Breast Cancer
Why would someone get prophylactic surgery for breast cancer?
if they have the BRCA 1 gene
What are the first signs/ symptoms seen that need to be checked?
changes in bowel/ bladder habits- need further evaluation
What are some teaching points for a patient with lymphedema?
- arm above chest
- elastic garments
- get up and move
- no ice or heat post op: can't feel it
What is TURP
resection of the prostate- bladder irrigation, prevent clots, can have pink/bloody urine
What is ABCD
asymmetry
border
color
diameter
What are the instructions after a mastectomy?
- avoid overuse of arm
- keep arm elevated
- do not carry heavy objects or bags
- avoid constricting clothes
- wear gardening gloves
- alert bracelet
- no BP or needlestick
What are some risk factors?
- over 45 yrs
- family hx of polyps/cancer
- inflammatory bowel disease
- hx of breast or ovarian cancer
If there is a shift to normal WBC is that normal for the patient?
no if they have low WBC and it goes normal: that is of concern: infection
What are some signs/ symptoms for lung cancer?
- nagging cough
- hoarseness
- hemoptysis
- weight loss
- weakness
- adventitious lung sounds
what is moh's surgery?
they take layers off of skin until theres no cancer cells left: clean border
What are some symptoms of breast cancer?
- painless mass
- bloody d/c from nipple
- nipple retraction
- asymmetrical breast size
- orange peel skin
what is the diagnostic and treatment test that a patient with colorectal cancer should get?
colonoscopy: can be diagnostic or treatment: biopsy
Explain AML: acute myelogenous leukemia
aggressive chemo, 15-39 yrs, no contact sports
What are teaching for bronchoscopy?
-can do biopsy
- get vitals: compare
- check for gag reflex
what is the biggest risk factor for squamous cell carcinoma?
deep sunburns
If breast cancer has metastasized to the brain what symptom would you see?
change in LOC
What are some complications that we need to monitor for?
- bowel perforation: abdomen rigid/ hard
- small bowel obstruction: thorough assessment, abdominal distention, vomit fecal matter
- hemorrhage
- fistula
What is the most definitive test and what do you warn the patient?
bone marrow biopsy: iliac crest: educate them on it is painful
If a patient has a nodule felt on rectal exam what diagnostic test would they be sent for?
PSA marker- then to biopsy
what do you want to be on the lookout for when someone receives a graft?
graft vs host disease: emergency: attacks the host
What is the non surgical intervention that does hormonal manipulation in postmenopausal ?
what are some interventions for an intestinal obstruction?
- NPO
- NG tube: low intermittent suction
- TPN
- surgery
- mouth care
chronic, 50 yrs, schedule rest and activity, still exercise
Where does prostate cancer metastasize?
- bone: main one: will complain of hip pain
- lung
- liver
- kidney
What are some comfort measures for someone who is on chemo?
- mouth care
- antiemetic
- small frequent meals: high protein
- wrap/wig
- pain control