Ovarian cancer is a complex malignancy that begins in the ovaries or fallopian tubes, requiring comprehensive nursing care throughout diagnosis, treatment, and recovery. This nursing diagnosis focuses on identifying and managing symptoms, preventing complications, and providing holistic support for patients throughout their cancer journey.
Causes (Related to)
Ovarian cancer development and progression can be influenced by various factors:
- Genetic predisposition (BRCA1/BRCA2 mutations)
- Family history of ovarian, breast, or colorectal cancer
- Advanced age (typically over 50)
- Risk factors including:
- Nulliparity
- Early menarche/late menopause
- Hormone replacement therapy
- Obesity
- Endometriosis
- Environmental factors such as:
- Exposure to talcum powder
- Industrial chemicals
- Tobacco use
Signs and Symptoms (As evidenced by)
Ovarian cancer often presents with subtle symptoms that nurses must recognize for early intervention.
Subjective: (Patient reports)
- Bloating or abdominal distention
- Early satiety
- Pelvic or abdominal pain
- Urinary frequency or urgency
- Fatigue
- Changes in bowel habits
- Loss of appetite
- Unexplained weight loss or gain
Objective: (Nurse assesses)
- Increased abdominal girth
- Ascites
- Palpable pelvic mass
- Decreased bowel sounds
- Peripheral edema
- Cachexia
- Pleural effusion
- Laboratory abnormalities
Expected Outcomes
The following outcomes indicate effective management of ovarian cancer:
- The patient will maintain an optimal nutrition status
- The patient will demonstrate effective pain management
- The patient will maintain adequate hydration
- The patient will show improved emotional coping
- The patient will understand the treatment plan and side effects
- The patient will maintain activities of daily living
- The patient will demonstrate reduced anxiety levels
Nursing Assessment
Monitor Vital Signs
- Check temperature, pulse, respiratory rate, and blood pressure
- Monitor for signs of infection
- Assess pain levels regularly
- Document weight changes
Assess Physical Status
- Perform abdominal assessment
- Monitor for ascites
- Check for peripheral edema
- Evaluate skin integrity
- Assess nutritional status
Evaluate Psychological Status
- Assess coping mechanisms
- Monitor for depression
- Evaluate support system
- Document anxiety levels
- Check sleep patterns
Monitor for Complications
- Assess for bowel obstruction
- Monitor for thromboembolism
- Check for infection signs
- Evaluate for treatment side effects
- Monitor for metastasis
Review Treatment Response
- Monitor laboratory values
- Assess tumor markers
- Document treatment side effects
- Evaluate symptom management
- Track quality of life indicators
Nursing Care Plans
Nursing Care Plan 1: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to tumor progression and metastasis as evidenced by reported pain level of 7/10 and guarding behavior.
Related Factors:
- Tumor mass effect
- Metastatic disease
- Surgical intervention
- Treatment side effects
Nursing Interventions and Rationales:
- Assess pain characteristics regularly
Rationale: Enables appropriate pain management strategy - Administer prescribed analgesics
Rationale: Provides consistent pain relief - Implement non-pharmacological pain measures
Rationale: Enhances overall pain management effectiveness
Desired Outcomes:
- The patient will report pain level ≤3/10
- The patient will demonstrate improved functional ability
- Patient will verbalize satisfaction with pain management
Nursing Care Plan 2: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to the disease process and treatment side effects as evidenced by weight loss and decreased appetite.
Related Factors:
- Nausea and vomiting
- Early satiety
- Treatment-related anorexia
- Altered metabolism
Nursing Interventions and Rationales:
- Monitor nutritional intake
Rationale: Identifies nutritional deficits - Provide small, frequent meals
Rationale: Improves nutrient absorption and tolerance - Administer antiemetics as prescribed
Rationale: Reduces nausea and improves intake
Desired Outcomes:
- The patient will maintain a stable weight
- The patient will demonstrate an improved appetite
- The patient will meet daily nutritional requirements
Nursing Care Plan 3: Anxiety
Nursing Diagnosis Statement:
Anxiety related to disease progression and uncertain prognosis as evidenced by expressed worries and increased tension.
Related Factors:
- Cancer diagnosis
- Treatment uncertainty
- Changed body image
- Financial concerns
Nursing Interventions and Rationales:
- Provide emotional support
Rationale: Reduces anxiety and improves coping - Teach relaxation techniques
Rationale: Provides tools for anxiety management - Facilitate communication with the healthcare team
Rationale: Improves understanding and reduces fear
Desired Outcomes:
- The patient will demonstrate reduced anxiety levels
- The patient will utilize effective coping mechanisms
- Patient will verbalize understanding of treatment plan
Nursing Care Plan 4: Risk for Infection
Nursing Diagnosis Statement:
Risk for Infection related to immunosuppression from chemotherapy and surgical procedures.
Related Factors:
- Compromised immune system
- Invasive procedures
- Nutritional deficits
- Cancer treatment
Nursing Interventions and Rationales:
- Monitor for infection signs
Rationale: Enables early intervention - Implement infection control measures
Rationale: Prevents exposure to pathogens - Educate about neutropenic precautions
Rationale: Promotes self-management of infection risk
Desired Outcomes:
- The patient will remain free from infection
- The patient will demonstrate proper infection-prevention techniques
- The patient will identify early signs of infection
Nursing Care Plan 5: Impaired Physical Mobility
Nursing Diagnosis Statement:
Impaired Physical Mobility related to weakness and fatigue as evidenced by decreased activity tolerance.
Related Factors:
- Cancer-related fatigue
- Pain
- Muscle weakness
- Treatment side effects
Nursing Interventions and Rationales:
- Assist with activity as needed
Rationale: Maintains safety and function - Implement a progressive mobility plan
Rationale: Prevents deconditioning - Teach energy conservation techniques
Rationale: Optimizes available energy
Desired Outcomes:
- The patient will maintain an optimal mobility level
- The patient will perform ADLs independently
- The patient will demonstrate improved endurance
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
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- Doubeni CA, Doubeni AR, Myers AE. Diagnosis and Management of Ovarian Cancer. Am Fam Physician. 2016 Jun 1;93(11):937-44. PMID: 27281838.
- Dunton CJ. New options for the treatment of advanced ovarian cancer. Semin Oncol. 1997 Feb;24(1 Suppl 5):S5-2-S5-11. PMID: 9122739.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
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