Aveneu Park, Starling, Australia

Post-registration OT)Name of Mentor : APN Serena

Post-registration Certificate Course in Perioperative Nursing

(5.8.2017 – 6.1.2018)

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Patient Care Study

on

___CA Corpus – TAHBSO + Staging___

 

 

 

 

 

 

Name & Student No.            : Chung Ka Yung (13)Rank                                        : Registered Nurse

Hospital                                  : Queen Elizabeth Hospital

Clinical Practicum Centre    : QEH (Anes & OT)Name of Mentor                   : APN Serena Kwok
Word Count                           :

 

CONTENT

 

Introduction

Learning objectives

Profile of the Client

Surgical Highlight

Anaesthetic Highlight

Patient Care Planning

Case Evaluation

Self Reflection & Conclusion

Appendix 1

Appendix 2

Reference List

 

Introduction

Endometrial carcinoma, or “Ca Corpus” is the fourth most common cancer amongst women in Hong Kong in 2015 (Hong Kong Cancer Registry, 2017). The “Average Annual Percent Change” (AAPC) of Age-standardized Rates of common cancers over the period 2006-2015 is the second highest (+3.4%) compared with all other sites of cancer among women in Hong Kong (Hong Kong Cancer Registry, 2017). Conventional therapy for most endometrial cancer begins with a hysterectomy. Surgical staging allows for full assessment of the abdominopelvic cavity, including visualization and palpation of tissues, collection of peritoneal cytology, and removal of the pelvic and para-aortic lymph nodes. (Lachance, Darus & Rice 2008) Survival data suggest that roughly 85% to 90% of all women who are diagnosed with endometrial cancer and treated appropriately will be alive at 5 years. (Lachance et al., 2008)

In the view of such common occurrence and the increasing trend of this disease in Hong Kong. A thorough understanding of the disease and treatment options, and to develop an all-rounded, well considered care plan is necessary for providing high quality care, promote surgical outcome and minimize post-operative complications.

Learning Objectives

1.      Assess and anticipate pre-operative/pre-anesthetic needs, concerns and risks to formulate appropriate and high-quality nursing care plan.

2.      Assess and anticipate intraoperative period needs, concerns and risks to formulate appropriate and high-quality nursing care plan.

3.      Continuously assess and monitor the patient’s immediate post-operative period to provide suitable care for the best outcome.

Profile of the Client

Ms. Lee is a 61 years old para 0 women. She is single with positive sexual exposure. She weights 59.2kg with height of 153cm. She has diabetes mellitus, hypertension with regular medication and regular follow up at family clinic. She is allergic to unknown flu medicine and unknown type of bandage. She had a left hemithyroidectomy with thyroid nodule removed and a left superficial parotidectomy for left parotid tumor done in the past. She had her menopause in 2014 and presented with post-menopausal bleeding. She is then referred to gynecology specialist out-patient clinic on 12/10/2017. Endometrial biopsy was done on the same day and the result was grade 1 endometrioid adenocarcinoma. Trans-abdominal and trans-vaginal ultrasound determined the uterus normal size was distended by tumor for 2.36cm with 2cm right hyperechoic mass. Her diagnosis was endometrioid adenocarcinoma grade 1.

She had her Magnetic Resonance Imaging(MRI) done in private which shows no invasion to cervix, vagina, parametrium, bladder and rectum. Computed Tomography of Thorax, Abdomen and Pelvis done and the result is consistent with the diagnosis, it also shown no evidence of liver, iliac and para-aortic region lymph node metastasis.

She is then clinically admitted for TAHBSO (Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy.

Surgical Highlight

The most common type of endometrial cancers are adenocarcinomas and the most common type of adenocarcinoma is endometrioid cancer (American Cancer Society, 2018). The main treatment for the patient in this case is TAHBSO, which is an operation to remove the uterus, ovaries, fallopian tubes and cervix.

For endometrial cancer, removing the uterus but not the ovaries is seldom recommended, but it may be considered in women who are premenopausal (American Cancer Society, 2018). To accurately stage the cancer, pelvic lymph node and aortic lymph node might also need to be removed.

Reference

Hong Kong Cancer Registry (2017). Leading Cancer Sites in Hong Kong in 2015 Retrieved December 28, 2017 from http://www3.ha.org.hk/cancereg/pdf/top10/rank_2015.pdf.

Hong Kong Cancer Registry (2017). Overview of Hong Kong Cancer Statistics of 2015 Retrieved December 28, 2017 from http://www3.ha.org.hk/cancereg/pdf/overview/Summary%20of%20CanStat%202015.pdf.

Lachance, J. A., Darus, C. J., & Rice, L. W. (2008). Surgical Management and Postoperative Treatment of Endometrial Carcinoma. Reviews in Obstetrics and Gynecology, 1(3), 97–105.

American Cancer Society (2018). What Is Endometrial Cancer? (n.d.). Retrieved January 27, 2018, from https://www.cancer.org/cancer/endometrial-cancer/about/what-is-endometrial-cancer.html

 

 Post-registration Certificate Course in Perioperative Nursing

(5.8.2017 – 6.1.2018)

 

 

Patient Care Study

on

___CA Corpus – TAHBSO + Staging___

 

 

 

 

 

 

Name & Student No.            : Chung Ka Yung (13)Rank                                        : Registered Nurse

Hospital                                  : Queen Elizabeth Hospital

Clinical Practicum Centre    : QEH (Anes & OT)Name of Mentor                   : APN Serena Kwok
Word Count                           :

 

CONTENT

 

Introduction

Learning objectives

Profile of the Client

Surgical Highlight

Anaesthetic Highlight

Patient Care Planning

Case Evaluation

Self Reflection & Conclusion

Appendix 1

Appendix 2

Reference List

 

Introduction

Endometrial carcinoma, or “Ca Corpus” is the fourth most common cancer amongst women in Hong Kong in 2015 (Hong Kong Cancer Registry, 2017). The “Average Annual Percent Change” (AAPC) of Age-standardized Rates of common cancers over the period 2006-2015 is the second highest (+3.4%) compared with all other sites of cancer among women in Hong Kong (Hong Kong Cancer Registry, 2017). Conventional therapy for most endometrial cancer begins with a hysterectomy. Surgical staging allows for full assessment of the abdominopelvic cavity, including visualization and palpation of tissues, collection of peritoneal cytology, and removal of the pelvic and para-aortic lymph nodes. (Lachance, Darus & Rice 2008) Survival data suggest that roughly 85% to 90% of all women who are diagnosed with endometrial cancer and treated appropriately will be alive at 5 years. (Lachance et al., 2008)

In the view of such common occurrence and the increasing trend of this disease in Hong Kong. A thorough understanding of the disease and treatment options, and to develop an all-rounded, well considered care plan is necessary for providing high quality care, promote surgical outcome and minimize post-operative complications.

Learning Objectives

1.      Assess and anticipate pre-operative/pre-anesthetic needs, concerns and risks to formulate appropriate and high-quality nursing care plan.

2.      Assess and anticipate intraoperative period needs, concerns and risks to formulate appropriate and high-quality nursing care plan.

3.      Continuously assess and monitor the patient’s immediate post-operative period to provide suitable care for the best outcome.

Profile of the Client

Ms. Lee is a 61 years old para 0 women. She is single with positive sexual exposure. She weights 59.2kg with height of 153cm. She has diabetes mellitus, hypertension with regular medication and regular follow up at family clinic. She is allergic to unknown flu medicine and unknown type of bandage. She had a left hemithyroidectomy with thyroid nodule removed and a left superficial parotidectomy for left parotid tumor done in the past. She had her menopause in 2014 and presented with post-menopausal bleeding. She is then referred to gynecology specialist out-patient clinic on 12/10/2017. Endometrial biopsy was done on the same day and the result was grade 1 endometrioid adenocarcinoma. Trans-abdominal and trans-vaginal ultrasound determined the uterus normal size was distended by tumor for 2.36cm with 2cm right hyperechoic mass. Her diagnosis was endometrioid adenocarcinoma grade 1.

She had her Magnetic Resonance Imaging(MRI) done in private which shows no invasion to cervix, vagina, parametrium, bladder and rectum. Computed Tomography of Thorax, Abdomen and Pelvis done and the result is consistent with the diagnosis, it also shown no evidence of liver, iliac and para-aortic region lymph node metastasis.

She is then clinically admitted for TAHBSO (Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy.

Surgical Highlight

The most common type of endometrial cancers are adenocarcinomas and the most common type of adenocarcinoma is endometrioid cancer (American Cancer Society, 2018). The main treatment for the patient in this case is TAHBSO, which is an operation to remove the uterus, ovaries, fallopian tubes and cervix.

For endometrial cancer, removing the uterus but not the ovaries is seldom recommended, but it may be considered in women who are premenopausal (American Cancer Society, 2018). To accurately stage the cancer, pelvic lymph node and aortic lymph node might also need to be removed.

Reference

Hong Kong Cancer Registry (2017). Leading Cancer Sites in Hong Kong in 2015 Retrieved December 28, 2017 from http://www3.ha.org.hk/cancereg/pdf/top10/rank_2015.pdf.

Hong Kong Cancer Registry (2017). Overview of Hong Kong Cancer Statistics of 2015 Retrieved December 28, 2017 from http://www3.ha.org.hk/cancereg/pdf/overview/Summary%20of%20CanStat%202015.pdf.

Lachance, J. A., Darus, C. J., & Rice, L. W. (2008). Surgical Management and Postoperative Treatment of Endometrial Carcinoma. Reviews in Obstetrics and Gynecology, 1(3), 97–105.

American Cancer Society (2018). What Is Endometrial Cancer? (n.d.). Retrieved January 27, 2018, from https://www.cancer.org/cancer/endometrial-cancer/about/what-is-endometrial-cancer.html

 

 

 

 

 

 

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