Answers to Oncology 3 Case Studies

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Lambton College *

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Apr 26, 2024

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Answers to Oncology 3 Case Studies Case Scenario: Emily Thompson Breast Cancer 1. What are the differences between benign and malignant breast tumors?  Benign tumors: Typically non-cancerous, grow slowly, have well-defined borders, and do not invade surrounding tissues or spread to other parts of the body.  Malignant tumors: Cancerous, tend to grow rapidly, may have irregular borders, invade surrounding tissues, and can metastasize to other organs. 2. What risk factors does Emily have for Breast Cancer?  Age (being over 40).  Gender (female).  Personal history of smoking (10 pack-years).  Family history is negative, but age and smoking history are risk factors. 3. What assessment findings are suggestive of Breast Cancer?  Painless lump in the left breast.  Noticeable asymmetry.  Firm, irregular mass measuring approximately 3 cm.  Location to outer upper quadrant 4. What teaching should you provide to Emily regarding the tests she should expect to go through to diagnose the lump in her breast?  Mammogram: Uses X-rays to detect abnormalities.  Ultrasound: Helps characterize the mass as solid or cystic.  Biopsy: Removes tissue for histopathological examination. 5. What is the difference between a lumpectomy, simple mastectomy, and modified radical mastectomy?  Lumpectomy: Removal of the tumor and a small margin of surrounding tissue.  Simple Mastectomy: Removal of the entire breast but not the lymph nodes.  Modified Radical Mastectomy: Removal of the entire breast and the axillary lymph nodes. 6. What teaching should be provided to Emily regarding her postoperative care?  Wound care instructions  Pain management

 Exercises to regain arm movement.  How to prevent lymphedema.  Emotional support and coping strategies.  Information on drains (if used).  Guidance on resuming normal activities. 7. What actions can the nurse take to ease Emily’s anxiety related to looking at her surgical site for the first time?  Offer emotional support and encourage open communication.  Prepare Emily for what to expect visually. Pictures can be helpful  Emphasize the importance of self-compassion and body positivity.  Provide resources for counseling or support groups. 8. What products could you recommend to Emily to support her body image until she receives her breast reconstruction?  Post-mastectomy bras and camisoles.  Breast prostheses or forms.  Scarves or wraps for added comfort and coverage.  Support groups or counseling for emotional well-being. Teaching How to prevent lymphedema : Early Mobility and Gentle Exercises: Encourage early and gentle exercises as advised by the healthcare team, including shoulder mobility exercises. Gradual movements can help prevent stiffness and enhance lymphatic flow. Avoid Heavy Lifting: Advise against heavy lifting or strenuous activities with the affected arm, especially in the initial postoperative period. This helps prevent strain on the lymphatic system. Compression Garments: Consider the use of compression garments or sleeves as recommended by the healthcare provider. These garments can provide gentle compression, promoting lymphatic drainage and reducing the risk of swelling. Elevate the Arm: Encourage the individual to elevate the affected arm when resting. This helps in minimizing fluid buildup and improving lymphatic drainage.

Skin Care: Promote good skin care to prevent infections. Encourage gentle washing and moisturizing of the skin, avoiding cuts, burns, or other injuries that could increase the risk of lymphedema. Avoid Constrictive Clothing and Jewelry: Advise against wearing tight clothing, jewelry, or accessories that may impede lymphatic flow. Gradual Progression of Activities: Counsel patients to gradually resume daily activities and to listen to their bodies. Overexertion or rapid progression in activities may increase the risk of lymphedema. Protect the Skin from Sunburn: Sunburn can compromise the skin's integrity, increasing the risk of infections. Advise individuals to use sunscreen and avoid prolonged sun exposure on the affected area. Regular Monitoring and Early Intervention: Regularly monitor the affected arm for any signs of swelling, redness, or changes in sensation. Early identification of symptoms allows for prompt intervention. Avoid Constriction During Blood Pressure Measurement: When measuring blood pressure, avoid using a blood pressure cuff on the affected arm, as this can impede lymphatic flow. Stay Hydrated: Adequate hydration is essential for maintaining overall health and supporting lymphatic function. Educate on Signs and Symptoms: Educate patients on the signs and symptoms of lymphedema, such as swelling, heaviness, or tightness in the arm. Prompt reporting of symptoms allows for early intervention. Post Operative Exercises for patient with a mastectomy see figure 54.10 page 1348 Case Scenario: James Mitchell Lung Cancer 1. What assessment findings are suggestive of lung cancer?  Persistent cough.  Shortness of breath.  Unintentional weight loss.  Hemoptysis (coughing up pink-tinged sputum).  History of long-term smoking.

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