Nursing 211

N211: Health Differences Across the Lifespan I of 148 Testicular cancer is the leading cause of death of men in the 20 to 35 age group. There is an unregulated growth of abnormal cells within the testes. Exact cause is unknown, but risk factors include cryptorchidism (undescended testes at birth), mumps orchitis, trauma, environmental factors, age and maternal treatment with DES during pregnancy. Testicular cancer is usually slow growing and localized with a good prognosis. Nurs Assessment Includes it is asymptomatic if confined to the gland; a feeling of heaviness or dragging sensation in the lower abdomen and groin, painless hardened area or lump found during a testicular self- examination (TSE). Dull ache in pelvis and scrotum, testicular pain may occur with associated infections, necrosis or hemorrhage. Weight loss, fatigue and with metastasis low back pain, aching in legs and hip pain. Diagnostics Includes scrotal ultrasound, CT or MRI scan of chest, abdomen, and pelvis to rule out metastasis. IVP to determine kidney involvement, AFP and beta unit of HCG are tumor markers; elevated levels strongly suggest testicular cancer. Serum lactic dehydrogenase (LDH) is elevated with testicular cancer. Medical Management Includes orchiectomy and exploration area to identify cancer cell type and stage of disease. Prepare client for chemotherapy after surgery and possible radiation therapy if cancer has spread to the lymph nodes. Nursing Interventions Include providing pain management, ice packs, and scrotal support to control pain and swelling. Monitor for complications such as bleeding or infection. Encourage genetic counseling, sperm banking is often recommended prior to surgery. Counsel that sexual functioning is usually not affected because the remaining testis undergoes hyperplasia, producing sufficient testosterone to maintain sexual functioning. 3.17 Breast Ca cer Breast Cancer is an unregulated growth of abnormal cells in the breast tissue. Breast cancer is the leading cause of cancer in women in the United States. One in eight women will develop breast cancer in her lifetime. Early detection is the key to successful treatment. Men may also develop breast cancer, they account for <1% of all reported cases. The cause of breast cancer is unknown, but some associated risk factors are female gender and Caucasian race, family history of mother or sister with breast cancer, medical history of cancer of the breast, endometrial cancer or atypical hyperplasia, menarche before the age of 12 (early) or menopause after the age of 50 (late). Other risk factors include use of oral contraceptives, prolonged use of estrogen replacement therapy, high fat diet, ©2012 Achieve Page 103