Using the information from the case study below, write an essay discussing the disease and the plan of care you will create for the patient.
R M. is a 72-year-old 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).
· 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 6 months.
· She spends most of her time watching TV
· 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
· 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.
1. Briefly explain the types and pathophysiology of breast cancer. What are R.M.’s risk factors for breast cancer?
2. R.M. tells you that she did not hear a word the doctor said after she heard the words “positive lymph nodes.” R.M. asks why she has to have chemotherapy and radiation and what they involve. How would you respond?
3. In the older adult population describe what are the sensitive and special considerations for physical examination and pharmacological administration? What are the anatomical, psychological, and physiological differences? What are the special considerations the nurse should take when implementing the nursing process and providing care for the older adult?
4. What classifications of Chemotherapy agents may be utilized for her type of cancer, give examples
5. What are the special considerations and nursing management for this elderly patient receiving radiation and chemotherapy treatment?
6. Explain the impact cancer has can have on her life, both physiologically and psychosocially. What are some supportive interventions for her and her family?
7. Discuss one priority nursing diagnosis, two expected outcomes in the smart goal format, and two nursing interventions using the NANDA format found in Nursing Diagnosis List.
8. Include how you will evaluate this problem’s plan in your conclusion