NR 509 Final Exam Study Guide Review 2024 PDF
Document Details
Uploaded by SaneVuvuzela
2024
Tags
Summary
This document is a study guide review for a medical exam, specifically focusing on Chapter 18: Breasts and Axillae. It covers examination techniques, breast anatomy, female breast assessment, lymph nodes, male breast, and breast cancer, including screening and risk factors. The guide is updated for 2024.
Full Transcript
NR 509 Final Exam Sudy Guide Review 2024 New Updaes Perec Revision Chapter 18 Breasts and Axillae Techniques o examinaon o Arms over head ▪ Can bring ou dimpling or reracon ha may b...
NR 509 Final Exam Sudy Guide Review 2024 New Updaes Perec Revision Chapter 18 Breasts and Axillae Techniques o examinaon o Arms over head ▪ Can bring ou dimpling or reracon ha may be invisible Palpae he breass ▪ Bes wih p. supine ▪ A horough examinaon akes a leas hree minues ▪ Use he vercal srip paern o deec breas mass ▪ Palpae in small, concenric circles applying ligh, medium, and deep pressure a each examining poin ▪ When pressing deeply on he breas a normal rib can be misaken or a hard breas mass ▪ To palpae laeral breas, ask paen o roll ono he opposie hip, placing her hand on her orehead bu keeping he shoulder pressed agains he bed or examining able as his aens he laeral breas ssue. ▪ To palpae he medial poron o he breas, have p. lie a wih shoulders agains he examining able ▪ Inspec he axillae ▪ Palpae he axillary nodes ▪ By moving in a sraigh line down he bra line, hen move ngers medially and palpae in a vercal rip up he ches o he clavicle. Anaomy o Female breas/axillae assessmen o Breas lump or mass ▪ Can be physiologic or pahologic ranging rom cyss and broadenomas o breas cancer o Breas cys ▪ Usually rm, round, mobile, and oen ender, mosly common beween ages o 25-50 years old o Breas discomor or pain ▪ SSRI, Haldol, Aldacone, and dig can cause breas pain Nipple discharge o Lymph nodes o The lymphac drainage o he breas is o grea imporance in he spread o carcinoma, and abou hree-quarers o i is o he axillary nodes. ▪ Cenral nodes (axillary) o The male breas o Gynecomasa: males who develop benign breas enlargemen. Causes include increased esrogen, decreased esoserone, and medicaon side eecs o Inspec he nipple and areola (nodules, swelling, ulceraon) o Palpae he areola and breas ssue (nodules) Breas cancer (including screening and risk acors) o Redness suggess local inecon or inammaory carcinoma Thickening and prominen pores suggess breas cancer o Flang o he normally convex breass sugges cancer Asymmery in nipple direcon suggess cancer o Eczemaous changes wih rash scaling or ulceraon on he nipple exending o areola suggess Page disease o Invered nipple sugges cancer o Breas dimpling or reracon sugges cancer o Milky discharge unrelaed o pregnancy is nonpuerperal galacorrhea ▪ Caused by hypohyroidism, piuiary prolacnoma, and dopamine anagoniss o Risk acors ▪ Increasing age 65+ unl age 80 ▪ Biopsy: conrmed aypical hyperplasia ▪ Firs-degree amily members diagnosed wih breas cancer a an early age ▪ Inheried genec muaons- BRCA 1 and BRCA2 ▪ Personal hisory o breas cancer or ducal or lobular carcinoma ▪ Relavely denser breass on mammography ▪ High-dose radiaon o he ches a a young age ▪ High levels o endogenous hormones ▪ Age a rs ull erm pregnancy ▪ Lae menopause o Modiable risk acors ▪ Breasteeding or less han 1 year, posmenopausal obesiy, use o HRT, smoking, alcohol consumpon, physical inacviy, and ype o conracepon. Clinical breas examinaon (CBE) and sel-breas examinaon (SBE) echniques o The bes me is in a paen who is sll mensruang 5-7 days aer he onse o mensruaon because breass end o swell and become more nodular beore menses o Inspec breass in our views: arms a sides, arms over head, arms pressed agains hips, and leaning orward. o Breas sel-examinaon ▪ A high proporon o breas masses are deeced by women examining heir own breass. For screening, he BSE has no been shown o reduce breas cancer moraliy bu may promoe healh awareness and earlier reporng o breas changes or masses, which may reduce unnecessary esng and biopsies compared o monhly sel-examinaon. The BSE is bes med 5 o 7 days aer menses, when hormonal smulaon o breas ssue is low. Physiologic changes associaed wih he normal aging process o Fibroadenoma ▪ very mobile, round dislike, ypically small (1-2cm), rm, usually single bu very well delineaed. 15-25 years, pubery. o Cys ▪ mobile, round, well delineaed, so o rm, single, 30-50 years. o Cancer ▪ may be xed o he skin or underlying ssues, usually single, irregular or sellae in shape, rm or hard, mos common over age o 50 Lacaon o