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NR509 / NR 509 Final Exam Study Guide Advanced Physical Assessment 1.Suspicious breast mass
: -A mobile mass that becomes fixed when the arm relaxes is
attached to the ribs and intercostal muscles; if fixed when the hand is pressed against the hip, it is attached to the pectoral fascia.-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues, strongly suggest cancer 2.Risk for Breast cancer
: --*Age*
-family history of breast/ovarian CA -inherited genetic mutations, -personal history of breast cancer -high levels of endogenous hormones -breast tissue density -proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen exposure related to early menarche -age of first full-term pregnancy 1 / 3
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-late menopause.-breastfeeding for less than 1 year, -postmenopausal obesity -cigarette smoking, alcohol ingestion, -physical inactivity, and type of contraception.- 3.Characteristics of a breast cyst
: Soft to firm, round, mobile, often tender.
4.The best way to examine the lateral portion of the breast
: -Have pt roll onto the opposite hip
-place her hand on her forehead.-keep shoulders pressed against the bed -palpate in the axilla, moving in a straight line down to the bra line, then move the fingers medially and palpate in a vertical strip up the chest to the clavicle. Continue in vertical overlapping strips until you reach the nipple 5.Bacterial Vaginosis (BV)
: -Caused by overgrowth of anaerobic bacteria (often from sex)
-Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal 2 / 3
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-Fishy/musty genital odor -Normal vulva and vaginal mucosa -Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff for fishy odor after applying KOH ("whiff test"); test the vaginal secretions for pH > 4.5 6.Candidal Vaginitis : -Cause: Candida albicans, a yeast (normal overgrowth of vaginal flora); many factors predispose, including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as
profuse as trichomonal infection, not malodorous
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