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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