Presenting Symptoms, Preliminary investigations and Results
The patient presented with a self-detected 23mm grade 2 ductal carcinoma involving the right upper quadrant of the right. The patient performs regular breast self-examination(BSE) to detect any lump before advanced symptoms manifest. Other symptoms included nipple discharge or retraction, skin changes, alteration in breast contour, lymphadenopathy, mammographic abnormality and distant metastasis. Subsequently, a core biopsy has been done to make a definitive diagnosis, confirmed that a ductal carcinoma with surrounding DCIS (Ductal carcinoma in Situ). She underwent a wide local excision and a sentinel lymph node biopsy. It revealed a 23mm mixed DCIS and ductal carcinoma with grade 2 histology and the sentinel lymph node was negative. The tumour was oestrogen and progesterone receptor positive and non-amplified for HER-2. There was no evidence of lymphovascular invasion. The patient has no family history of breast cancer.
Management Statement and Radiation Treatment Prescription
The common disease management options for breast cancer are surgery, chemotherapy, endocrine
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Although the patient in this case study is having a right breast treatment, DIBH is an interesting topic to discuss because of its convinence of not have to utilize any intricate and expensive equipment. Methods to reduce long term side effects gradually become increasingly important due to the improvements in survival rate. Today, there are two main gating techniques being used clinically. The first requires a digital spirometer to breathe through it; the second technique is breath-hold technique perform on respiratory gating system. Both technique are effective in reducing side effects, however, they require expensive equipment and high maintenance cost that prevent tight budget department from adapting
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
Fluid volume overload within the intervascular space can cause shortness of breath, fluid within the lungs, engorged neck veins, increased blood pressure and heart rate with a bounding pulse. As blood volume increases so will blood pressure and heart rate. Impaired gas exchange related to pulmonary congestion causes crackles within the lung fields. If oxygen saturation is low the nurse should supply supplemental oxygen. The nurse would raise head of the bed at least thirty degrees or higher to promote breathing and reduce cardiac pressure. Having the patient cough and breath deep can pop open alveoli to clear lung passages. Once the patient is comfortable and in safe position the nurse can call the doctor. The nurse should anticipate another dose of diuretics, such as furosemide. This treatment will decrease respiratory rate and blood pressure by reducing the amount of sodium and fluid within the body. Breath sounds will improve as crackles decrease. Maintaining appropriate fluid volume stabilizes blood pressure, cellular metabolism and proper nutrition gained or wastes lost. Supplemental oxygen if oxygen saturation is low and the nurse has already supplied the patient with oxygen. (Ignatavicius & Workman,
Surgery is the most common treatment for all stages of colon cancer. Cancer cells may be removed by one of the below procedures:
It is usually found in one breast but can affect both breast at the same time. Increase in lump size and breast tenderness happens just before the menstrual cycle and decreases in size and resolution after the menstrual cycle. Having one or many cysts does not increase one’s risk of breast cancer but it may interfere with the ability to detect abnormal changes that may need to be evaluated. The supporting tissue that gives the breast shape is made up of fatty tissue and fibrous connective tissue. Cysts develop when there is an overgrowth of glands and fibrocystic changes within the milk ducts causing them to dilate and fill with fluid (Laronga et
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
In conclusion, tension pneumothorax is emergency procedure which can develop if chest tubes are occluded. The writer has learned to check for a proper functioning drainage and a patent chest tube as well as the management of tension pneumothorax which prioritise establishing adequate perfusion and cardiac output. Education is also important to both patients and healthcare workers as insufficient knowledge could lead to fatal conditions.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
Symptoms women often start noticing that indicate the possibility of having a cancerous tumor in the breast include a lump on the underarm or armpit, thickening of the nipple, fluid (not milk) leaking from the nipple, change in the size of the nipple or breast, changes of color, shape or texture of the nipple or the areola, and unusual pain in the breast or in the armpit (Stephan., 2010). These are the symptoms women usually start noticing before go to the doctor to ge...
Breast cancer is a type of cancer originates from breast tissue, generally from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from lobules are known as lobular carcinomas whereas from ducts are called ductal carcinomas. (Ref: Breast Cancer, National Cancer Institute) Invasive breast cancer is breast cancer that has spread from the point of origin in the breast ducts/lobules to the surrounding normal tissue cells. In exceptional cases, breast cancer can start in at other sites in breast. Breast cancer occurs in both women and men, though male breast cancer is uncommon.
Of the few people that know what breast cancer is some of them just believe that it is a lump. They do not know that there is a process to breast cancer they do not know that the tumor comes from somewhere and does not magically appear. Breast cancer can happen a few different ways in the breast, but “the most common type of breast cancer is ductal carcinoma” (cancer.gov). This type of breast cancer begins in the lining of the milk ducts. The ducts are the tubes that carry the milk from the lobules to the nipple. Think of them as little veins running from the nipple to a little pouch. Another place that the cancer could start is...
“One in every ten women in the United States will develop breast cancer sometime during her life”. (Breast Care). More than six percent of these cases are linked to hereditary. There are many measures that can be taken to detect breast cancer early in its stages. Women who believe they have a higher risk should have the breast cancer gene testing.
Ductal carcinoma cancer starts in the breast milk ducts (Chen, 2010). The milk ducts drain milk from the lobules to the nipple: 50-75% of breast cancer starts in the ducts (Understanding; Facts).
Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient's failin...
...o those patients with chest pain, in order to maintain oxygen saturations as close to 100%, unknowingly realizing that the patient is being exposed to significant periods of hyperoxia (Moradkham & Sinoway, 2010 ). It has been suggested that this is due to poor monitoring skills by health professionals. (Moradkham & Sinoway, 2010 ). From reading this essay it is clear that there is a high demand and need of further clinical research into the effectiveness of oxygen in the client with chest pain. More research also has to be conducted in order for the health professionals to fully understand what oxygen does to the body. Through completing and implementing more updated and reviewed evidence and research on the effect of oxygen on the client with chest pain, a better practice can be put in place to ensure the patient is receiving the best care to save their life.
Breast cancer is a malignant, metastasizing tumor of the mammary gland. It is the leading cause of death in women between the ages of 35 and 45 years old, but it is most common in women over the age of 50. Almost 90% of all breast cancer begins in the ducts and lobes of the mammary glands (Bartholomew).