Question

A 44-year-old Caucasian woman is admitted for local wide excision of a large mole that has been diagnosed as malignant melanoma on her upper thigh. Her past history is negative for serious illness. She was hospitalized for the birth of her three children. She admits to being an avid sun worshipper" and is noted to have very dark brown skin and some premature aging of the facial skin. 1. Considering the possible etiology of melanoma, what effect does the exposure to sunlight have on this form of cancer? 2. During her preoperative instructions, the patient asks why she is going to have a 4-inch circle of skin and tissue removed to get rid of a "mole." What information should the nurse consider before responding to her question? 3. The patient has a wide excision of the melanoma, and the surgical site is closed with a split-thickness skin graft from the opposite thigh. Following surgery, the wound is dressed with a bulky dressing, and the donor site is covered with a pressure dressing. When the nurse is assessing the dressings, the patient asks to "peek” at the surgical site so that she can see where the mole had been. How should the nurse respond? 4. On the following morning, the patient reports that the donor site "hurts worse than the cancer site." What should the nurse say and what interventions are appropriate? 5. On the third day after surgery, the bulky dressing is removed. The wound appears wet with cloudy fluid oozing from it, and the skin graft is unattached to the wound. The surrounding tissues are red and swollen. What is the likely cause of these features in the graft site?

Answer 1

1, when we exposed to too much UV radiation from the sun it can damage out DNA skin cells, this damaged DNA cell starts to grow more and form melanocytes that lead to skin cancer.
2, 4inch circle of skin and tissue removed to have a biopsy. abnormal tissue and a small amount of normal tissue surrounding the abnormal tissues to look for cancer cells.
3, the nurse should tell the patient that removing the dressing as soon as the surgery finish and looking at the incision site make you more stressful. The initial dressing will be removed before discharge that time surgeon will show you the surgical site to look for where the mole had been.
4, Donar site will hurt more than cancer site because donor site because skin grafting surgery that involved the nerve ending the donor site. Donar site has healthy skin has more blood supply there will be single and smaller blood vessels. Interventions include subcutaneous anesthetic agents like adrenaline-lidocaine, using a topical agent like bupivacaine and lidocaine, wound dressing with hydrocolloid and polyurethane with fibrin sealant and lice application will help reduce the pain at the donor site.