ATI System Disorder breast cancer clinicals PDF

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Summary

ATI System Disorder breast cancer from the clinicals weekly patient assigned to provide care and report assignment...

Description

ACTIVE LEARNING TEMPLATE:

System Disorder

Abdeljalek ST UDENT NAME Alejandra _____________________________________ Breast cancer DISORDER/DISEASE PROCESS __________________________________________________________

Alterations in Health (Diagnosis) Malignant proliferation of epithelial cells lining the ducts or lobules of the breast Prognosis considerably influenced by early detection and treatment The most common cancer and the most frequently diagnosed life-threatening cancer in women worldwide

Pathophysiology Related to Client Problem Breast cells undergo a series of changes, leading to an outgrowth and spread of the cells. Cancer spreads by way of the lymphatic system and the bloodstream through the right side of the heart to the lung and to the other breast, chest wall, liver, bone, and brain.

Lippincott REVIEW MODULE CHAPTER ___________

Health Promotion and Disease Prevention Breast cancer can't be prevented, but early detection increases the chance of survival. All women age 40 and older should have a yearly clinical breast exam and be taught breast self-awareness.

ASSESSMENT

SAFETY CONSIDERATIONS

Risk Factors

Expected Findings

Advanced age Family history of breast cancer, particularly first-degree and maternal relatives, including mother, sister, maternal grandmother, and maternal aunt Positive test results for genetic mutations (BRCA1, BRCA2, human epidermal receptor type 2 [HER2]) Long menstrual cycles Early onset of menses, late menopause

Laboratory Tests

Hard lump, mass, or thickening of breast tissue Nipple discharge, nipple retraction, scaly skin around the nipple, and skin changes, such as dimpling or inflammation Arm edema Dilated breast veins Lymphadenopathy Ulceration in breast

Diagnostic Procedures

An alkaline phosphatase level test and liver function test may reveal distant metastasis. A hormonal receptor assay may determine whether the tumor is estrogen- or progesterone-dependent and can guide the decision to use therapy that blocks the action of the estrogen hormone that supports tumor growth.

Mammography can reveal a tumor that's too small to palpate. Ultrasonography can distinguish between a fluid-filled cyst and solid mass. Magnetic resonance imaging may identify a lump or abnormal change seen on a mammogram and is extremely useful in patients with axillary nodal adenocarcinoma or Paget disease. Percutaneous, vacuum-assisted, large-gauge core biopsy under image guidance confirms the diagnosis. Fine-needle aspiration and excisional biopsy provide cells for histologic examination that may confirm the diagnosis.

PATIENT-CENTERED CARE

Nursing Care Provide information about the disease process, diagnostic tests, and treatment. Administer chemotherapy agents, as prescribed. Assist with measures to minimize adverse effects. Provide emotional support. Encourage adequate nutrition and hydration.

Therapeutic Procedures Lumpectomy Partial, total, or modified radical mastectomy Axillary or sentinel lymph node dissection Breast reconstruction (optional)

ACTIVE LEARNING TEMPLATES

Fall risk Postoperative complications Adverse effects of chemotherapy agents or radiation Vital signs Intake and output White blood cell count Pain level and effectiveness of interventions Body image Psychological status; coping mechanisms

Complications Medications -Chemotherapy -Targeted therapy -Hormone therapy -Immunotherapy -Calcium and vitamin D supplementation possibly recommended for women at high risk for fracture -Analgesics for pain

Client Education -Disorder, diagnostic tests, procedures, and treatments, including the expected frequency and duration of radiation therapy or chemotherapy -Activities or exercises that promote healing -Measures to take to minimize and cope with the adverse effects of chemotherapy and radiation therapy -Signs and symptoms that need to be reported to the practitioner immediately,

Interprofessional Care The team may include the social worker, case manager, oncologist, and surgeon.

-Postoperative infection, lymphedema, limited shoulder motion -Adverse effects of chemotherapy or radiation -Metastasis...