Mrs. V. Reyes, 50-year-old, married and scheduled for a modified radical mastectomy. She was diagnosed with Breast Ca du

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Mrs. V. Reyes, 50-year-old, married and scheduled for a modifiedradical mastectomy. She was diagnosed with Breast Ca due toabnormality in her left breast accompanied by palpable axillarylymph nodes. In her visit to the MD’s clinic, she reported episodesof deep aching pain awakened her at night. The unexplained weightloss for several weeks accompanied by loss of muscle strengthprompted her to seek medical advises, thus consulted. She also hada strong family history of cancer. Due to client’s physical andfamily history, the MD performed series of breast examinationsincluding mammogram. A primary tumor was found about 5.5 cm indiameter at the upper left corner of her left breast but noevidence of spread to underlying lymph nodes and surroundingorgans. Local breast excision followed and biopsy revealed positivewith cell carcinoma.
Thorough conversation was done between the surgeon and client inrelation to the surgical treatment and medical oncology. Modifiedradical mastectomy was discussed with the inclusion of healthytissues around the tumor, called the margin; to make sure that theentire tumor is removed. Adjuvant therapy to be followed such aschemotherapy to lower the risk of recurrent and get rid ofremaining cancer cells in the body. Reconstructive surgery was alsooffered but the patient refused.
Prior to her schedule of MRM, diagnostic studies were done,chest radiograph performed as normal, complete blood count showeddecrease level of hemoglobin, hematocrit and monocytesconcentrations. Fasting blood sugar – 110mg/dl, no abnormal ECGfindings, V/ S within normal. No medications ordered except forMultivitamins to boost immune system.
Identify the abnormal breast findings by performing theappropriate breast examination techniques.
Formulate atleast 2 nursing diagnosis and design anursing care plan prior to surgical intervention
Formulate another 2 Nursing diagnosis and design anursing care plan post-surgical intervention
Discuss different kinds of chemotherapeutic agents usedfor clients with breast Ca.
Examine the risks and benefits of chemotherapeuticintervention to client with breast Ca
If there are nursing procedures to bed one on theclient, discuss briefly the important nursing responsibilities inperforming such procedure.