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Ovarian Disorders (Cyst, Torsion, Rupture) for Certified Emergency Nursing (CEN)

Ovarian Disorders (Cyst, Torsion, Rupture) for Certified Emergency Nursing (CEN)

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Outline

Ovarian Disorders (Cyst, Torsion, Rupture)

Definition/Etiology:

Ovarian Cyst – A fluid-filled sack that develops on or inside the ovary. Cysts are common among women of childbearing age. Related to cyclic changes and are usually asymptomatic and self-limiting. Resolve without intervention in most cases.

Ovarian Torsion – occurs when the ovary twists on the tissue that supports it. May also include the fallopian tube.

Pathophysiology:

Ruptured Ovarian Cyst –Rupture is most likely to occur during strenuous exercise or sexual intercourse

Ovarian torsion – blood supply is cut off to the ovary which can cause tissue death. Having an ovarian cyst is a huge risk factor for torsion as it can make the ovary or fallopian tube unbalanced and ultimately twist on itself

Clinical Presentation:

Ruptured ovarian cyst

Unilateral pain
Sudden and sharp
May follow sexual intercourse or trauma but not always

Ovarian Torsion

Severe pelvic pain, maybe unilateral and often sudden nausea/vomiting

Collaborative Management:

Ruptured ovarian cyst:

RULE OUT PREGNANCY – MAKE SURE NO BABIES WERE INVOLVED IN THE MAKING OF THE RUPTURE OVARIAN CYST
(Urine or beta hCG)
Pelvic examination
Transvaginal US
CT

Interventions:

Pain management
Fluid
Hemodynamic monitoring for possible shock
OR prep

Ovarian Torsion:

Transvaginal ultrasound

Evaluation | Patient Monitoring | Education:

Pain management!
Hemodynamic monitoring for signs of shock
Monitor for vaginal bleeding or any change in condition.

Linchpins: (Key Points)

Women of childbearing age with pelvic pain are pregnant until proven otherwise.
Time is tissue – get imaging ASAP to ensure there is not a ruptured cyst or torsion.
A pelvic emergency patient is usually fixed from the inside out – prep for the OR.

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Management of ruptured ovarian cyst. Johns Hopkins Medicine. (2021, August 8). Retrieved October 9, 2022, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/management-of-ruptured-ovarian-cyst
Sheehy, S. B., Hammond, B. B., & Zimmermann, P. G. (2013). Sheehy’s manual of emergency care. 7th ed. / St. Louis, Mo., Elsevier/Mosby.
Yale Medicine. (2021, July 13). Ovarian torsion. Yale Medicine. Retrieved October 9, 2022, from https://www.yalemedicine.org/conditions/ovarian-torsion

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