Exam (elaborations) NURS 190 QUIZ 3 solved (NURS190)

Exam (elaborations) NURS 190 QUIZ 3 solved (NURS190) • Breast & Axillae o Breast Abnormality (1) ▪ Female • Benign breast disease (Fibrocystic breast disease) o Most common breast problems, caused by fibrosis (thickening of the normal breast tissue), May result in ductal hyperplasia & dysplasia, which may eventually develop into noninvasive intraductal, lobular, or intraepithelial carcinoma. Presence of nodular breast tissue makes the early detection of malignant nodules more challenging. Most often occurs in females 20’s. After menopause, symptoms usually resolve due to lack of estrogen. Treatment may include pharmacologic agents such as hormones, diuretics, & mild analgesics. Limiting caffeine & reducing salt intake may help relieve symptoms. Reinforce regular BSE as well as regular mammography & physical exam. o Subjective findings: ▪ Breast pain/tenderness that begins immediately before onset of menses. Resolution of pain @ the end of menses o Objective findings: ▪ Soft breast lumps that are well demarcated and freely movable to palpation; lumps are almost always bilateral ▪ Nipple discharge (clear, straw colored, milky, or green) ▪ Cysts also may be present (usually located in the upper outer quadrant) • Fibroadenoma o Benign tumor of the glandular tissue of the breast, most common in adolescent girls & women 30 y.o. Development in girls linked to breast hypertrophy (may occur during growth spurt in puberty). Treatment consists of careful observation over time. If the findings for this abnormality is inconclusive, a biopsy or excision of the lump may be done. o Subjective findings: ▪ Asymptomatic besides the breast mass (often found during BSE or during clinical breast examination) o Objective findings: ▪ Presence of well-defined, round, firm tumors, about 1- 5cm in diameter, that can be moved freely w/in the breast tissue ▪ Usually involves single tumor near the nipple or in the upper outer quadrant of the breast • Intraductal Papilloma o Tiny growths of epithelial cells that project into the lumen of the lactiferous ducts. Primary cause of nipple discharge in females who aren’t pregnant or lactating & are more commonly found in menopausal females but may occur at any age. Treatment usually involves surgical removal (excision) & biopsy of the affected ducts o Subjective findings: ▪ Breast enlargement/pain o Objective findings: ▪ 1 or more lumps in the breast & nipple discharge • Mammary duct ectasia o Inflammation of the lactiferous ducts behind the nipple. They can become enlarged and can form a palpable mass if cellular debris and fluid collect inside of it. A careful assessment is required to distinguish the condition from breast cancer. Disorder is painful, but not associated with cancer & usually resolves spontaneously o Subjective findings: ▪ Thick, sticky nipple discharge & nipple retraction o Objective findings: ▪ Often asymptomatic, but breast tenderness or inflammation of the clogged duct may be present • Carcinoma (Cancer) o Subjective findings: ▪ Perceived change in breast size/shape (irregular shape of 1 breast as compared to the other, such as a flattening of 1 quadrant) ▪ Breast/nipple pain or tenderness & nipple itching o Objective findings: ▪ Breast lump or thickening of local area of breast tissue ▪ Dimpling of the skin over the tumor caused by a retraction or pulling inward of breast tissue, this results primarily from tissue fibrosis. Retraction is also caused by fat necrosis & mammary duct ectasia ▪ Deviation of the breast or nipple from its normal alignment, also caused by retraction. The nipple typically deviated toward the underlying cancer ▪ Nipple retraction. It flattens or even turns inward. Retraction is also caused by tissue fibrosis ▪ Edema, which may result in a peau d’orange appearance, especially near the nipple. Edema is caused by blockage of the lymphatic ducts that normally drain the breast ▪ Discharge, which may be bloody or clear ▪ Male • Gynecomastia o Enlargement of breast tissue @ birth due to maternal hormone secretion. It can also occur at puberty, affecting one or both