Question

hello there, could I get an answer to my scenario question

1.Breast Cancer

Patient Profile

R M. is a 68-year-old white female who went to her health care provider with a complaint of "feeling tightness" around a lump in her right breast. She has a history of hypertension and smoking (25 pack-year history).

Subjective Data

Has a family history of breast cancer-one sister recently had lumpectomy and radiation therapy. Mother and aunt died from breast cancer when they were in their “60s.”

Has had history of "lumpy" breasts but this lump feels “different”

Says she cannot quit smoking because of all of the stress in her life. Her husband recently left her and she has not seen her two daughters in more than six months.

She spends most of her time watching TV

Objective Data

Physical Examination

5’9”, 205 lb.

Blood pressure 165/100, pulse 76, respirations 20, temperature 98.8° F

Palpable mass in right breast in upper outer quadrant

Diagnostic Studies

Bilateral mammogram and ultrasound of right breast

Case Study Progress

R.M. goes to her follow-up visit and is told that the mammogram and ultrasound show a 4 cm mass. She undergoes a core needle biopsy. The results indicate that the mass is infiltrating lobular carcinoma. She undergoes a lumpectomy and axillary lymph node dissection. Six of 15 axillary lymph nodes are positive for cancer. Two weeks after surgery, she is being seen to discuss further treatment options.

Discussion Questions (16 marks)

What are R. M.’s risk factors for breast cancer? (2 marks)

R.M. asks why she has to have more than one chemotherapy agent. How would you respond? (2 marks)

What instructions should R. M. receive regarding caring for and protecting the skin of a radiation treatment area? (3 marks)

What are some factors that you should assess for that may influence how R.M. will cope with this new diagnosis of cancer? (9 marks)

Answer 1

1. R. M.'s RISK FACTORS FOR CANCER :

Race : As R.M. is an old white women she is more likely to develop breast cancer rather than other race

Hereditary : R.M. have a family history of breast cancer which puts her at higher risk to develop breast cancer.

Habits : R.M. also has history of smoking which is also one of the high risk for breast cancer in women.

Gender : Although men also suffer from breast cancer females are more prone to develop breast cancer.

2. We need to explain R.M. that we may need to use more than one chemotherapy agents as to prevent the cancerous cells to be resistant towards the drugs, if the cancerous cells is resistant towards the given drugs it will be difficult to treat the condition.

3. Advice R.M. to keep the area clean, dry and always moisturise it.

• Wear a confortable and not too tight clohs.
• Do not use any perfume or soap which you are allergic to.
• Always use luke warm water while taking bath.
• Avoid any injury or scratch near by the area.

4. FACTORS TO ASSESS THAT MAY INFLUENCE :

• Assess whether R.M. is having an anxiety.
• Assess R.M.'s knowledge regarding breast cancer.
• Assess family support and their presence.
• Assessing R.M.'s coping mechanisms.