Deck 69: Care of Patients With Breast Disorders

Question 1

A 46-year-old Caucasian lesbian woman is diagnosed with breast cancer and scheduled for a radical right mastectomy and chemotherapy. She tells you that she often feared developing cancer because her mother and aunt were both diagnosed with breast cancer in their 40s. She says she is fearful because her employer does not offer insurance and she is not eligible to be covered under her partner's insurance plan. She also shares that she feels sad because she has been attempting to get pregnant for the first time and she now realizes that this will not be possible for the foreseeable future.
What evidence-based risk factors does this patient have?

Answer 1

Women from the Euro-American origin of age above 40-years; family history of breast cancer; and the delayed pregnancy are the higher risk factors for the breast cancer.
From the given case, the evidence based risk factors are listed below.
• Aged 46-years.
• Caucasian.
• Lesbian.
• Mother and Aunt have the breast cancer in their 40's.
• She attempts to get pregnant.

Question 2

The nurse is caring for four clients. Which client does the nurse recognize as having the highest risk for development of breast cancer?

A) 45-year-old male with gynecomastia
B) 40-year-old female whose father had colon cancer
C) 50-year-old male whose mother had ovarian cancer
D) 65-year-old female with history of a prior episode of breast cancer

Answer 2

Generally, male breast cancer is rare , and occurs less than 1% of all the breast cancers cases. In addition, the average onset of breast cancer in men is 68 years. The given option (A) representing a 45 year old men with Gynecomastia ; Gynecomastia is caused due to the hormonal imbalances in men; and it is not considered as a biggest risk for developing as breast cancer.
So, the option (A) is not the correct answer.
On considering the genetic factors of breast cancer; the presence of breast cancer in the family history will gives the increased risk for the development of breast cancer in the generations (woman); but not with the family history of colon cancer. So, the colon cancer of father doesn't give the increased risk for developing the breast cancer in daughter.
Hence, the option (B) is not the correct answer.
Generally, breast cancer is rare in men. On speaking about genetics, if the mother had a breast cancer means, there is a chance for the development of breast cancer in son. And, the son doesn't have any increased risk for the development of breast cancer, whose mother had the ovarian cancer.
So, the option (C) is also not the correct answer.
A female of age above 60 years, and had the previous breast cancer episodes, gives the increased risk for the development of breast cancer again. The surgery helps to remove the cancer tissue mass; but, there are more chances for some tiny cancerous cells left over; and they will produce the cancer again in the treated location. The patient aged above 60-years possess the reduced immunity, so the regular immune system regulation doesn't gives any effects on the new cancer cell developments. Hence, the patients aged above 60-years, and having the previous episodes of cancer, gives the increased risk for new cancer development.
Hence, the correct answer is option (D)

Question 3

A 46-year-old Caucasian lesbian woman is diagnosed with breast cancer and scheduled for a radical right mastectomy and chemotherapy. She tells you that she often feared developing cancer because her mother and aunt were both diagnosed with breast cancer in their 40s. She says she is fearful because her employer does not offer insurance and she is not eligible to be covered under her partner's insurance plan. She also shares that she feels sad because she has been attempting to get pregnant for the first time and she now realizes that this will not be possible for the foreseeable future.
What discharge instructions will you provide for her and why?

Answer 3

The instruction to the patient during the discharge after the Mastectomy is listed below with the explanation.
.

Question 4

The nurse is assigned to care for a client who has undergone a modified radical left mastectomy for breast cancer. When delegating care, which statement by the nursing assistant would require further teaching by the nurse?

A) "I will report urine intake and output to you."
B) "If the client appears to be in pain, I will tell you right away."
C) "It is important for me to take blood pressure on the client's left arm."
D) "When ambulating, I will assist the client to stand straight with arms hanging at the side."

Question 5

A 46-year-old Caucasian lesbian woman is diagnosed with breast cancer and scheduled for a radical right mastectomy and chemotherapy. She tells you that she often feared developing cancer because her mother and aunt were both diagnosed with breast cancer in their 40s. She says she is fearful because her employer does not offer insurance and she is not eligible to be covered under her partner's insurance plan. She also shares that she feels sad because she has been attempting to get pregnant for the first time and she now realizes that this will not be possible for the foreseeable future.
What will you teach the patient about chemotherapy to maintain her safety?

Question 6

A 46-year-old Caucasian lesbian woman is diagnosed with breast cancer and scheduled for a radical right mastectomy and chemotherapy. She tells you that she often feared developing cancer because her mother and aunt were both diagnosed with breast cancer in their 40s. She says she is fearful because her employer does not offer insurance and she is not eligible to be covered under her partner's insurance plan. She also shares that she feels sad because she has been attempting to get pregnant for the first time and she now realizes that this will not be possible for the foreseeable future.
How might you help address the patient's emotional concerns?