NR 325 - FINAL EXAM STUDY GUIDE
BREAST CANCER SCREENING GUIDELINES (Answer)- regular screening
mammography starting at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should transition to biennial screening or have the
opportunity to continue screening annually.
continue screening mammography as long as overall health is good and life
expectancy is 10 years or longer
THE BREAST SELF-EXAMINATION (Answer)- lie down and place one arm
behind the head
use finger pads of three middle fingers of the other hand to feel for lumps
use overlapping dime-sized circular motions to feel the breast tissue
use three different levels of pressure
up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS (Answer)- inflammation of the breast
occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth
MASTITIS - CLINICAL MANIFESTATIONS (Answer)- warm to touch
indurated/painful
often unilateral
most commonly caused by staphylococcus aureus
,BEST TIME TO PERFORM SELF BREAST EXAM (BSE) (Answer)- Perform
BSE at the end of the menstrual period
breast tenderness is less likely to occur
RISK FACTORS FOR BREAST CANCER (Answer)- early menarche
late menopause
Age - at or older than 50 yrs
hormone use
Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian)
First full term pregnancy after age 30
nulliparity (never given birth)
benign breast disease (atypical epithelial hyperplasia)
weight gain/obesity after menopause
exposure to ionizing radiation
alcohol consumption
ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY (Answer)-
FNA is performed in outpatient settings
results are available within 24-48 hours
no incision required
BREAST LUMPS - ASSESSMENT (Answer)- *painless* and *fixed* lumps
suggest breast cancer/malignancy
,HORMONE THERAPY (HT) (Answer)- *HT has been linked to increased risk for
breast cancer*; patient and HCP must determine whether or not HT therapy is
appropriate
*Breast cancer incidence is increased in women using HT*, independent of other
risk factors
HT increases the risk for both non-BRCA-associated cancer and BRCA-related
cancers
CLASSIFICATION OF BREAST CANCER (Answer)- based on tissue type
based on invasiveness
based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
(Answer)- Ductal carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
Lobular carcinoma (milk-producing glands)
Other
- Inflammatory
- Paget's disease
- Phyllodes tumor
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
(Answer)- Noninvasive (In situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
Invasive (spreads)
- invasive ductal carcinoma
- invasive lobular carinoma
, CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE
RECEPTOR STATUS/GENETIC STATUS (Answer)- *Estrogen and
Progesterone Receptor Status*
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
*HER-2 Genetic Status*
- HER-2 positive
- HER-2 negative
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE (Answer)- this Rx is
for the treatment of of tumors that have the HER-2 receptor
TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT (Answer)- this Rx can
lead to ventricular dysfunction
patient is taught to self-monitor for symptoms of heart failure
TAMOXIFEN (NOLVADEX - THERAPEUTIC USE (Answer)- this Rx is for the
treatment of estogen-dependent breast tumors in premenopausal women
ESTRADIOL - CAUTION (Answer)- this Rx will increase the growth of estrogen-
dependent tumors
RALOXIFENE - THERAPEUTIC USE (Answer)- this Rx is used to prevent
breast cancer
this Rx *IS NOT USED* postmastectomy
RADICAL MASTECTOMY - POST OP NURSING CARE (Answer)- patients are
at increased risk for lymphedema and infection
therefore, *NO BLOOD PRESSURES OR VENIPUNCTURES* in the affected
arm
signage should be posted at the bedside to help remind staff
BREAST CANCER SCREENING GUIDELINES (Answer)- regular screening
mammography starting at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should transition to biennial screening or have the
opportunity to continue screening annually.
continue screening mammography as long as overall health is good and life
expectancy is 10 years or longer
THE BREAST SELF-EXAMINATION (Answer)- lie down and place one arm
behind the head
use finger pads of three middle fingers of the other hand to feel for lumps
use overlapping dime-sized circular motions to feel the breast tissue
use three different levels of pressure
up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS (Answer)- inflammation of the breast
occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth
MASTITIS - CLINICAL MANIFESTATIONS (Answer)- warm to touch
indurated/painful
often unilateral
most commonly caused by staphylococcus aureus
,BEST TIME TO PERFORM SELF BREAST EXAM (BSE) (Answer)- Perform
BSE at the end of the menstrual period
breast tenderness is less likely to occur
RISK FACTORS FOR BREAST CANCER (Answer)- early menarche
late menopause
Age - at or older than 50 yrs
hormone use
Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian)
First full term pregnancy after age 30
nulliparity (never given birth)
benign breast disease (atypical epithelial hyperplasia)
weight gain/obesity after menopause
exposure to ionizing radiation
alcohol consumption
ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY (Answer)-
FNA is performed in outpatient settings
results are available within 24-48 hours
no incision required
BREAST LUMPS - ASSESSMENT (Answer)- *painless* and *fixed* lumps
suggest breast cancer/malignancy
,HORMONE THERAPY (HT) (Answer)- *HT has been linked to increased risk for
breast cancer*; patient and HCP must determine whether or not HT therapy is
appropriate
*Breast cancer incidence is increased in women using HT*, independent of other
risk factors
HT increases the risk for both non-BRCA-associated cancer and BRCA-related
cancers
CLASSIFICATION OF BREAST CANCER (Answer)- based on tissue type
based on invasiveness
based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
(Answer)- Ductal carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
Lobular carcinoma (milk-producing glands)
Other
- Inflammatory
- Paget's disease
- Phyllodes tumor
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
(Answer)- Noninvasive (In situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
Invasive (spreads)
- invasive ductal carcinoma
- invasive lobular carinoma
, CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE
RECEPTOR STATUS/GENETIC STATUS (Answer)- *Estrogen and
Progesterone Receptor Status*
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
*HER-2 Genetic Status*
- HER-2 positive
- HER-2 negative
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE (Answer)- this Rx is
for the treatment of of tumors that have the HER-2 receptor
TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT (Answer)- this Rx can
lead to ventricular dysfunction
patient is taught to self-monitor for symptoms of heart failure
TAMOXIFEN (NOLVADEX - THERAPEUTIC USE (Answer)- this Rx is for the
treatment of estogen-dependent breast tumors in premenopausal women
ESTRADIOL - CAUTION (Answer)- this Rx will increase the growth of estrogen-
dependent tumors
RALOXIFENE - THERAPEUTIC USE (Answer)- this Rx is used to prevent
breast cancer
this Rx *IS NOT USED* postmastectomy
RADICAL MASTECTOMY - POST OP NURSING CARE (Answer)- patients are
at increased risk for lymphedema and infection
therefore, *NO BLOOD PRESSURES OR VENIPUNCTURES* in the affected
arm
signage should be posted at the bedside to help remind staff
