NUR 1600 EXAM 4 - populations at risk for developing severe medic...

NUR 1600 EXAM 4

• Vulnerable Populations

populations at risk for developing severe medical problems due to substandard healthcare, poor health literacy, and higher rate of communicable diseases

• Examples of vulnerable populations

working poor, elderly, homeless, racial/ethnic minorities, uninsured

• Breast cancer risk factors

-female 99%

-age, risk increases w age

-race/ ethnicity white women -mutation of BRCA 1 BRCA 2- (5-10% women) (5-20% men) -family history- mother/sister 1st degree relative -personal medical history -reproductive history -breast density -estrogen replacement therapy -obesity -alcohol intake -long menstrual history -first pregnancy after 30

• Breast cancer average risk

no personal health history of breast cancer no strong family history 1 / 4

no genetic predisposition no radiation to chest before age 30 no illness/syndrome predisposition breast cancer assessment tool <20%

• Breast cancer high risk

breast cancer assessment tool >20-25%

BRCA gene mutation or relative with gene had chest radiation before age 30 history of illness or syndromes

• Healthy people 2020 breast cancer guidelines

reduce female breast cancer death rate

reduce late stage breast cancer increase proportion of women who receive breast cancer screening and women who were counseled by providers about mammograms

• American cancer society breast cancer guidelines for women with average risk

women 40-44

optional mammogram every year women 45-54

yearly mammogram women 55+

mammogram every other year no MRI needed

screenings should continue as long as woman is in good health and expected to live at least 10 more years 2 / 4

• asymptomatic women with negative history screening recommendation

-

40-49

individual/ provider decides 50-74

every 4 years

75+

no benefit

monthly breast self exam no longer recommended for cancer screenings

• BRCA related risk assessment

women with family members with breast, ovarian, tubal, peritoneal cancer

screened for family history associated with increased risk for genetic mutations

women with + screening for family history associated with increased risk for BRCA 1/2 should receive genetic counseling and if indicated BRCA screening

• Normal breast assessment findings

breast symmetry in size and shape no tissue dimpling, retraction, bulging

no erythema/inflammation no discoloration skin texture smooth

areolae

round, symmetrical, even in color no discharge from nipple 3 / 4

no enlarged axillary lymph nodes no lumps or masses no pain w exam no supernumerary nipple

• Breast cancer signs and symptoms

asymmetry or change in size swelling of all or any part

irregular shape/color/areola/nipple nipple retraction discharge thickening of skin / nipple erythema or redness enlarged axillary lymph nodes new lumps/ masses hard fixed lumps lump usually painless

• breast cancer primary prevention

healthy lifestyle to decrease modifiable risks physical activity decrease weight/ obesity decrease alcohol intake Breast self awareness

• breast cancer secondary prevention

early detection screenings per guidelines

mammograms early diagnosis and treatment

• breast cancer tertiary prevention

coping post treatment sexuality concerns reproductive concerns

• Healthy people 2020 guidelines for cervical cancer
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