Podcast
Questions and Answers
Which of the following is NOT a specific health history question for skin cancer assessment?
Which of the following is NOT a specific health history question for skin cancer assessment?
Patients should wear clothing during the physical assessment for skin cancer.
Patients should wear clothing during the physical assessment for skin cancer.
False
What is the best type of light for inspecting skin lesions?
What is the best type of light for inspecting skin lesions?
Natural, bright light
During skin assessment, the skin should be stretched tightly to facilitate assessment of __________ lesions.
During skin assessment, the skin should be stretched tightly to facilitate assessment of __________ lesions.
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Match the following assessment observations with their significance:
Match the following assessment observations with their significance:
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Which area is assessed after the head and neck in the order of assessment?
Which area is assessed after the head and neck in the order of assessment?
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The assessment of chest and abdomen includes paying special attention under pendulous breasts.
The assessment of chest and abdomen includes paying special attention under pendulous breasts.
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What should be done to record skin lesions during the assessment?
What should be done to record skin lesions during the assessment?
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The area assessed with special attention to skinfolds, mucous membranes, and areas covered with hair is the external ___.
The area assessed with special attention to skinfolds, mucous membranes, and areas covered with hair is the external ___.
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Match the body areas with their specific attention requirements during assessment:
Match the body areas with their specific attention requirements during assessment:
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Which of the following is a potential problem for a patient diagnosed with malignant melanoma?
Which of the following is a potential problem for a patient diagnosed with malignant melanoma?
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It is important for the patient to conduct skin self-examinations at least once monthly.
It is important for the patient to conduct skin self-examinations at least once monthly.
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What is one suggested goal of care for a patient diagnosed with skin cancer?
What is one suggested goal of care for a patient diagnosed with skin cancer?
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Patients should be aware of the proper use of __________ to help prevent skin cancer recurrence.
Patients should be aware of the proper use of __________ to help prevent skin cancer recurrence.
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Match the following patient goals with their descriptions:
Match the following patient goals with their descriptions:
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What role do nurses play in skin cancer prevention?
What role do nurses play in skin cancer prevention?
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Patients diagnosed with malignant melanoma often feel a sense of hopelessness.
Patients diagnosed with malignant melanoma often feel a sense of hopelessness.
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What is one important nursing intervention for a patient with malignant melanoma to promote psychosocial well-being?
What is one important nursing intervention for a patient with malignant melanoma to promote psychosocial well-being?
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Nurses advocate for the avoidance of _______ beds to help prevent skin cancer.
Nurses advocate for the avoidance of _______ beds to help prevent skin cancer.
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Match the nursing interventions with their purposes:
Match the nursing interventions with their purposes:
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What is the recommended schedule for medical checkups after a malignant melanoma diagnosis?
What is the recommended schedule for medical checkups after a malignant melanoma diagnosis?
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Patients diagnosed with malignant melanoma should have a medical checkup every year after the first 5 years.
Patients diagnosed with malignant melanoma should have a medical checkup every year after the first 5 years.
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What is one of the primary goals of patient education for someone with malignant melanoma?
What is one of the primary goals of patient education for someone with malignant melanoma?
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Patients who have undergone a lymph node dissection need to be educated on how to protect against __________.
Patients who have undergone a lymph node dissection need to be educated on how to protect against __________.
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Match the following resources with their descriptions:
Match the following resources with their descriptions:
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Which of the following statements is true regarding patient feelings and concerns?
Which of the following statements is true regarding patient feelings and concerns?
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Patients should not be encouraged to participate in decision-making regarding their care.
Patients should not be encouraged to participate in decision-making regarding their care.
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What is an important aspect of creating a supportive environment for patients with malignant melanoma?
What is an important aspect of creating a supportive environment for patients with malignant melanoma?
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What is the primary focus of interventions for reducing anxiety in patients with cancer?
What is the primary focus of interventions for reducing anxiety in patients with cancer?
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Anxiety tends to decrease after the initial cancer diagnosis.
Anxiety tends to decrease after the initial cancer diagnosis.
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Name one coping mechanism that nurses can support in patients experiencing anxiety.
Name one coping mechanism that nurses can support in patients experiencing anxiety.
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Patients are encouraged to actively participate in their care to gain some __________ over their future and reduce anxiety.
Patients are encouraged to actively participate in their care to gain some __________ over their future and reduce anxiety.
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Match the following coping strategies with their descriptions:
Match the following coping strategies with their descriptions:
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Which of the following is an expected outcome when evaluating a patient's post-operative care?
Which of the following is an expected outcome when evaluating a patient's post-operative care?
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Patients should actively avoid unprotected sun exposure after skin cancer treatment.
Patients should actively avoid unprotected sun exposure after skin cancer treatment.
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What does the ABCDE acronym stand for in skin lesion evaluation?
What does the ABCDE acronym stand for in skin lesion evaluation?
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The patient's perception of a satisfactory 'quality of life' is considered an important __________ outcome.
The patient's perception of a satisfactory 'quality of life' is considered an important __________ outcome.
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Match the following patient actions with their expected outcomes:
Match the following patient actions with their expected outcomes:
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Study Notes
Skin Cancer Assessment
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Patient Interview: Inquire about family history of skin cancer, previous skin cancer removals, changes in moles, warts, birthmarks, or scars, itchy or painful lesions, geographic locations lived in, sunburns, tanning salon or bed usage, exposure to hazardous chemicals, and self-examination practices.
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Physical Examination: Remove all clothing and ensure good lighting. Inspect and palpate the skin, stretching it to assess lesions in the dermis.
Assessment Focus
- Look for: Obvious lesions, visible swellings, alterations in nevi, enlarged lymph glands, skin or mucosal discolorations, ulceration, scaling, crusting, or erosion.
Assessment Order
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Head and Neck: Entire scalp, eyelids, ears, auditory canals, external/internal nose, oral cavity, facial skin & glands.
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Thyroid & Neck: Include lymph glands.
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Chest & Abdomen: Pay attention to under breasts, skinfolds, and hairy areas.
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Back & Buttocks: Focus on the intergluteal area.
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Extremities: Prioritize axillae, nail beds, webs between fingers/toes, and soles of feet.
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External Genitals: Examine skinfolds, mucous membranes, and hairy areas.
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Documentation: Record the size and description of all skin lesions on an anatomical chart. Take photographs of suspicious lesions for future reference.
Diagnosis Problems
- Impaired skin integrity: Malignant melanoma affects skin, resulting in compromised skin integrity.
- Lack of knowledge about skin cancer: Patient may be unfamiliar with the nature of skin cancer and relevant information.
- Potential for infection: Open wounds due to treatment or surgery increase the risk of infection.
- Hopelessness: Diagnosis of malignant melanoma can lead to feelings of hopelessness.
- Anxiety: The disease and its treatment can cause significant anxiety.
Planning Care
- Planning involves individualization based on factors such as location, metastasis, treatment, and patient age.
Care Goals
- Treatment Understanding: Patient should understand treatment options, pros, and cons to make informed decisions.
- Infection Prevention: Goal to prevent signs or symptoms of infection postoperatively.
- Skin Self-Examination: Patient will conduct monthly skin self-examinations and report changes.
- Prevention Awareness: Patient expresses understanding of skin cancer prevention measures like sunscreen use and avoiding tanning.
- Emotional Expression: Patient verbalizes emotions and concerns related to diagnosis and treatments.
Nurses and Skin Cancer Prevention
- Nurses play a crucial role in promoting awareness of skin cancer prevention.
- They advocate for sun protection practices and discourage tanning bed use to prevent skin cancer.
Nursing Interventions for Malignant Melanoma
- Nurses are involved in preventing infections and fostering open communication with patients.
- They also aim to promote psychosocial well-being.
Addressing Feelings of Hopelessness in Malignant Melanoma Patients
- A diagnosis of malignant melanoma can lead to feelings of hopelessness due to the potential for metastasis, recurrence, and death.
- Patients may experience alterations in self-concept, roles, and relationships.
- These feelings can lead to withdrawal, passivity, and apathy.
- Nurses should encourage patients to verbalize their feelings, concerns, and goals to foster a therapeutic relationship and promote self-worth.
Patient Education for Malignant Melanoma
- Self-care and ongoing self-monitoring: Vital component of patient education, tailored to specific treatment.
- Post-lymph node dissection care: Focus on wound care and preventing bleeding, trauma, and infection.
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Regular medical checkups: Crucial for early detection and monitoring. Schedule includes:
- Every 3 months for the first 2 years
- Every 6 months for the next 5 years
- Yearly thereafter
- Importance of proper self-care: When combined with regular medical care, it can help patients lead a fairly normal life.
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Support and Resources: Referrals to community health, home care agencies, and local cancer support groups. Additional resources include:
- American Cancer Society (http://www.cancer.org)
- Skin Cancer Foundation (http://www.skincancer.org)
- Emotional Support: Create an environment where patients can express their feelings, concerns, and goals. Encourage open communication and provide empathetic understanding of fears and concerns.
- Positive Emotions: Help patients express positive emotions like hope, faith, a sense of purpose, and the will to live.
- Patient Empowerment: Empower patients to identify and address misconceptions, identify support systems, and actively participate in self-care and decision-making. This fosters confidence and coping mechanisms.
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Future-Oriented Approach: Encourage a focus on both the present and the future.
- Explore past instances of hope
- Discuss the personal meaning of hope
- Set and evaluate short-term goals with the patient and family
- Encourage expression of hope for the future
Anxiety in Cancer Patients
- Anxiety is a common reaction to cancer diagnosis and treatment.
- The intensity of anxiety depends on the severity of the situation and the patient's ability to cope.
- Anxiety frequently increases at diagnosis and persists throughout treatment, regardless of treatment type or setting.
- Interventions aim to help patients recognize anxiety symptoms, assess their desire to manage anxiety, and facilitate coping strategies.
Melanoma and Prognosis
- The prognosis for melanoma depends on various factors, such as the stage of the disease and the presence of metastasis.
- Complete cure is less likely with metastasis.
Surgical Procedures and Anxiety
- Wide margin excision for melanoma can lead to disfigurement, potentially increasing anxiety.
- Active participation in care can provide patients with a sense of control and help manage anxiety.
Nursing Interventions for Anxiety Management
- Provide reassurance and comfort through:
- Spending quiet time with the patient.
- Active listening.
- Speaking calmly and slowly.
- Empathetic touch.
- Supporting coping mechanisms like crying and talking.
- Avoid making demands or pressuring patients to make decisions.
- Decrease sensory stimuli by:
- Using short, simple sentences.
- Focusing on the present moment.
- Providing concise information.
- Provide accurate information about the illness, treatment, and recovery expectations.
- Encourage patient and family involvement in care.
- Facilitate discussions on expected physical changes and strategies for minimizing disfigurement, such as cosmetics and clothing.
Nursing Care Plan Evaluation
- Nursing care plan efficacy is evaluated based on patient progress in meeting care goals.
- Expected outcomes used to evaluate care include:
- Absence of infection signs and symptoms
- Adequate wound healing, including well-approximated edges and tissue granulation
- Pain rating within a tolerable level or absence of pain
- Patient awareness of the need for skin lesion examination
- Patient understanding of reporting skin changes to the healthcare provider
- Patient-made informed decisions regarding treatment options
- Avoiding unprotected sun exposure and tanning beds
- Demonstrating healthy coping mechanisms for body image alterations
- Achieving personal satisfaction with quality of life
Education and Intervention
- Patient education is crucial, especially regarding the importance of skin lesion vigilance.
- The ABCDE guidelines should be taught for mole inspection.
- Suspicious moles, actinic dermatoses, and precancerous lesions identified during evaluation should be surgically removed.
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Description
This quiz focuses on the assessment procedures for skin cancer, including patient interviews and physical examinations. It covers essential aspects to look for during assessments, such as lesions and alterations in nevi. Gain a deeper understanding of the systematic approach to assessing skin cancer risk and signs.
