Health Assessment Final Exam /complete
with answers /sure passA+
1. Subjective information - breasts and regional lymphatics: breasts
- pain
- lump
- discharge
- rash
- swelling
- trauma
- history of breast disease
- surgery or radiation
- medication
- patient-centered care: perform breast self-examination, last mammogram
axilla
- tenderness, lump, or swelling
- rash
2. Health promotion - breast and regional lymphatics: self breast exams
3. self breast exams - women: - monthly
- day 4-7 of menses
- (same day monthly, for post menopausal women)
4. inspection - breast and regional lympphatics: - general appearance
- skin - smooth and even in color
- lymphatic drainage area - note any bulging, discoloration, or edema
- nipple - placed symmetrically, protrude, note any dry scaling, fissure, or ulceration, and
bleeding or other discharge
- maneuvers to screen for retraction - life arms slowly over head, both breasts should move up
symmetrically
5. palpate the breasts: - supine position
- arm over head
- flatten the breast tissue and displace it medially
- any significant lumps feel more distinct
- vertical strip pattern is the best way to detect a breast mass
6. gynecomastia: - benign growth of breast tissue
- male
- occurs with use of anabolic steroids, some medications, cirrhosis, and other disease
states
,7. supernumerary nipple: an extra nipple
8. premature thelarche: - early breast development with no other hormone depen- dent signs
(pubic hair, menses)
9. breast cancer risk factors: - age >50 years
- previous DX of breast cancer or benign breast disease
- family history: 1st degree relative (mom, daughter, sister) or 2/more 2nd degree relatives
- early menarche <12 years
- late menopause >50 years
- more periods = more life long exposure to estrogen
- nulliparity late age at birth of 1st child > 30 years old
10.the aging female: < estrogen
- breast atrophy
- breast sagging
11.serious findings of the breast: breast cancer: - dimpling
- edema: Peau d'Orange
- Hard/rock/pebble
- non-movable/fixed
- nipple discharge
- nipple retraction
- retraction, varied nipple height
12. serious findings of the breast: paget's disease (intraductal carcinoma): - rash on
nipple
13. serious findings of the breast: lumps: - benign breast disease multiple tender masses
- caffeine can make it worse
- may be related to menstrual cycle
- more tender premenstrual
- fibroadenoma considered benign breast disease
14.serious findings of the breast: lactation disorder: - mastitis
- infected milk duct while breast feeding
- breast abscess- more severe complication of mastitis - stop breastfeeding in that breast
15. serious findings of the breast: abnormalities of the male brest: - gyneco- mastia
- puberty
- aging males
- changing horomones
- liver disease
- cancer
- medications: digitalis
, 16.nipple dimpling: - also called a skin tether
- sign of skin retraction
- apparent at rest, with compression, or with lifting of the arms
17. nipple retraction: suggests cancer, which causes fibrosis of the whole duct system
and pulls in the nipple
- may occur with benign lesions such as ectasia of the ducts
- do not confuse with inversion, has no broadening and is not fixed
18.edema (peau d'Orange): - lymphatic obstruction produces edema
- pigskin or orange-peel look
- suggests cancer
- begins in the skin around and beneath the areola
19. fixation: - asymmetry, distortion, or decreased mobility with the elevated arm
maneuver
- as cancer becomes invasive, the fibrosis fixes the breast to the underlying pectoral muscles
20. deviation in nipple pointing: - underlying cancer causes fibrosis in the mam- mary
ducts, which pulls the nipple angle toward it.
- swelling behind the right nipple and nipple tilts laterally
21. benign ("fibrocystic") breast disease: - swelling and tenderness (cyclic dis- comfort)
- mastalgia (severe pain, both cyclic and noncyclic)
- nodularity (significant lumpiness, both cyclic and noncyclic)
- dominant lumps (including cysts and fibroadenomas)
- nipple discharge (including intraductal papilloma and duct ectasia)
- infections and inflammations (including subareolar abscess, lactational mastitis, breast
abscess, and mondor disease)
- occurs bilaterally
22.cancer: - solitary, unilateral, nontender mass
- single focus in one area, although it may be interspersed with other nodules
- solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes invasive
- borders are irregular and poorly delineated
- grows constantly
- often painless, although the person may have pain
- most common in upper outer quadrant
- found in women 30-80 years
- increased risk until age 80
- as cancer advances, signs include firm or hard irregular axillary nodes; skin dimpling;
nipple retraction, elevation, and discharge
with answers /sure passA+
1. Subjective information - breasts and regional lymphatics: breasts
- pain
- lump
- discharge
- rash
- swelling
- trauma
- history of breast disease
- surgery or radiation
- medication
- patient-centered care: perform breast self-examination, last mammogram
axilla
- tenderness, lump, or swelling
- rash
2. Health promotion - breast and regional lymphatics: self breast exams
3. self breast exams - women: - monthly
- day 4-7 of menses
- (same day monthly, for post menopausal women)
4. inspection - breast and regional lympphatics: - general appearance
- skin - smooth and even in color
- lymphatic drainage area - note any bulging, discoloration, or edema
- nipple - placed symmetrically, protrude, note any dry scaling, fissure, or ulceration, and
bleeding or other discharge
- maneuvers to screen for retraction - life arms slowly over head, both breasts should move up
symmetrically
5. palpate the breasts: - supine position
- arm over head
- flatten the breast tissue and displace it medially
- any significant lumps feel more distinct
- vertical strip pattern is the best way to detect a breast mass
6. gynecomastia: - benign growth of breast tissue
- male
- occurs with use of anabolic steroids, some medications, cirrhosis, and other disease
states
,7. supernumerary nipple: an extra nipple
8. premature thelarche: - early breast development with no other hormone depen- dent signs
(pubic hair, menses)
9. breast cancer risk factors: - age >50 years
- previous DX of breast cancer or benign breast disease
- family history: 1st degree relative (mom, daughter, sister) or 2/more 2nd degree relatives
- early menarche <12 years
- late menopause >50 years
- more periods = more life long exposure to estrogen
- nulliparity late age at birth of 1st child > 30 years old
10.the aging female: < estrogen
- breast atrophy
- breast sagging
11.serious findings of the breast: breast cancer: - dimpling
- edema: Peau d'Orange
- Hard/rock/pebble
- non-movable/fixed
- nipple discharge
- nipple retraction
- retraction, varied nipple height
12. serious findings of the breast: paget's disease (intraductal carcinoma): - rash on
nipple
13. serious findings of the breast: lumps: - benign breast disease multiple tender masses
- caffeine can make it worse
- may be related to menstrual cycle
- more tender premenstrual
- fibroadenoma considered benign breast disease
14.serious findings of the breast: lactation disorder: - mastitis
- infected milk duct while breast feeding
- breast abscess- more severe complication of mastitis - stop breastfeeding in that breast
15. serious findings of the breast: abnormalities of the male brest: - gyneco- mastia
- puberty
- aging males
- changing horomones
- liver disease
- cancer
- medications: digitalis
, 16.nipple dimpling: - also called a skin tether
- sign of skin retraction
- apparent at rest, with compression, or with lifting of the arms
17. nipple retraction: suggests cancer, which causes fibrosis of the whole duct system
and pulls in the nipple
- may occur with benign lesions such as ectasia of the ducts
- do not confuse with inversion, has no broadening and is not fixed
18.edema (peau d'Orange): - lymphatic obstruction produces edema
- pigskin or orange-peel look
- suggests cancer
- begins in the skin around and beneath the areola
19. fixation: - asymmetry, distortion, or decreased mobility with the elevated arm
maneuver
- as cancer becomes invasive, the fibrosis fixes the breast to the underlying pectoral muscles
20. deviation in nipple pointing: - underlying cancer causes fibrosis in the mam- mary
ducts, which pulls the nipple angle toward it.
- swelling behind the right nipple and nipple tilts laterally
21. benign ("fibrocystic") breast disease: - swelling and tenderness (cyclic dis- comfort)
- mastalgia (severe pain, both cyclic and noncyclic)
- nodularity (significant lumpiness, both cyclic and noncyclic)
- dominant lumps (including cysts and fibroadenomas)
- nipple discharge (including intraductal papilloma and duct ectasia)
- infections and inflammations (including subareolar abscess, lactational mastitis, breast
abscess, and mondor disease)
- occurs bilaterally
22.cancer: - solitary, unilateral, nontender mass
- single focus in one area, although it may be interspersed with other nodules
- solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes invasive
- borders are irregular and poorly delineated
- grows constantly
- often painless, although the person may have pain
- most common in upper outer quadrant
- found in women 30-80 years
- increased risk until age 80
- as cancer advances, signs include firm or hard irregular axillary nodes; skin dimpling;
nipple retraction, elevation, and discharge
