exam 3 important from lectures Flashcards
the four groups of axillary nodes
central axillary nodes
pectoral
subscapular
lateral
central axillary nodes
high up in the middle of the axilla, over the ribs and serratus anterior muscle, receives lymph from the other three groups of nodes
pectoral
along the lateral edge of the the pectoralis major muscle, just inside the anterior axillary fold
subscapular
along the lateral edge of the scapula, deep in the posterior axillary fold
lateral
along the humerus, inside the upper arm
developmental competence in adolescents
- at puberty, the estrogen hormones present stimulate breast changes
tanner staging and sexual maturity occurs when
around 8-10 yrs. of age
what is gynecomastia
when breast tissue enlarges
what percent of breast cancers occur in men
less than 1% of breast cancers occur in men
gynecomastia may appear?
- may reappear due to a testosterone deficiency
- should follow up with primary care provider if concerned about asymmetry (for aging adults)
- for adolescents reassure the patient that everyone develops at different times
if you have a first-degree relative (parent) that was diagnosed with breast cancer what should you know
that the patient is at an increased risk of having breast cancer
supernumerary nipple
an extra nipple on the embryonic “milk line” on the thorax or abdomen
collecting objective data
1) when inspecting: have the patient stand straight up with their hands to their sides to view symmetry
2) inspect and palpate the axilla
3) palpate the breasts
4) if examining someone with a healed mastectomy palpate the intact breast first then the abnormal one
if a women comes in and mentions a right breast lump that she has discovered herself which breast do you exam first?
the left one so that you know what normal breast feels like for her, and to be able to compare it with the abnormal one
edema (Peau D’Orange)
when the skin thickens and exaggerates the hair follicles
- Peau d’orange, French for “orange skin,” is a term used to describe a skin condition characterized by dimpling and pitting that resembles the surface of an orange peel
mammary duct ectasia
a paste-like matter in the subcolar ducts that produces sticky, purulent discharge that may be yellow-green or bloody
with benign (fibrocystic) breast cancer and fibroadenoma what should you make sure to look for?
is it moveable?
is there just one lump?
what populations are at the highest risks for dehydration
older adults
infants and children
individuals with chronic illnesses
individuals who work out in the elements
normal electrolyte level for potassium
Potassium (K+) 3.5 - 5 mEq/L
normal electrolyte number for sodium
Sodium (Na+) 136 - 145 mEq/L
normal electrolyte value for calcium
Calcium (Ca2+) 9 - 10.5 mg/dL
normal electrolyte value for magnesium
Magnesium (Mg2+) 1.3 - 2.1 mg/dL
potassium
Helps with nerve and muscle cell function
plays an important role in the muscle cells in the heart.
low potassium
Low potassium levels are called hypokalemia.
* Symptoms include:
* Muscle Weakness
* Hypotension
* Dysrhythmia
high potassium
High potassium levels are known as hyperkalemia.
Symptoms include:
Decreased deep tendon reflexes
Paralysis
Dysrhythmia
sodium
Supports the function of nerves and muscles
Maintains normal blood pressure
regulates the body’s fluid balance.
Low sodium levels are called hyponatremia.
High sodium levels are called hypernatremia.
possible assessment findings of hypervolemia (Exam)
Tachycardia
Crackles in the lungs
Cough
Pallor
Peripheral Edema
intravenous rehydration
Small particles that can easily pass from the bloodstream into cells and tissues are known as crystalloid solutions.
Each crystalloid solution is categorized by its tonicity, or ability to make water move in or out of cells via osmosis.
Hypotonic solutions move water from extracellular space into cells.
Hypertonic solutions cause water to leave the cells.
There is no movement between extracellular and intracellular fluids in isotonic solutions.
Appropriate fluids should be chosen based on the patient’s condition
common causes of metabolic acidosis
Kidney disease
Lactic acidosis
Diabetic keto acidosis – ketones that are acidic build up when diabetes is uncontrolled
Severe dehydration
Severe diarrhea due to loss of too
much sodium bicarbonate
common causes of metabolic alkalosis
Diuretic overuse
Excess vomiting
Antacids
Loss of potassium or sodium from the body quickly
Ingestion of bicarbonate
Alcohol abuse
Laxatives
Heart, kidney, or liver failure
what is respiratory alkalosis
Respiratory alkalosis occurs when the carbon dioxide levels in the body drop too low and may result from breathing too fast or too deep.
Hyperventilation, or over-breathing, is a common cause of respiratory alkalosis
Due to the action of deep or rapid breathing ridding the body of too much carbon dioxide.
hypotonic solution with IV therapy
Hypotonic – water moves into cells
- 0.45% Sodium Chloride
- Treats hypernatremia
isotonic with IV therapy
Isotonic – water doesn’t move in or out
- 0.9% Sodium Chloride
- Treats dehydration
hypertonic with IV therapy
Hypertonic – water moves out of cells
- 3% Sodium Chloride
- Treats symptomatic hyponatremia
normal ranges:
pH
PaCO2
HCO3
pH = 7.35-7.45
PaCO2 = 35-45 mmHg
HCO3 = 22-26 mEq/L
