Nursing 211

N211: Health Differences Across the Lifespan I obesity, breast trauma, smoking, ingesting more than two alcoholic beverages a day and exposure to radiation through chest x-ray or fluoroscopy. Breast cancer begins as a single, transformed cell and is hormone dependent, most occur in the ductal areas of the breast. Breast cancer is generally adenocarcinoma, originating in the epithelial cells, and it occurs in the ducts or lobes. Non-invasive breast cancer does not penetrate the surrounding tissue, may be ductal or lobular, usually diagnosed through mammogram or nipple discharge. Invasive breast cancer is the penetration of tumor into surrounding tissue. Staging depends on the size of the tumor, lymph node involvement, and metastasis to distant sites. Tumors tend to be located in the upper right quadrant of the breast and more often in the left breast than the right. Women should be taught the importance of conducting a monthly self-breast examination. Every woman should perform breast self-examination monthly, preferably as soon as menstrual bleeding ceases or if postmenopausal the same date every month. Mammography is very helpful in early detection. Baseline mammogram should be performed at approximately 35-40 years of age. Mammogram every 1-2 years for women in their forties. Annual mammogram for women over the 50 years of age. Instruct clients not to use lotion, deodorant under the arms prior to the procedure. Tumors that are 4cm or smaller are deemed curable. Larger tumors require much more aggressive treatment and cure is difficult. Diagnostics Include mammogram and biopsy with frozen section, which is the definitive diagnosis and radionucleotide bone scan to detect for metastasis Nursing Assessme t Incudes hard lump, not freely movable and not painful; dimpling of the skin, retraction of the nipple, alterations in contour of the breast, change in skin color, change in skin texture (peau d’orange), discharge from nipple, pain and ulcerations. Nursing Diagnosis • Pain related to surgical interventions and manipulation of tissue • Impaired skin integrity related to surgical intervention • Ineffective individual coping related to fear of cancer • Body image disturbance related to loss of body part • Ineffective management of therapeutic regime related to knowledge deficit Medical Int rventio s

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