Physical Assessment - Quiz 3 Review.

Breast Health & Respiratory – Physical Assessment Quiz #3 Breast self-exam: steps and instructions Step 1 Lie down and put your right arm behind your head. Place the 3 middle fingers of your left hand on your right breast. Move your fingers in a circular motion, pressing with light pressure first, then medium, and then firm pressure. Feel for any lumps or thickening in the breast. Step 2 Follow this process in an up-and-down path over the breast. Be sure to check all of the breast tissue. Repeat the previous steps with the left breast with right hand. Step 3 Stand in front of a mirror with your hands pressed firmly on your hips. Inspect your breasts for any changes in size, shape, or appearance. Look for dimpling, rash, puckering, or scaliness of the skin or nipple, or discharge. Step 4 Next, raise your arms over your head (palms pressed together), and look for changes. Step 5 Examine your underarms with your arms only slightly raised so you can feel these areas easier. Assessment: Breast and Axillae:  Inspection for size and symmetry  Inspection for color, venous patterns moles, etc.  Inspection of areola and nipples  Observation of shape, characteristics, and suspensory ligaments  Palpation of skin turgor and breast tissue  Palpation of the nipple and areolae, including compression  Inspection and palpation of axillae Breast cancer signs and symptoms:  Dimpling of skin  Deviation of nipple  Nipple retraction This study source was downloaded by from CourseH on :41:27 GMT -05:00  Change in breast shape  Edema  Discharge Fibrocystic breast disease: Caused due to the variation in levels of hormones, especially estrogen, during the menstrual cycle. Characterized by changes in breast texture, increased tenderness, lumpiness, and pain or discomfort. Treatment is not usually necessary. It may involve use of over-the-counter drugs such as acetaminophen to manage pain, and fine-needle aspiration for diagnostic and therapeutic benefits Breastfeeding complications and treatments: Engorgement If you baby does not adequately remove the milk from your breasts, it may lead to breast engorgement. This can cause your breasts to feel hard, painful, hot, and appear taut or shiny. Engorgement can make nursing difficult for your baby, and painful for you. Treatment  Apply a hot, moist towel or take a hot shower before nursing your baby. Hand express some milk to allow for easier latching.  Apply cold compresses or cold cabbage leaves prior to nursing if breasts are severely swollen or engorged. Ice as necessary to relieve discomfort and reduce swelling.  Massage breast before and during breastfeeding and pumping.  Relax. Try taking deep breaths, listening to music and other techniques to ease discomfort.  Use a breast pump as necessary to express milk if your baby is having problems latching or if you only nurse on one side per feeding. Plugged Duct Plugged ducts are tender spots or lumps in the breast that occur when milk is unable to flow freely. While a plugged duct may be uncomfortable and painful to the touch, you will generally feel fine otherwise. Symptoms tend to come on gradually and do not include fever. Treatment  Rest  Moist heat to affected area before feedings  Massage lump before and after feeding from behind the lump toward the nipple This study source was downloaded by from CourseH on :41:27 GMT -05:00  Nurse (or pump) often. Remember your baby is more efficient at emptying the breast than a pump. Mastitis One of the more serious complications of breast feeding includes a breast infection, otherwise known as mastitis. Mastitis can be caused by an improperly or untreated plugged duct or cracked nipple, as well as from anemia, stress or fatigue. Unlike with a clogged duct, symptoms of a breast infection may come on a suddenly and be more bothersome, including: Fatigue and flu-like muscle aches, fever above 101, headache, intense, localized pain, red, hot and swollen breast Treatment  Talk with your physician and determine if antibiotics are necessary.  Rest.  Breastfeed frequently and try to keep breasts as empty as possible. Your baby will not get ill from the milk.  Try not to skip or delay feedings. Pump frequently if unable to nurse.  Apply moist compress or soak breast in warm water before feedings. Massage the affected area using a gentle but firm circular motion after warm soaks.  Wear a support bra that does not cause painful pressure.  Take Tylenol for fever or discomfort. Determining the cause of the infection will help to prevent a recurrence, as will proper breast care. Milk production (Lobes and milk line): Milk line: an embryological ridge running from armpits to groin Lobes: how many lobes is the breast divided into? 15-20 What is a lobe of the breast composed of? Several lobules containing many alveoli What component of the breast is concerned with milk production? Epithelial component What does oxytocin do? Causes contraction of myoepithelial cells around the mammary alveoli creating milk