.d.). Ovarian Tumors. https://www.dignityhealth.org/conditions-and-

treatments/womens-services/ovarian-tumors

Huang, J., Chan, C.C., Ngai, C.H., Lok, V., Zhang, L., Lucero-Prisno, D.E., Xu, W., Zheng, Z. J.,
Elcarte, E., Withers, M. & Wong, M. (2022). Worldwide Burden, Risk Factors, and
Temporal Trends of Ovarian Cancer: A Global Study. National Library of Medicine. doi:
10.3390/cancers14092230

Velayo, C., Reforma, K., Sicam, R.V., Diwa, M., Sy, A. D. & Tantengco, O.A. (2022). Improving
Diagnostic Strategies for Ovarian Cancer in Filipino Women Using Ultrasound Imaging
and a Multivariate Index Assay. Science Direct.
https://doi.org/10.1016/j.canep.2022.102253

Cancer.Net. (n.d.). Ovarian, Fallopian Tube, and Peritoneal Cancer: Introduction. Retrieved from:
https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-
cancer/introduction#:~:text=Fallopian%20tube%20cancer.,start%20in%20the%20fallopia
n%20tube.

Cleveland Clinic. (n.d.) Fallopian Tubes. Retrieved from:

https://my.clevelandclinic.org/health/body/23184-fallopian-tubes

Cleveland Clinic. (n.d.) Fallopian Tubes Cancer. Retrieved from:

https://my.clevelandclinic.org/health/diseases/21540-fallopian-tube-
cancer#:~:text=Recent%20research%20indicates%20that%20the,the%20surface%20of%
20the%20ovary.

Mayo Clinic. (n.d.). Ovarian Cancer. Retrieved from: https://www.mayoclinic.org/diseases-

conditions/ovarian-cancer/symptoms-causes/syc-
20375941#:~:text=Doctors%20know%20that%20ovarian%20cancer,(tumor)%20of%20c
ancer%20cells.

Ovarian cysts.(n.d.) Retrieved from:

http://www.csh.org.tw/dr.tcj/educartion/f/web/Ovarian%20tumor/index.htm#:~:text=Path
ophysiology%3A%20Each%20month%2C%20normally%20functioning,structure%20wit
h%20a%20cystic%20center.

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

MEMBERS & THEIR CONTRIBUTIONS

Name: Bugnon, John Mark

 Introduction
 Facilitated the printing and submission of hardcopy at QCGH

Name: Calbay, Liana Marnica D.

 Laboratory/Diagnostic Exams
 Drug Study
 Revising of Recommendation Planning
 Editing & Compilation Final Revisions of Case Study

Name: Calimag. Christian Imhel G.

 (#1) NCP

Name: Calingay, Sophia Crizelle F.

 Learning Objectives
 Introduction

Name: Capili, Lynette M.

 (#2) NCP

Name: Capili, Nichole M.

 Pathophysiology

Name: Castaneda, Tristan S.

 (#3) NCP
 Facilitated the printing and submission of hardcopy at QCGH

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 OUR LADY OF FATIMA UNIVERSITY
VALENZUELA CITY
S.Y. 2022-2023

Name: Castro, Marion John A.

 Recommendation Planning

Name: Chua, Sophia Marie Yesha R.

 Epidemiology
 Drug Study
 Revising of Anatomy and Physiology

Name: Clarete, Kashmir Carl A.

 Patient’s Profile, History, and Physical Assessment

Name: Era, Sherilyn

 Anatomy and Physiology

32