NR509 / NR 509 Final Exam Study Guide
Advanced Physical Assessment
1. Suspicious breast mass
: -A mobile mass that becomes fixed when the arm relaxes is
attached to the ribs and intercostal muscles; if fixed when the hand
is pressed against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or
underlying tissues, strongly suggest cancer
2. Risk for Breast cancer
: --*Age*
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of
unopposed estrogen exposure related to early menarche
-age of first full-term pregnancy
1/
,- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
-
3. Characteristics of a breast cyst
: Soft to firm, round, mobile, often tender.
4. The best way to examine the lateral portion of the breast
: -Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then
move the fingers medially and palpate in a vertical strip up the chest to
the clavicle. Continue in vertical overlapping strips until you reach the
nipple
5. Bacterial Vaginosis (BV)
: -Caused by overgrowth of anaerobic bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal
2/
, - Fishy/musty genital odor
-Normal vulva and vaginal mucosa
-Scan saline wet mount for clue cells (epithelial cells with stippled
borders); sniff for fishy odor after applying KOH ("whiff test"); test the
vaginal secretions for pH > 4.5
6. Candidal Vaginitis
: -Cause: Candida albicans, a yeast (normal overgrowth of vaginal
flora); many factors predispose, including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as
profuse as trichomonal infection, not malodorous
3/
Advanced Physical Assessment
1. Suspicious breast mass
: -A mobile mass that becomes fixed when the arm relaxes is
attached to the ribs and intercostal muscles; if fixed when the hand
is pressed against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or
underlying tissues, strongly suggest cancer
2. Risk for Breast cancer
: --*Age*
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of
unopposed estrogen exposure related to early menarche
-age of first full-term pregnancy
1/
,- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
-
3. Characteristics of a breast cyst
: Soft to firm, round, mobile, often tender.
4. The best way to examine the lateral portion of the breast
: -Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then
move the fingers medially and palpate in a vertical strip up the chest to
the clavicle. Continue in vertical overlapping strips until you reach the
nipple
5. Bacterial Vaginosis (BV)
: -Caused by overgrowth of anaerobic bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal
2/
, - Fishy/musty genital odor
-Normal vulva and vaginal mucosa
-Scan saline wet mount for clue cells (epithelial cells with stippled
borders); sniff for fishy odor after applying KOH ("whiff test"); test the
vaginal secretions for pH > 4.5
6. Candidal Vaginitis
: -Cause: Candida albicans, a yeast (normal overgrowth of vaginal
flora); many factors predispose, including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as
profuse as trichomonal infection, not malodorous
3/
