Nur 1600 Final Exam Study Guide With Complete Solutions.

NUR 1600 FINAL EXAM STUDY GUIDE WITH COMPLETE SOLUTIONS. Breast, Cervical, Testicular, Prostate CA: 7 questions Breast Cancer ● Risk Factors o Gender- more female (99%) but male can get it o Age- older (66% 55 or older) o Race- White women o BRCA 1 or 2 gene- 5-10% in women, 5-20% in men o Family history- first degree family relative (higher if mom or sister) o Personal medical history ▪ Previous breast cancer ▪ Previous radiation treatments ▪ Long menstrual histories (cycle before age 12 or lasts longer than age 55) ▪ Certain syndromes/ illnesses o Breast density o No physical activity/ smoking/ alcohol use/ obesity (modifiable) o Estrogen replacement therapy o Gail model 20% increases risk ● Health People 2020 Goals o Reduce the female breast cancer death rate o Reduce late-stage female breast cancer o Increase proportion of women who receive a breast cancer screening based on the most recent guidelines o Increase the proportion of women who were counseled by their providers about mammograms** ● Screening o Asks what is missing in documentation after lump on breast in found ▪ answer: size (I think).....in the question it says nurse documented “small” but gives no exact measurement o Mammogram- useful in finding breast cancer at an early stage ▪ Less likely to have aggressive experience/ surgery if you have had a mammogram ▪ Can miss some breast cancers ▪ Some times will detect cancers that if they were left alone, may have never developed into anything ▪ 50-74: every 2 years o Breast Self Exams (BSE)- no longer recommended ▪ Need to have sense of awareness of breast to know if there are any changes o Procedure for feeling for lumps in breast: look it up I wasn’t sure - either “use 3 fingers” “use palm of one hand” “use one finger on each breast” “pinch nipple” ● Using finger pads of first 2 or 3 fingers, gently/firmly and symmetrically palpate all quadrants of breast ● Signs and Symptoms ● Question: woman shows up to clinic after finding lump on her breast, what do you do….answer: make prompt appt with pcp (not sure if this is right) o Asymmetry of breasts or rapid change in breast size o Swelling of all or part of the breast even if no lump is felt o Irregular shape/color in areolae, or nipple o Nipple retraction or nipple turning inward o Nipple discharge o Scaliness, or thickening of the nipple or breast skin o Dimpling of the skin o Erythema or redness of the breast o Enlarged axillary lymph nodes o New lumps or masses o Hard fixed lumps o Lump is usually painless ● Levels of Prevention o Primary ▪ Physical activity ▪ Decrease obesity ▪ Decrease alcohol intake ▪ Breast self-awareness o Secondary ▪ Early detection ▪ Screening per guidelines ▪ Mammograms ▪ Early diagnosis and treatment ● Clinical Breast Examination o Inspect for symmetry: breasts should hang equally w/ smooth contour o Palpate breast tissue: ▪ Normal Findings→ firm, smooth, elastic, no lumps/nodules, no pain upon touch ● Breast tissue softer/looser after: pregnancy, menopause ● Breasts engorged when on premenstrual/menstrual period (abnormal if not on period) ● Inframammary ridge = ridge along lower edge of breast (not a mass) ▪ Using finger pads of first 2 or 3 fingers, gently/firmly and symmetrically palpate all quadrants of breast ▪ Systematic approach ensures all of breast was palpated ▪ Vertical Strip Approach (best method) ● Press firmly to feel underlying tissue ● Gently slide fingers over breast tissue, moving along the designated pattern of palpation ● If large boobs, ask patient to lean forward and put hands between boobs ● If mass found, palpate mass on its own.