NR 325 - FINAL EXAM STUDY GUIDE, (Answered) Complete Verified Solution, Over 280 Questions Ans Correct Answers
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NR 325
NR 325 - FINAL EXAM STUDY GUIDE, (Answered) Complete Verified Solution, Over 280 Questions Ans Correct Answers
BREAST CANCER SCREENING GUIDELINES
regular screening mammography starting at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should ...
NR 325 - FINAL EXAM STUDY GUIDE, (Answered)
Complete Verified Solution, Over 280 Questions Ans
Correct Answers
BREAST CANCER SCREENING GUIDELINES
regular screening mammography starting at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should transition to biennial screening or have the
opportunity to continue screening annually.
continue screening mammography as long as overall health is good and life expectancy
is 10 years or longer
THE BREAST SELF-EXAMINATION
lie down and place one arm behind the head
use finger pads of three middle fingers of the other hand to feel for lumps
use overlapping dime-sized circular motions to feel the breast tissue
use three different levels of pressure
up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS
inflammation of the breast
occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth
MASTITIS - CLINICAL MANIFESTATIONS
warm to touch
indurated/painful
often unilateral
most commonly caused by staphylococcus aureus
BEST TIME TO PERFORM SELF BREAST EXAM (BSE)
,Perform BSE at the end of the menstrual period
breast tenderness is less likely to occur
RISK FACTORS FOR BREAST CANCER
early menarche
late menopause
Age - at or older than 50 yrs
hormone use
Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian)
First full term pregnancy after age 30
nulliparity (never given birth)
benign breast disease (atypical epithelial hyperplasia)
weight gain/obesity after menopause
exposure to ionizing radiation
alcohol consumption
ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY
FNA is performed in outpatient settings
results are available within 24-48 hours
no incision required
BREAST LUMPS - ASSESSMENT
painless and fixed lumps suggest breast cancer/malignancy
HORMONE THERAPY (HT)
HT has been linked to increased risk for breast cancer; patient and HCP must
determine whether or not HT therapy is appropriate
Breast cancer incidence is increased in women using HT, independent of other risk
factors
HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers
CLASSIFICATION OF BREAST CANCER
based on tissue type
,based on invasiveness
based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
Ductal carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
Lobular carcinoma (milk-producing glands)
Other
- Inflammatory
- Paget's disease
- Phyllodes tumor
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
Noninvasive (In situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
Invasive (spreads)
- invasive ductal carcinoma
- invasive lobular carinoma
CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE RECEPTOR
STATUS/GENETIC STATUS
Estrogen and Progesterone Receptor Status
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
HER-2 Genetic Status
- HER-2 positive
- HER-2 negative
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE
this Rx is for the treatment of of tumors that have the HER-2 receptor
TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT
this Rx can lead to ventricular dysfunction
patient is taught to self-monitor for symptoms of heart failure
TAMOXIFEN (NOLVADEX - THERAPEUTIC USE
this Rx is for the treatment of estogen-dependent breast tumors in premenopausal
women
ESTRADIOL - CAUTION
this Rx will increase the growth of estrogen-dependent tumors
RALOXIFENE - THERAPEUTIC USE
, this Rx is used to prevent breast cancer
this Rx IS NOT USED postmastectomy
RADICAL MASTECTOMY - POST OP NURSING CARE
patients are at increased risk for lymphedema and infection
therefore, NO BLOOD PRESSURES OR VENIPUNCTURES in the affected arm
signage should be posted at the bedside to help remind staff
RADICAL MASTECTOMY - PATIENT TEACHING
patients should avoid any activity that might injure the affected arm
analgesics can be used
exercises should be continued in order restore strength/ROM
affected arm should be elevate at or above the heart to improve ROM/function
SITES OF BREAST CANCER RECURRENCE/METASTASIS
LOCAL RECURRENCE
skin
chest wall
REGIONAL RECURRENCE
lymph nodes
DISTAL METASTASIS
skeletal
spinal cord
brain
pulmonary
liver
bone marrow
TNM SYSTEM OF STAGING & PROGNOSIS
T = tumor size
N = nodal involvement
M = metastasis
TUMOR SIZE AS PROGNOSTIC INDICATOR
the larger the tumor, the poorer the prognosis
well differentiated the tumors = less aggressive
poorly differentiated tumors = more aggressive
RECEPTOR-POSITIVE TUMORS
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