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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
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
Mike Isaacs, MSN, RN, CEN, TCRN 
