Med-Surg Final Exam Study Guide (2020)

Tema 1: Cancer screenings: Screening tests for some cancers 1 1- Colon Cancer XXXXXXXXXXXXXXX  Colonoscopy is the gold standard test, if there are lesions, a biopsy is taken  Many times, the client is asymptomatic ...

Tema 1: Cancer screenings: Screening tests for some cancers 1 1- Colon Cancer XXXXXXXXXXXXXXX  Colonoscopy is the gold standard test, if there are lesions, a biopsy is taken  Many times, the client is asymptomatic but occult blood is discovered in the stool during a rectal exam. Risk factors for colorectal cancer  Ageolderthan50years  Previous colorectal polyps, history of colorectal cancer, History of ovarian or breast, and stomach cancers  Smoking and Dietary Habits (not eating veggies). Assessment  Blood in stool (most common) detected by fecal occult blood testing, sigmoidoscopy, and colonoscopy  Anorexia,vomiting,andweightloss,secondaryAnemia  Abnormal stools  Ascendingcolontumor:Diarrhea  Descendingcolontumor:Constipationorsomediarrhea,orflat,ribbon-likestoolcausedbyapartial obstruction  Rectaltumor:Alternatingconstipationanddiarrhea Stages:  Stage I – Tumor invades up to muscle layer  Stage II – Tumor invades up to other organs or perforates peritoneum  Stage III – Any level of tumor invasion, up to 4 regional lymph nodes  Stage IV – Any level of tumor invasion; many lymph nodes affected with distant metastasis General interventions 1. Monitor for signs of complications (bowel perforation with peritonitis, abscess or fistula formation (fever associated with pain), hemorrhage (signs of shock), and complete intestinal obstruction. 2. Monitor for signs of bowel perforation, which include low blood pressure, rapid and weak pulse, distended abdomen, and elevated temperature. 3. Monitor for signs of intestinal obstruction, which include vomiting (maybe fecal contents), pain, constipation, and abdominal distention; provide comfort measures. . 2- Breast Cancer XXXXXXXXXXXXXXXXXXXXX  Metastasis occurs through the lymph nodes and the common sites (bones and lungs) (brain and liver).  Confirmatory Diagnosis: BREAST BIOPSY by needle aspiration or by surgical removal of the tumor with microscopic examination to detect malignant cells.  Screening: Begins at age 50 and every 10 years if colonoscopy is negative  If colonoscopy has benign polyps – the next colonoscopy is 3 – 5 years  History of colorectal disease: every 5 years  Sigmoidoscopy: every 5 years Risk factors  Age (+ 65 year increases with ages)  Obesity:Lifestyle:highfatdietandLowfiberdiet(possiblerisk)  Family history genetic predisposition and Previous cancer of the breast, uterus, or ovaries  Early menarche and late menopause or Nulliparity (+30 years)  High-dose radiation exposure to chest  Assessment:  Presenceofa orincreaseinhardeningofthebreast  Swelling, orpainintheskin  Appearanceofthe  Malignant tumor: unilateral mass (lump) in one breast, irregular shape, firm and hard, embedded in the surrounding tissue  Benign tumor: single or multiple lumps in one or both breasts. Round, smooth or firm, mobile.    .  MRI: especially when the mammogram is inconclusive. Determine the actual size of the cancer  BreastBiopsy: Breast self-examination and client instructions. 1. Take advantage of the bathroom schedule and with the opposite hand carry out the self-examination with the fingertips in a circular spiral or from top to bottom. The same is done on the opposite breast. Also examined in the armpit area 2. The objective is to 3. Stand with your arms at your sides, raise your arms and check for changes in the shape of your breasts, dimpling of the skin, or changes in the nipple. 4. Then place your hands on your hips and press firmly, squeezing the pectoral muscles to see if there are any asymmetries or changes. 5. Lie down and repeat step 1, 6. Mark on your calendar that you have completed your self-test 7. Write down any changes or unique features you want to discuss with your healthcare provider. BRCA1 and BRCA2: Genetic blood test that can indicate if you have an increased risk of cancer). It can be done in both women and men  Recommended for women who have  A consent form is required. It cannot be done within 3 months of a blood transfusion. HER2 gene cell:  A pathology report from a biopsy may determine if cancer cells contain the HER2 gene.  If the result is positive  Patients with HER2 may be successfully treated with a targeted therapy for this type of cancer 2 bump or ball indentations (such as orange peel), redness, nipple (retraction) Diagnosis: Triple Approach BSE (Breast Self-Examination), Perform regularly 7 to 10 days after menstruation. Clinical breast exam (CBE): - 1 to 3 years for women 20 and 30 - Annually for women age 40 and older. Mammography: beginning at age 40 and older It is the only definitive way to diagnose breast cancer. verify in time the presence of lumps, hard nodules or thickening of the tissue. Look at your breasts in a mirror. 2 first-degree relatives who were diagnosed with breast cancer before age 50 or women who have a family history of breast and ovarian cancer. , this gene may be responsible for the rapidly cancerous growing cells. Trastuzumab (Herceptin), Nursing Care Postoperative