NR 325 - FINAL EXAM STUDY GUIDE
BREAST CANCER SCREENING GUIDELINES (Answer)- regular screening mammography starting at age 45 years.Women aged 45 to 54 years should be screened annually.Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually.continue screening mammography as long as overall health is good and life expectancy is 10 years or longer THE BREAST SELF-EXAMINATION (Answer)- lie down and place one arm behind the head use finger pads of three middle fingers of the other hand to feel for lumps use overlapping dime-sized circular motions to feel the breast tissue use three different levels of pressure up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS (Answer)- inflammation of the breast occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth MASTITIS - CLINICAL MANIFESTATIONS (Answer)- warm to touch indurated/painful often unilateral most commonly caused by staphylococcus aureus 1 / 4
BEST TIME TO PERFORM SELF BREAST EXAM (BSE) (Answer)- Perform BSE at the end of the menstrual period breast tenderness is less likely to occur RISK FACTORS FOR BREAST CANCER (Answer)- early menarche late menopause Age - at or older than 50 yrs hormone use Family history/Genetics History of cancer (breast, colon, endometrial, ovarian) First full term pregnancy after age 30 nulliparity (never given birth) benign breast disease (atypical epithelial hyperplasia) weight gain/obesity after menopause exposure to ionizing radiation alcohol consumption ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY (Answer)- FNA is performed in outpatient settings results are available within 24-48 hours no incision required BREAST LUMPS - ASSESSMENT (Answer)- *painless* and *fixed* lumps suggest breast cancer/malignancy 2 / 4
HORMONE THERAPY (HT) (Answer)- *HT has been linked to increased risk for breast cancer*; patient and HCP must determine whether or not HT therapy is appropriate *Breast cancer incidence is increased in women using HT*, independent of other risk factors HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers CLASSIFICATION OF BREAST CANCER (Answer)- based on tissue type based on invasiveness based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
(Answer)- Ductal carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
- Inflammatory
- Paget's disease
- Phyllodes tumor
Lobular carcinoma (milk-producing glands) Other
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
(Answer)- Noninvasive (In situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
- invasive ductal carcinoma
- invasive lobular carinoma 3 / 4
Invasive (spreads)
CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE
RECEPTOR STATUS/GENETIC STATUS (Answer)- *Estrogen and Progesterone Receptor Status*
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
- HER-2 positive
- HER-2 negative
- / 4
*HER-2 Genetic Status*
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE (Answer)- this Rx is for the treatment of of tumors that have the HER-2 receptor TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT (Answer)- this Rx can lead to ventricular dysfunction patient is taught to self-monitor for symptoms of heart failure TAMOXIFEN (NOLVADEX - THERAPEUTIC USE (Answer)- this Rx is for the treatment of estogen-dependent breast tumors in premenopausal women ESTRADIOL - CAUTION (Answer)- this Rx will increase the growth of estrogen- dependent tumors RALOXIFENE - THERAPEUTIC USE (Answer)- this Rx is used to prevent breast cancer this Rx *IS NOT USED* postmastectomy RADICAL MASTECTOMY - POST OP NURSING CARE (Answer)- patients are at increased risk for lymphedema and infection therefore, *NO BLOOD PRESSURES OR VENIPUNCTURES* in the affected arm signage should be posted at the bedside to help remind staff