Breast cancer Case Study Jan Leinser PDF

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Jan Leisner is a 50-year-old Caucasian woman who has been healthy with no previous medical history. One year ago, she noted a small palpable lump in her right breast about the size of an almond....

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Breast Cancer/Complications of Chemotherapy

Jan Leisner, 50 years old

Primary Concept Perfusion Interrelated Concepts (In order of emphasis) 1. Infection 2. Pain 3. Fluid and Electrolyte Balance 4. Thermoregulation 5. Immunity 6. Cellular Regulation 7. Clinical Judgment 8. Patient Education 9. Communication 10. Collaboration

Unfolding Clinical Reasoning Case Study: STUDENT

Breast Cancer History of Present Problem: © 2016 Keith Rischer/www.KeithRN.com

Jan Leisner is a 50-year-old Caucasian woman who has been healthy with no previous medical history. One year ago, she noted a small palpable lump in her right breast about the size of an almond. Because she has been healthy, she assumed it was nothing and ignored it. Over the last month she has noted that this lump has been increasing in size. Her mammogram confirmed a 5 cm mass. An ultrasound biopsy confirmed the presence of cancer cells in the tumor as well as in three of her lymph nodes most proximal to the tumor. An MRI scan that followed revealed a 1 cm tumor on her lumbar spine. She is not a surgical candidate at this time, so an implanted venous access device (VAD) will be placed later this afternoon so that chemotherapy can be started as soon as possible. You are the nurse responsible for her care on the oncology unit of a community hospital.

Personal/Social History: Jan has four children under the age of 17. She has no personal or family history of breast cancer. She has never smoked and lives with her husband in a suburban community. She works part-time as a substitute teacher. Jan is a devout Christian who has a strong faith and trust in God. She also believes in the power of prayer and believes that God can heal her. She chose to have a mammogram just before her husband’s insurance plan expired because he just lost his job. What data from the histories are RELEVANT and has clinical significance to the nurse? RELEVANT Data from Present Problem: Clinical Significance: 1. Patient did not seek medical attention when 1. Ignored palpable lump on right cancer was in the earlier stages. breast for a year. 2. Cancer has spread into her lymph nodes and in 2. Lump has increased in size. her spine (further from initial lump). This can Mammogram confirmed 5cm and indicate that the cancer is in its late stages. biopsy confirmed cancerous cells 3. Patient will have to be watched carefully for in tumor and in lymph nodes. 1 cm signs of infection from the VAD. tumor on lumbar spine 3. Not a surgical candidate VAD device will be placed. RELEVANT Data from Social History: 1. Four children...