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NR 325 - FINAL EXAM STUDY GUIDE Questions And Well Elaborated Solutions

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NR 325 EXAMS 1,2 AND FINAL EXAM QUESTIONS AND WELL VERIFIED ANSWERS(Best For Exam Practice)

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1. Tentamen (uitwerkingen) - Nr 325 exam 1 questions and answers/guaranteed a+(latest updated)
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3. Tentamen (uitwerkingen) - Nr 325 - final exam study guide questions and well elaborated solutions
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NR 325 - FINAL EXAM STUDY GUIDE Questions And
Well Elaborated Solutions
MASTITIS - ANSWER -inflammation of the breast

occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth

MASTITIS - CLINICAL MANIFESTATIONS - ANSWER -warm to touch

indurated/painful

often unilateral

most commonly caused by staphylococcus aureus

BEST TIME TO PERFORM SELF BREAST EXAM (BSE) - ANSWER -Perform BSE at
the end of the menstrual period

breast tenderness is less likely to occur

RISK FACTORS FOR BREAST CANCER - ANSWER -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 - ANSWER -FNA is
performed in outpatient settings

results are available within 24-48 hours

no incision required

BREAST LUMPS - ASSESSMENT - ANSWER -*painless* and *fixed* lumps suggest
breast cancer/malignancy

HORMONE THERAPY (HT) - ANSWER -*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 - ANSWER -based on tissue type

based on invasiveness

based on hormone receptor and genetic status

CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE - ANSWER
-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 - ANSWER -
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 - ANSWER -*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 - ANSWER -this Rx is for the
treatment of of tumors that have the HER-2 receptor

TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT - ANSWER -this Rx can lead to
ventricular dysfunction

patient is taught to self-monitor for symptoms of heart failure

TAMOXIFEN (NOLVADEX - THERAPEUTIC USE - ANSWER -this Rx is for the
treatment of estogen-dependent breast tumors in premenopausal women

ESTRADIOL - CAUTION - ANSWER -this Rx will increase the growth of estrogen-
dependent tumors

RALOXIFENE - THERAPEUTIC USE - ANSWER -this Rx is used to prevent breast
cancer

this Rx *IS NOT USED* postmastectomy

RADICAL MASTECTOMY - POST OP NURSING CARE - ANSWER -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 - ANSWER -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 - ANSWER -*LOCAL
RECURRENCE*
skin
chest wall

*REGIONAL RECURRENCE*
lymph nodes

*DISTAL METASTASIS*
skeletal
spinal cord
brain
pulmonary
liver
bone marrow

TNM SYSTEM OF STAGING & PROGNOSIS - ANSWER -T = tumor size

N = nodal involvement

M = metastasis

TUMOR SIZE AS PROGNOSTIC INDICATOR - ANSWER -the larger the tumor, the
poorer the prognosis

well differentiated the tumors = less aggressive

poorly differentiated tumors = more aggressive

RECEPTOR-POSITIVE TUMORS - ANSWER -commonly show histologic evidence of
being well differentiated

frequently have a diploid (more normal) DNA content and low proliferative indices

have a lower chance for recurrence

are frequently hormone dependent and responsive to hormone therapy

RECEPTOR-NEGATIVE TUMORS - ANSWER -are often poorly differentiated
histologically

have a high incidence of aneuploidy (abnormally high or low DNA content) and higher
proliferative indices

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