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Questions and Answers
What is the most common type of pediatric skin cancer?
What is the most common type of pediatric skin cancer?
What percentage of childhood cancers does melanoma account for?
What percentage of childhood cancers does melanoma account for?
What increases the risk for melanoma in children?
What increases the risk for melanoma in children?
What is a significant reason for the increasing incidence of skin cancer among older adults?
What is a significant reason for the increasing incidence of skin cancer among older adults?
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What is the estimated likelihood of developing skin cancer by the age of 70 in Americans?
What is the estimated likelihood of developing skin cancer by the age of 70 in Americans?
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What type of biopsy is less frequently positive in the older adult population?
What type of biopsy is less frequently positive in the older adult population?
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What is a potential treatment option for basal cell carcinoma or squamous cell carcinoma in older adults who cannot undergo surgery?
What is a potential treatment option for basal cell carcinoma or squamous cell carcinoma in older adults who cannot undergo surgery?
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Which factors must be considered when prescribing topical treatments to older adults?
Which factors must be considered when prescribing topical treatments to older adults?
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Which of the following is not a physical assessment aspect for patients with skin cancer?
Which of the following is not a physical assessment aspect for patients with skin cancer?
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Patients with skin cancer should be assessed for any changes in the appearance of moles, warts, or scars.
Patients with skin cancer should be assessed for any changes in the appearance of moles, warts, or scars.
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What emotional support should nurses provide to patients diagnosed with skin cancer?
What emotional support should nurses provide to patients diagnosed with skin cancer?
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The assessment of skin lesions should be conducted in ______ light, preferably natural light.
The assessment of skin lesions should be conducted in ______ light, preferably natural light.
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Match the following assessment criteria with their descriptions:
Match the following assessment criteria with their descriptions:
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Which of the following questions is relevant during the patient interview for skin cancer assessment?
Which of the following questions is relevant during the patient interview for skin cancer assessment?
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Patients should only be assessed for skin cancer once a year regardless of their risk factors.
Patients should only be assessed for skin cancer once a year regardless of their risk factors.
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What should be done before conducting a physical examination of a patient with skin cancer?
What should be done before conducting a physical examination of a patient with skin cancer?
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What primarily influences the intensity of anxiety in patients?
What primarily influences the intensity of anxiety in patients?
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Anxiety tends to decrease after the diagnosis and remains unchanged throughout treatment.
Anxiety tends to decrease after the diagnosis and remains unchanged throughout treatment.
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What should the nurse avoid doing when interacting with an anxious patient?
What should the nurse avoid doing when interacting with an anxious patient?
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The ABCDE guidelines are used to assess changes in _____ for skin lesions.
The ABCDE guidelines are used to assess changes in _____ for skin lesions.
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Match the following coping strategies with their descriptions:
Match the following coping strategies with their descriptions:
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What is a potential consequence of higher levels of anxiety?
What is a potential consequence of higher levels of anxiety?
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Correct wound healing includes well-approximated wound edges and granulation of tissue.
Correct wound healing includes well-approximated wound edges and granulation of tissue.
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What should patients be educated about to stay vigilant against skin changes?
What should patients be educated about to stay vigilant against skin changes?
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To avoid skin damage, patients should avoid unprotected _____ exposure.
To avoid skin damage, patients should avoid unprotected _____ exposure.
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Which of the following is NOT an expected outcome to evaluate nursing care?
Which of the following is NOT an expected outcome to evaluate nursing care?
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Which area is NOT included in the initial order of assessment for skin-related issues?
Which area is NOT included in the initial order of assessment for skin-related issues?
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Patients with a diagnosis of malignant melanoma may experience feelings of hopelessness.
Patients with a diagnosis of malignant melanoma may experience feelings of hopelessness.
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What is one suggested goal for a patient with malignant melanoma regarding skin self-examinations?
What is one suggested goal for a patient with malignant melanoma regarding skin self-examinations?
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Regular medical checkups should occur every ______ months for the first 2 years after diagnosis.
Regular medical checkups should occur every ______ months for the first 2 years after diagnosis.
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Match the following issues related to malignant melanoma with their corresponding explanations:
Match the following issues related to malignant melanoma with their corresponding explanations:
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What is one important nursing intervention for patients with malignant melanoma?
What is one important nursing intervention for patients with malignant melanoma?
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Patients should verbalize their emotions and concerns to improve their therapeutic relationships with caregivers.
Patients should verbalize their emotions and concerns to improve their therapeutic relationships with caregivers.
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Name a support resource available for patients with malignant melanoma.
Name a support resource available for patients with malignant melanoma.
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The nurse should address feelings of ________ in patients diagnosed with malignant melanoma.
The nurse should address feelings of ________ in patients diagnosed with malignant melanoma.
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Match the following actions to their intended purpose regarding skin cancer care:
Match the following actions to their intended purpose regarding skin cancer care:
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What is a crucial topic of patient education for those undergoing treatment for malignant melanoma?
What is a crucial topic of patient education for those undergoing treatment for malignant melanoma?
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Encouraging passive behavior in patients diagnosed with skin cancer is beneficial for their emotional health.
Encouraging passive behavior in patients diagnosed with skin cancer is beneficial for their emotional health.
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List one psychological response commonly seen in cancer patients.
List one psychological response commonly seen in cancer patients.
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The nurse should encourage patients to identify and express ________ systems.
The nurse should encourage patients to identify and express ________ systems.
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Study Notes
Skin Cancer in Children
- Melanoma, although uncommon in children, is the most prevalent form of pediatric skin cancer.
- Around 500 children are diagnosed with melanoma annually, representing approximately 2% of all childhood cancers.
- The incidence of melanoma increases with age, affecting 8% of teenagers, particularly girls.
- Sun exposure and tanning beds are significant risk factors for melanoma in children and adolescents.
Skin Cancer in Older Adults
- Skin cancer incidence is rising among older adults, with basal cell and squamous cell carcinomas being most common in this age group.
- Malignant melanoma also occurs more frequently in older adults.
- At least one in five Americans will develop skin cancer by the age of 70.
- Symptom presentation and prognosis of skin cancers differ in older adults compared to younger individuals, often with more advanced disease at diagnosis.
- Melanoma is often asymptomatic in older adults, and its subtypes tend to be more aggressive.
- Immunosenescence, a decline in immune function with aging, increases the susceptibility to skin cancer in older adults.
- Older adults face greater difficulty identifying new or changing skin lesions.
- Biopsy remains the standard diagnostic tool for suspected skin cancer, with sentinel node biopsies showing lower positivity rates in older adults.
- Treatment options for skin cancer in older adults are similar to those offered to younger individuals.
- Surgical interventions may not be suitable for all older adults due to coexisting conditions like diabetes, cardiovascular diseases, and arthritis.
- Radiotherapy presents a viable alternative for squamous cell or basal cell carcinomas, achieving a 90% 5-year cure rate for non-surgical candidates.
- Topical treatments can be considered but require careful assessment of arthritis and dementia levels.
- Comorbidities must be taken into account when prescribing adjuvant therapies.
- Complete lymph node dissection is indicated for metastatic melanoma with positive sentinel lymph node, but poses significant morbidity for older adults.
- Systemic therapies are generally poorly tolerated by older adults and can complicate existing health conditions.
- Prevention research targeting skin cancer risk reduction in older adults has received limited attention.
- Educational initiatives focusing on sun protection measures, UV exposure reduction, and sunburn avoidance are crucial for this population.
Nursing Care for Skin Cancer Patients
- Assessment: Involves a thorough skin examination, including a comprehensive health history and a physical examination of the entire body.
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Key Assessment Questions:
- Family history of skin cancer.
- Previous skin cancer diagnosis and treatment.
- Changes in mole, wart, birthmark, or scar appearance.
- Itching, pain, crusting, or bleeding in moles, warts, birthmarks, or scars.
- Travel history.
- Sunburn history.
- Tanning salon or bed use.
- Exposure to hazardous chemicals at work.
- Skin self-examination practices.
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Physical Examination:
- Remove clothing and wear an examination gown for optimal visibility.
- Ensure good lighting, with natural light preferred.
- Inspect and palpate the skin, stretching it taut for better assessment.
- Assess for:
- Obvious lesions.
- Visible swellings.
- Alterations in nevus borders and contours.
- Enlarged lymph glands.
- Skin or mucosal discolorations.
- Areas of ulceration, scaling, crusting, or erosion.
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Assessment Order:
- Head and neck.
- Thyroid and neck, including lymph glands.
- Chest and abdomen.
- Back and buttocks.
- Extremities, with attention to axillae, nail beds, and webs between fingers and toes.
- External genitals.
- Documentation: Measure and record skin lesion descriptions on an anatomical chart. Take photographs of suspicious lesions for future reference.
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Diagnosis:
- Impaired skin integrity.
- Lack of knowledge about skin cancer.
- Potential for infection.
- Hopelessness.
- Anxiety.
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Planning: Care is tailored based on the location, presence of metastasis, indicated treatment, and patient age.
- Goals include:
- Patient understanding treatment options and their pros and cons.
- Prevention of postoperative infection.
- Regular skin self-examinations and reporting abnormalities.
- Patient awareness of skin cancer prevention measures.
- Expression of emotions and concerns regarding the diagnosis and treatment options.
- Goals include:
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Implementation:
- Nurse's role in skin cancer prevention awareness: Promote sun protection and avoid tanning beds.
- Focus on addressing infection prevention, open communication, and psychosocial well-being.
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Addressing Hopelessness:
- Encourage verbalization of feelings, concerns, and goals.
- Provide active listening and ask open-ended questions.
- Validate and address feelings of apathy or anger.
- Acknowledge and empathize with fears and concerns.
- Foster positive emotions like hope and purpose.
- Correct misconceptions and clarify perceptions.
- Identify support systems and coping mechanisms.
- Encourage active participation in self-care and decision-making.
- Focus on both present and future.
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Reducing Anxiety:
- Reassure and comfort patients.
- Avoid demands and allow time for decision-making.
- Minimize sensory stimuli.
- Provide accurate information about the illness, treatment, and recovery process.
- Encourage patient and family involvement in care.
- Discuss expected physical changes and ways to minimize disfigurement.
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Evaluation:
- Assess patient progress towards meeting goals of care.
- Expected outcomes:
- Absence of infection.
- Adequate wound healing.
- Tolerable pain levels.
- Awareness of skin lesion changes.
- Reporting integumentary changes to healthcare providers.
- Informed treatment decisions.
- Avoidance of unprotected sun exposure and tanning beds.
- Healthy coping mechanisms for body image changes.
- Achievement of a satisfactory quality of life.
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Reinforcing Education:
- If the patient doesn't understand the importance of skin vigilance, provide further education.
- Teach the ABCDE guidelines for inspecting moles for changes.
- Remove suspicious moles, actinic dermatoses, and precancerous lesions.
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Description
This quiz explores the differences in skin cancer incidence and characteristics between children and older adults. It covers the types of skin cancers most prevalent in each age group, risk factors, and the impact of sun exposure. Understanding these variances is crucial for effective prevention and treatment strategies.