MDC3 Exam 1 Concepts_ Breast, GYN, and STI Overview & Practice Questions

MDC3 Exam 1 concept

1. Breast cancer
Catergories:
onon invasive:
DCIS: early noninvasive form of breast cancer. Cancer cells are located
within the duct and have not invaded surrounding fatty breast tissue.
LCIS: noninvasive disease in which the cells look like cancer cells and are
contained within the lobules (milk producing glands) of the breast. Less
common than DCIS.
oInvasive:
Ductal carcinoma: remain in duct, none in fatty breast tissue. Noninvasive
but can become invasive.
Inflammatory breast cancer: aggressive type of breast cancer. Diffuse
eryhthema and edema (peau d’orange). Breast pain or rapidly growing
breast lump. S/S: tender firm, enlarged breast and breast itching. Often
hard to treat.
oRisk factors:
Modifiable: postmenopausal obesity, physical inactivity, use of combined
estrogen and progestin postmenopausal hormone replacement therapy,
alcohol consumption, lack of breast feeding.
Non modifiable: age (65 years or higher), genetics (BRCA1 and BRCA2),
history of previous breast cancer, breast density, family history, radiation,
atypical hyperplasia (abnormal epithelial proliferative breast lesions),
reproductive history.
oNursing interventions:
Preoperative: relieving anxiety, education, including spouse or partner or
family, review the procedure, open ended questions, address body image
and expectations, emotional support.
Postoperative: avoid using affected arm, assess vital signs, assess
drainage, monitor amount and color of drainage, observe for s/s of
infection, assess posture, affected arm should be elevated, analgesics,
comfort measures, ambulation.
oPharmacologic drugs:
AC-T tumors: chemotherapy regimen used in the treatment of breast
cancer
LH-RH agonist: inhibits the production of estrogen limiting the availability
to grow
Trastuzumab: is less likely to harm normal, healthy cells, has fewer side
effects
Tamoxifen: SERM-reduces the chance of cancer coming back by ½

Benign breast cancer

, Fibroadenoma: well defined solid mass of connective tissue that is unattached to the
surrounding breast tissue and is usually discovered by the woman herself during
mammography.
oTumors are oval, freely mobile, and rubbery. May occur anywhere in breast.
Fibrocystic changes and cysts (FCC): occurs in premenopausal woman between 20 and
50 years of age. Imbalance of normal estrogen to progesterone ratio.
oBreast pain, firm, hard, tender lumps or swelling of the breasts (usually before a
woman’s menstrual cycle)
Limit salt intake before mensus, reduce caffeine intake, supportive bra,
ice or heat, oral contraceptives, SERMS, diuretics.

Gynecology problems

Uterine leiomyoma: benign, slow growing tumors of uterine myometrium that develops
from excessive local growth of smooth muscle cells.
oIntramural
Contained within the uterine wall within the myometrium.
Submucosal: protrude into the cavity of the uterus and can cause
bleeding and disrupt pregnancy
Subserosal: protrude through the outer surface of the uterine wall and
may extend to broad ligament.
Laboratory testing hematocrit, THS test, pregnancy test,
transvaginal ultrasound,
PRIORITY PROBLEM: prolonged or heavy bleeding due to
abnormal uterine growth.
Nursing care: observation, hormonal therapies, PCA, uterine atery
embolization, myolysis, myomectomy, hysterectomy
Endometrial cancer:
Vulvoganinits
Toxic shock syndrome
GYN post op teaching
Prostate cancer (MOST COMMON): testosterone and DHT (dihydrotesterone). Stony
hard with palpable irregularities or indrations
oRisk factors
Advanced age, first degree relative with the disease, African American
men, BRCA2 mutation.
oSigns and symptoms
Gross blood in urine (hematuria) (MOST COMMON SIGN OF LATE
PROSTATE CANCER), NOCTURIA, pain in pelvis, hip, spine or ribs, swollen
nodes
Elevated levels of serum acid phosphate
Screening
DRE (digital rectal examination): prostate that is stony hard with
palpable irregularities or indurations is suspected to be malignant