Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3512 - Class 7-12 > Week 11 - Breast Cancer > Flashcards

Week 11 - Breast Cancer Flashcards

1
Q

what things occur w cancer cells (5)

A
  • poor differentiated
  • uncontrolled & unregulated growth of cells
  • cells are abnormal
  • invade and infiltrate other tissues (metastasis)
  • can recur (after remission)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the diagnosis of cancer is focused on (7)

A
  • health history (carcinogens)
  • family history
  • physical exam
  • CXR
  • CT
  • blood work
  • biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the most definitive diagnostic test for breast cancer

A
  • biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment options for cancer are based on..

A

-biopsy results –> cancer staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the goal of cancer treatment (3)

A
  • cure
  • control
  • palliation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is cancer cured & controlled (3)

A
  • surgery to remove or debulk tumour
  • chemo
  • radiation

can be a combo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the goal of supportive & palliative care for cancer

A
  • goal is to relieve or control symptoms

- optimize QOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some examples of supportive & palliative care for pts w cancer (3)

A
  • colostomy to prevent bowel obstruction
  • laminectomy to relieve spinal cord compression
  • debulking of tumor, radiation, chemo to relieve pain or pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some risk factors for breast cancer (8)

A
  • age 50 or older
  • personal history
  • family history
  • alcohol intake
  • sedentary lifestyle
  • weight gain during adulthood
  • dietary fat intake
  • exposure to ionizing radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are symptoms of breast cancer (5)

A
  • hard, irregular shaped lump that is nonmobile & nontender
  • clear or bloody nipple discharge
  • nipple retraction
  • dimpling/pulling in of skin
  • possible rash or skin changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the main complication of breast cancer

A
  • recurrence that can be local/regional near the masectomy site or distant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is included in diagnostic studies for breast cancer (5)

A
  • mammography
  • MRI
  • physical exam
  • US
  • biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the treatment for breast cancer

A
  • directed by stage and type
  • surgery = primary
  • combined w drug therapy, chemo, and radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are different types of surgeries for treatment of breast cancer (5)

A
  • lumpectomy
  • radical mastectomy
  • axillary node dissection (ALND)
  • modified radical mastectomy
  • sentinal lymph node dissection (SLND)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a lumpectomy

A
  • breast conserving surgery
  • removal of the entire tumour along w a marigin of normal surrounding tissue
  • may also remove some lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is required post-lumpectomy

A
  • radiation to the entire breast + a boost to the tumour bed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are contraindications to a lumpectomy (4)

A
  • breast too small in relation to tumour size
  • masses in more than one quadrant
  • masses in the same breast quadrant
  • central location of the tumour near the nipple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the goal of a lumpectomy

A
  • maximize cancer treatment and cosmetic outcome w minimal risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the benefit to a lumpectomy

A
  • the breast and nipple and preserved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what may make a mastectomy a better option over a lumpectomy (2)

A
  • contraindications to radiation therapy –> ex. active lupus, prior radiation therapy in the radiation field
  • contraindications to lumpectomy (as previously discussed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are disadvantages to a lumpectomy (2)

A
  • increased cost of surgery + radiation over surgery alone

- possible s/e of irradation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a modified radical mastectomy

A
  • removal of the breast and axillary nodes

- spares the pectoralis major muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when is a modified radical mastectomy preferred over lumpectomy

A
  • if tumour is too large to excise w adequate margina

- if tumour is so large it will produce a poor cosmetic result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a radical mastectomy

A
  • removal of the entire breat, entire chest wall, and all nodes (not often done)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is a radical mastectomy

A
  • removal of the entire breat, entire chest wall, and all nodes (not often done)
26
Q

when a mastectomy is preferred, patients have the option of _____? when can this be performed

A

breast reconstruction

  • can be performed simultaneously w surgery (more common d/t only one surgery, anasthesia needed once, one postop period)
  • or delayed until postop recovery is done
27
Q

what is the main indication for reconstructive breast therapy (3)

A
  • self-image
  • regain sense of normality
  • assist in coping w loss of a breast
28
Q

what impact does breast reconstruction have on the nipple

A
  • cannot restore lactation, nipple sensation, or nipple erectility
  • can have nipple reconstructed or tattooed
29
Q

what are different types of breast reconstruction (3)

A
  • breast implants & tissue expansion
  • DIEP flap
  • nipple areolar reconstruction
30
Q

describe the procedure of breast implants

A
  • involves the placement of breast implants (sacs filled w saline or silicone gel) into a pocket under the pectoralis muscle
31
Q

why might tissue expanders bc required w breast implants

A
  • many pts who have undergone mastectomy have insufficient tissue = implant may cause tight or firm reconstruction
  • tissue expander is used to stretch the skin & muscle at the masectomy site before insertion of implants
32
Q

describe the procedure of tissue expansion for breast implants

A
  • the tissue expander is gradually filled by weekly injections of sterile water or saline = stretch the skin & muscle
  • once the tissue is adequately stretched, the expander is surgically removed and a permanent implant is inserted
  • some expanders stay in place and become the implant
33
Q

what is a DIEP flap

A
  • use of autologous tissue to re-create a breast mound
  • involves fat, skin, and blood vessels cut from the wall of the lower abdomen and moved up to reconstruct the breast
  • no muscle is cut or removed
  • then, blood vessels of the flap are carefully reattached to blood vessels in the chest wall
34
Q

what is nipple-aerolar reconstruction

A
  • procedure that gives the reconstructed breast a more natural appearance by reconstructing a nipple from the opposite breast or a small flap of tissue from the reconstructed breast
  • may be tattooed on
35
Q

what is an auxillary node dissection

A
  • procedure done before the yr 2000

- involves the removal or 12-20 nodes on the same side as the breast cancer

36
Q

what is sentinal lymph node dissection

A
  • removal of nodes that drain from the tumour and sent to pathology (1-4)
  • if 1 or more sentenil cells contain malignant cells, ALND is generally recommend
37
Q

what is the benefit of SNLD

A
  • lower rates of lymphede,a
38
Q

what is lymphedema

A
  • accumulation of lymphatic fluid in soft tissue d/t the excision or irradication of lymph nodes
39
Q

what does lymphedema lead to

A
  • axillary lymph cannot return fluid to central circulation bc of removal of nodes or damage from radiation
  • fluid accumulates in the arm = obstructive pressure on the veins and venous return
40
Q

what are signs of lymphedema (4)

A
  • heaviness
  • pain
  • impaired motor function in the arm
  • numbness and paraesthesis in the fingers
41
Q

what nursing interventions can help prevent lymphedema (4)

A
  • affected arm should not be dependent (even during sleep) –> elevate arm
  • no BP, venipuncture, and injections on affected arm
  • no elastic bandages in early postop (inhibit collateral lymph drainage)
  • protect the arm from trauma or sunburn
42
Q

when lymphedema is acute, what treatment is involved (5)

A
  • massage therapy
  • compression bandage and pneumatic compression sleeve
  • elevation
  • isometric exercises
  • diuretics
43
Q

describe follow up r/t surgeries for breast cancer (3)

A
  • pt must be monitored for rest of their life at regular intervals
  • usually professional exams after 6 months for 2 years, then annually
  • recommended that pt performs regular self examination
44
Q

what is postmasectomy pain syndrome

A
  • pain that occurs after a mastectomy or axillar node dissection that persists beyond the normal 3 month healing time
45
Q

what are signs of post-masectomy pain syndrome (5)

A
  • chest and upper arm pain
  • tingling sensations down the arm
  • numbness
  • shooting, prickling pain
  • unbearable itching
46
Q

what adjuvant therapies are used for breast cancer (3)

A
  • local radiation
  • chemo
  • oral meds
47
Q

when might radiation be used (3)

A
  • primary treatment to prevent local breast recurrences after breast-conserving therapy
  • adjuvant therapy after masectomy to prevent local & nodal recurrences
  • palliative treatment for pain
48
Q

brachytherapy

A
  • internal radiation used for early stage breast cancer
49
Q

what is the goal of systemic therapy (chemo, hormone therapy)

A
  • destroy tumour cells that may have spread to distant sites
50
Q

what oral meds might be used as adjuvant therapy for breast cancer (3)

A
  • hormonal therapy
  • estrogen receptor blockers
  • biological & targeted therapy
51
Q

what is included in nursing care from the time between diagnosis of breast cancer and selection of a treatment plan (5)

A
  • help the pt accurately explore the advantages and disadvantages of options
  • provide info relevant to the decision
  • support the pt
  • review postop care & exercises
  • explain the recovery period
52
Q

what are the main priorities for nursing care after a mastectomy (4)

A
  • care for incisions
  • control pain
  • restore arm mobility
  • adjuvant therapy
53
Q

what is included in care for incisions after a masectomy (4)

A
  • monitor & prevent infection
  • monitor for any bleeding
  • will have drains in place for at least 5 days
  • teach pt how to care for drains at home
54
Q

why are drains in place post-masectomy

A

-drains are placed under the incision to drain any accumulating fluids (blood, lymph) while theyre healing

55
Q

when are drains removed post-mastectomy

A
  • after a couple weeks –> when less than 30 ccs in 24 hr period for 2 consecutive days
56
Q

describe the drainage post-op (4)

A
  • red at first
  • then pink
  • then apple juice color
  • the nothing/minimal
57
Q

why is it important to restore arm mobility post-mastectomy (3)

A
  • prevent contractures & muscle shortening
  • improve lymph & blood circulation = prevent lymphedema
  • gradual increase of function over 4-6 weeks
58
Q

what nursing interventions are involved in restoring arm mobility post-mastectomy (7)

A
  • place in semi-fowlers with the arm on the affected side elevated on a pillow
  • flex and extend the fingers
  • postop arm & shoulder exercise gradually w surgeons direction
  • analgesics 30 min before exercise
  • interventions to prevent lymphedema (mentioned earlier)
  • warm water to relax muscles and reduce pain
  • teach pt when to seek medical attention (increased pain, infection)
59
Q

what is included in psychosocial care for pts breast cancer (7)

A
  • sensitivity to the pts efforts to cope
  • safe enviro to discuss feelings
  • help identify sources of support & strength
  • encourage her to identify and learn coping strengths
  • promote communication between the pt & their friends and fam
  • provide accurate and complete answers to questions
  • offer info about community resources
60
Q

a nursing diagnosis post mastectomy or lympectomy is impaired physical mobility. what nursing interventions are done for this (4)

A
  • initiate pain control measures before exercise
  • instruct pt on passive, assisted, or active ROM exercises
  • incorporate ADLs into exercise protocol
  • use motor activites that require attention to & use of both sides of body
61
Q

a nursing diagnosis post-mastectomy & lumpectomy is acute pain. what nursing interventions are done for this (7)

A
  • assess pain
  • explore pt factors that worsen or relieve pain
  • teach use of nonpharm techniques for pain
  • provide optimal pain relief
  • use pain control measures before pain becomes severe
  • elevate affected limb 20 degrees or higher
  • support arm & limit activity to prevent tension of suture line
62
Q

a potential complication post-mastectomy or lumpectomy is lymphedema. what nursing interventions are done for this (5)

A
  • assess for signs
  • instruct pt about self-care strategies and precautions to reduce risk
  • do not perform venipunctures, injections, BP measurements on affected arm
  • avoid dependent arm position
  • use compression bandage if ordered

NURS 3512 - Class 7-12 (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions