Exam 3 Flashcards
Breast Exam Inspection Positions
- Arms extended over head or behind neck
- Hands on hips w/ shoulder rolled forward
- seated and leaning over
- recumbent position
Breast Inspection (What to look for)
Compare both sides:
- size
- symmetry
- contour
- retractions or dimpling
- skin color and texture
- venous patterns
- lesions
- supernumerary nipples
Nipple Inspection (What to look for)
Compare both sides:
- shape
- symmetry
- color
- smoothness
- size
- inversion, eversion, retraction
Chest Wall Sweep
with the palm, sweep from the clavicle to the nipple, covering area from the sternum to midaxillary
Bimanual digital palpation
walk fingers across the breast tissue, compressing it between your fingers and the palmar surface of your hand that is cupping below the breast
Palpate Breasts
- palpate while seated: lymph nodes in axilla, epitrochlear, clavicular
- palpate breast tissue while supine: light, medium, and deep pressure
- Depress the nipple into the well
Fibrocystic Changes
-fluid filled cyst caused by ductal enlargement
usually bilateral multiple or single Round soft to firm, tents Mobile absent retraction signs usually tender borders are well delineating varies with menses
Fibroadenoma
-Benign tumors composed of stomal and epithelial elements in a single terminal ductal unit
15-55 usually bilateral usually single but maybe multiple Round or discoid firm, rubbery Mobile absent signs of attraction usually non-tender borders are well delineating no variation with menses
Breast Cancer
-ductal carcinoma arises from duct lining; lobular carcinoma originates in gland tissue of lobules
30-80 usually unilateral single Mass irregular or stellate shape consistency is hard or Stone Lake Mobility is fixed retraction is often present usually non-tender poorly delineated no variation with menses
Normal Breast Exam Findings
Inspection: Bilaterally symmetric with an even contour and absence of dimpling, retraction, or deviation.
Palpation: (women) dense, firm and elastic; may have normal variations
Three Routine Questions
- Have you been sexually active in the past year?
- Do you have vaginal, oral, or anal sex with men, women, or both?
- How many people have you had sex with in the past year? Men and Women
5 P’s of Sexual Health
- Partners (type and #)
- Practices (oral, vag, anal)
- Past Hx of STIs
- Protection from STIs
- Pregnancy Status
cultural competence
sensitivity to heritage, sexual orientation, SE, ethnicity, and cultural background
health literacy
degree to which individuals have the capacity to obtain, process, and understand basic health info and services needed to make appropriate health decisions; Dependent on individual and systemic factors: communication skills of lay persons and professionals
High Context Cultures
There is less need for formal, direct, and written communication, as communication is more about process and relationship than problem solving. In high context cultures the group has a strong external boundary, so outsiders must work harder to earn trust.
- relationships build slowly
- space is communal
- change is slow
Low Context Cultures
members have many superficial connections in which the goal of communication is specific and task oriented so as to clarify rules and procedures and solve problems
- relationships are quick
- nonverbal elements are not significant
- privacy is important
- events are schedule for specific times
Components of Health Literacy
Reading writing listening speaking numeracy critical analysis communication interaction skills
Six Skin Inspection Characteristics
- color
- uniformity
- thickness
- symmetry
- hygiene
- Presence of any lesions, which are any pathologic skin change or occurrence.
