Quiz 1: Patient Education and Assessment Flashcards
what is the biggest risk factor for breast cancer
gender
consent assumed by nonverbal cues, such as nodding or lifting the arm when told that an injection is required
expressed consent
consent assumed in an emergency situation where the patient is unable to make a decision generally, additional documentation is required.
implied consent
defines information collected from the patient and can be seen, heard, or felt (ex. lump in the breast)
objective data
are factors perceived by the affected individual only (ex. pain in the breast)
subjective data
use non-directed or non-leading methods to avoid leading the patient to give only certain responses and to allow an unbiased input
open-ended questions
uses gestures such as a nod or saying “yes” “okay” or “go on” to encourage elaboration
facilitiation
used to get more details about the problem
probing questions
will reword the question to clarify information and can be used to verify that the patient has not changed his or her mind
repitition
is used to verify the accuracy of the information
summarization
are Breast Self Examinations recommended to be performed routinely?
no
when is the best time to perform BSE?
a few days after the end of the menstral period or 5-10 days after the start of the period
when does the ACS start recommending CBE and how often.
ages 20-39 every 3 years and every year for age 40 and up
which position(s) should the CBE be performed?
upright and supine
what are the 2 main criteria in any breast examination
looking for changes & feeling for changes
Screening Guidelines for US Preventative Services Task Force (USPSTF)
*BSE and CBE not recommended
Ages 40-49: screening only based on risk factors. The USPSTF recommends against routinely providing this service.
Ages 50-74: screening begins, mammogram every 2 years
Ages 75 & Up: no screening recommendations
Screening Guidelines for American College of Obstetetricians and Gynecologists
Ages 40-49: screening every 1 o 2 years
Age 50+: screening every year
Screening Guidelines for American Cancer Society ACS
Ages 40-44: annual screening/CBE if they wish
Ages 45-54: screening if they wish and CBE every year
Ages 55+: screening every 1-2 years; BSE and CBE not recommended
Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer
breast examinations not recommended for average risk women at any age
what is breast cancer
a disease caused by abnormal and uncontrolled growth of cells.
what is the key to breast cancer treatment
discovering and removing the cancer at an early stage
what is the sensitivity of mammography dependent on?
tissue composition, patient age, and hormone status of patient
what is the error rate for mammography screenings?
10% - 15%
what happens to womens breast composition as they age?
the glanularity of breast composition decreases and the sensitivity of mammography increases
what is the dose of choice when calculating radiation doses associated with mammography
glandular dose
how is the glandular dose in screening mammography and why?
the glandular dose is very low because the dose falls off rapidly as the low photon energy beam penetrates the breast
what glandular dose of a singular projection does the ACR recommend with and without a grid?
With Grid - 3 mGy (0.3 rad or 300 mrad)
Without Grid - 1 mGy (0.1 rad or 100 mrad)
what are the major risk factors for breast cancer?
age, gender, genetic risk factors, family history of breast cancer, personal history of breast cancer, radiation therapy
what was DES used for
it was used by pregnant women in the US during 1940-1971 to prevent miscarriage. studies showed that women who took DES while pregnant had a slightly increased risk of breast cancer
how does menstration affect breast cancer risk factors?
early menstruation (before age 12) or late menopause (after age 55). increased menstrual cycles means increased risk of breast cancer
which race has highest incidence rate for breast cancer?
white women
which race is the most likely to die from breast cancer?
African Americans
how does breast feeding affect likeliness of getting breast cancer?
breastfeeding has a protective affect on breast cancer
what is DCIU
ductal carcinoma in situ
is early breast cancer symptomatic?
no
early DCIU shows up normally as what initially?
microcalcifications
another word for skin thickening
lymphedema
non malignant skin thickening
sarcoidosis (an inflammatory disease)
what color of nipple discharge could suggest malignancy?
red or red-brown
what can the remnant of deodorant show up as on mammogram images?
microcalcifications
during BSE, what is the most effective pattern for covering the entire breast without missing any breast tissue?
vertical pattern or up-and-down pattern
what is the second most common cancer among women in the United States?
Skin Cancers
what is the second most common cause of cancer-related deaths in women?
what is the first?
breast; lung
what is thought to be the reason for the decrease in the incidence of breast cancer?
it’s related to the reduced use of hormone replacement therapy
what is the 5 year survival rate for a patient with stage 0 breast cancer
100%
what are 4 major factors affecting the average glandular dose?
type of mammography unit, the x-ray beam energy(kVp), breast compression, breast composition
greater compression of breast tissue will result in ________ dose
decreased
are patients MORE likely or LESS likely to tolerate compression if they are allowed to play an active roll in applying the compression?
more likely
in breast imaging, the dose calculation is based on
dose absorbed by the glandular tissue of the breast
what does the term primipara mean?
carried a pregnancy to over 20 weeks but had a still birth
includes signs that can be seen, heard, or felt and other factors, such as laboratory reports
objective data
which type of consent is binding but difficult to prove
oral
having a dense breast will ______ the risk of breast cancer
increase
