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.
Transcript
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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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Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Circulatory System
- Nervous System
- Skeletal System
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
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- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
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- Oncologic Disorders
- Med Term Basic
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- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
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- Pediatric
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- State of Consciousness
- Sensory System