Chapters 4, 6, 7, 8, 9 Flashcards
a natural process that occurs in all women’s lives as part of normal aging. “haulting month” point in time at which menses and fertility cease
-Explain further
Menopause
-one year without period
the transition from a woman’s reproductive phase of her life to her final menstrual period
Menopausal transition/ perimenopause
the period of life starting from the decline in ovarian activity until after the end of ovarian function
Climacteric
time when menopause approaches
-how long?
perimenopause (2 to 8 years before cessation)
Impact of menopause to the brain:
- ) hot flashes
2. ) sleep, mood, and memory problems
- ) Impact of menopause to Heart
- )” “ Bones
- )” “ breasts
- ) low HDL and increased risk for CVD
- ) bone density loss; osteoporosis risk
- )duct and gland tissue replaced by fat
- ) impact of menopause to Genitourinary:
- ) “ “ GI
- ) Skin
- ) vaginal dryness, stress incontinence, and cystitis.
- ) low Calcium absorption and increased fractures
- ) dry skin thin, and decrease in collagen
the state of diminished bone density.
Osteoporosis
Risks of osteoporosis:
- Small frame, asian, white, women
- sedentary lifestyle, low calcium and Vit D
- post menopausal
screening test that calculates the mineral content of the bone at the spine and hip
Dual-energy x-ray absorptiometry (DEXA)
Pharmacologic treatment for Osteoporosis
- ) Alendrolate
- )Risedronate
- )Denosumab
- ) Zoledronic acid
- ) Calcium and Vit D
Nursing assessment for Menopausal transition
- screenings for osteoporosis, CVD, and Cancer
- assess lifestyle (diet, weight, Calcium intake, use of drugs, smoking and alcohol, and exercise)
Fibrocystic breast changes
- ) discharge
- ) site
- ) treatment
- ) can be positive or negative
- )bilateral
- ) limit caffeine, supportive bra, ibuprofen
fibroandenomas
- ) discharge
- ) site
- ) treatment
- ) none
- ) unilateral nipple area)
- ) expectant therapy, surgical excision
Mastitis
- ) discharge
- ) site
- ) treatment
- ) none
- ) unilateral
- ) antibiotics, warm shower, express milk, supportive bra
- ) Response of breast tissue to monthly estrogen and progesterone levels (AKA)
- ) when is it most common and least common
- ) Fibrocystic breast changes (Benign breast disease)
2. ) most common in ages 20 to 50 and least common postmenopausal women.
Therapeutic techniques for Fibrocystic breast changes
- diet, healthy lifestyle, supportive bra, drugs for severe cases.
- educate about breast self examination
Nursing assessment for fibrocystic breast changes
-what methods to use and when?
- lumpy tender beasts (week before menses)
- dull aching fullness
- drainage that is usually yellow
- fibrosis (thickening early on) formation of cysts come later
- triple touch, a week after menses
- mammograph and ultrasound
difference between cysts and Cancerous lesions
- cysts tend to be mobile and tender and do not cause skin retraction
- cancerous lesions are fixed, painless, and cause skin retractions
- ) benign sold breast tumors
- ) when most common in women?
- ) treatment
- ) Fibroadenomas
- ) 15 to 25 years
- ) expectant therapy because it goes away on its own (if not, then surgically removed)
- )Signs and symptoms of Fibroadenomas
2. ) nursing management for Fibroadenomas
- ) - firm lumps, rubbery and freely mobile
2. ) reevaluate in 6 months, educate to perform monthly BSE, and annual CBE
- )is an infection or inflammation of the connective tissue in the breast that occurs primarily in lactating or engorged women.
- ) two types and main difference
- )mastitis
- )-lactational, often caused by staph. aureus.
- non lactational is often caused by duct ectasia
milk ducts become congested with secretion and debris
duct ectasia
Theraputic techniques for mastitis
- antibiotics, milk expression, warm compress,
- nursing assessment for mastitis
- risk factors
- unilateral inflammation, fever, flu-like symptoms
- poor hygiene, incomplete or infrequent breast feedings
neoplastic disease in which normal body cells are transformed into malignant ones. Most common cancer in women
Breast cancer
Breast cancer that have not extended beyond their duct, lobule (AKA)
Noninvasive (situ)
most common breast cancer
invasive ductal carcinoma
breast cancer originating from terminal lobular units of breast ducts
invasive lobular carcinoma
How are breast cancers staged
- tumor size, extent of lymph node, evidence of metastasis
Stages of breast cancer
0 - in Situ, early type
I - localized with <1 in tumor
II - Tumor 1-1 in, spread to axillary
III - 2 in or larger, spread to lymph and tissue
IV - cancer has metastasized to other parts
nonmodifiable risks to breast cancer
- gender (female)
- > 50 years old
- genes, history of cancer
- early menarche or late menopause
Modifiable risks
- not having children or not having children before 30
- use of estrogen and progestin
-failing to breastfeed for up to a year after pregnancy
alcohol, smoking, obesity, sedentary life style
diagnostic tests for breast cancer
- mamograms (50 to 74 yrs)
- fine needle aspiration and biopsy
- DNA ploidy status
Therapeutic treatments for Breast cancer:
- Surgical
- Breast conserving surgery
- Mastectomy
- Adjunct therapy
surgery to remove the suspicious mass along with tissue free of malignant cells to prevent recurrence.
-Breast conserving surgery
- ) removal of all breast tissue, the nipple, and the areola.
- ) involves removal of breast tissue, and a few positive axillary nodes.
- ) simple mastectomy
2. )modified radical mastectomy
a common surgical procedure with women undergoing it with implants for a variety of reasons ranging from aesthetic to reconstructive surgery following a mastectomy
breast augmentation
- ) therapy is supportive or additional therapy that is recommended after surgery
- ) uses high-energy rays to destroy cancer cells that might have been left behind in the breast
- ) refers to the use of drugs that are toxic to all cells and interfere with a cell’s ability to reproduce.
- ) objective is block or counter the effect of estrogen.
- ) used as an adjunct to surgery, represents an attempt to stimulate the body’s natural defenses to recognize and attack cancer cells.
- ) adjunctive therapy
- ) radiation
- ) chemotherapy
- ) Endocrine therapy
- )immunotherapy
Breast cancer breast changes to look for?
- breast changes and changes in color and texture
- lump in one breast
- nipple irritation, retraction, and discharge
- breast swelling and asymmetry
post op nursing interventions for breast cancer
- elevate affected arm and exercise full ROM (no treatments or draw labs from arm)
- wound care