NUR 251/NUR 251 Quiz 4 Case Studies

NUR 251/NUR 251 Quiz 4 Case Studies NUR 251 Quiz 4 Case Studies Case Study #1 34 y/o patient Mary Simmons is recently diagnosed with ductal breast cancer. She is scheduled to undergo sentinel node mapping with excisional lumpectomy. She is also going to receive chemotherapy (cisplatin and adriamycin) post-surgery. She is anxious and has questions regarding her surgery and chemo. You are doing her surgical work-up. 1. Describe sentinel node mapping and lumpectomy to the patient. Cite your source for this information. The surgeon will inject a radioactive substance, blue dye, or both to the tumor location. Once the dye is located the surgeon makes a small incision & removes the node/lump. C 2. List the risks and benefits of the surgical procedure. Pain, swelling, bruising, risk for infection, possible allergic reaction to dye, falsenegative, lymphedema. Benefits: estimate risk for tumor cells spreading, avoid extra lymph node surgery, helps doctors stage the cancer. 3. Provide the patient with detailed information on the chemo therapy drugs she is to receive. Review side indication for the medication, side effects and any nursing implications. Cite your drug source. Cisplatin & adriamycin are combined chemo therapy. Side effects include decreased sense of taste, nausea, vomiting, fatigue, hair loss, pain, swelling, burning, irritation around needle site, menstrual irregularities, puffy eyelids. Assess & monitor for possible anaphylactic reaction, assess for infiltration, neurotoxicity, cardiac dysrhythmias. C 4. List the available community resources for breast cancer patients. Provide Mary with a list of those in the Hampton Roads area. American cancer society Sentara cancer support groups Norfolk 388-4268 Bon secours, Riverside cancer care 5. Where does metastasis usually occur in patients with breast cancer? Meta stasis usually occurs in lymph nodes under the arm or above collarbone on the same side as the cancer. Other common sites are the brain, bones, and liver.