Interventions for Clients with Lung Cancer

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Interventions for Clients with Lung Cancer
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Benign Breast Disorders

• Fibroadenoma, most common cause of breast
• masses during adolescence may occur in
• clients in their 30s
• Solid, slowly enlarging, benign mass round,
• firm, easily movable, nontender, and clearly
• delineated from the surrounding tissue
• Usually located in the upper outer quadrant of
• the breast

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Fibrocystic Breast Disease

• Physiologic nodularity of the breast, most
• common breast problem of women between 20
• and 30 years of age
• Stage 1 premenstrual fullness and tenderness,
• symptoms occur on menstrual cycle
• Stage 2 multiple nodular areas in both breasts
• (Continued)

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Fibrocystic Breast Disease (Continued)

• Stage 3 microscopic or macroscopic cysts
• associated with pain, tenderness, or burning
• occurring in women between 35 and 55 years of
• age

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Collaborative Management

• Symptomatic management
• Hormonal manipulation
• Drug therapy vitamins C, E, and B complex
• Diuretics
• Avoidance of caffeine
• Mild analgesics
• (Continued)

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Collaborative Management (Continued)

• Limited salt intake before menses
• Well-padded supportive bra
• Local application of heat or ice for pain
  relief

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Ductal Ectasia

• Benign breast problem of women approaching
• menopause caused by dilation and thickening of
• the collecting ducts in the subareolar area
• Mass that is hard with irregular borders,
  tender
• Greenish brown nipple discharge, enlarged
• axillary nodes and edema over the site of the
• mass

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Intraductal Papilloma

• Occurs most often in women 40 to 55 years of
• age
• Benign process in the epithelial lining of the
• duct, forming an outgrowth of tissue
• (Continued)

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Intraductal Papilloma (Continued)

• Trauma and erosion within the duct, resulting
  in
• bloody or serous nipple discharge
• Diagnosis aimed first at ruling out breast
  cancer

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Gynecomastia

• Benign condition of breast enlargement in men
• Can be a result of primary cancer such as lung
• cancer
• Causes include
• Drugs
• Aging
• Obesity
• (Continued)

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Gynecomastia (Continued)

• Underlying disease causing estrogen excess
• Androgen deficiency
• Breast cancer

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Breast Cancer

• Types of breast cancer
• Complications include
• Invasion of lymph channels causing skin
• edema
• Metastasis to lymph nodes
• Bone, lungs, brain, and liversites of
• metastatic disease from breast cancer
• Ulceration of overlying skin

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Breast Cancer in Men

• Of all breast cancers, only 1 occurs in men.
• Breast cancer in men usually presents as a
  hard, nonpainful subareolar mass.
• Breast cancer in men is often a widely spread
  disease because it is usually detected at a later
  stage than in women.

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Mammography

• Baseline screening mammography yearly at age
• 40 is recommended.
• Barriers to mammography compliance can
• involve factors such as fear.
• Increase compliance through education.

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Breast Self-Examination

• The goal of screening for breast cancer is
  early
• detection because breast self-examination
• cannot prevent breast cancer.
• Early detection reduces mortality rate.
• Teach breast self-examination.

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Breast Care

• Clinical breast examination
• Cancer surveillance
• Prophylactic mastectomy
• Chemoprevention

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Pathologic Examination

• Key to diagnosis of breast cancer
• Presence or absence of estrogen receptors or
• progesterone receptors
• S-phase index, or growth rate
• DNA ploidy
• Histologic or nuclear grade
• HER2/neu gene expression

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Anxiety

• Interventions
• Anxiety for the woman with breast cancer
• begins the moment the lump is discovered.
• Level of anxiety may be related to past
• experiences and personal associations with
• the disease.
• Allow the client to ventilate feelings.
• Flexibility is the key to nursing care.

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Potential for Metastasis

• For clients with late-stage breast cancer,
• nonsurgical treatment may be the only
• alternative tumor may be removed with local
• anesthetic, follow-up treatment with hormonal
• therapy, chemotherapy, and sometimes
• radiation.
• (Continued)

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Potential for Metastasis (Continued)

• For breast cancer at a stage for which surgery
  is
• the main treatment, follow-up with adjuvant
• radiation, chemotherapy, hormone therapy, or
• targeted therapy is commonly prescribed.

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Surgical Management

• Mass should be removed to reduce risk for local
• recurrence but controversy exists concerning
• the best treatment.
• Axillary lymph nodes (dissection or removal)
• Sentinel lymph node biopsy
• Preoperative care
• Operative procedure

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Postoperative Care

• Avoidance of using the affected arm for blood
• pressure measurement, giving injections, or
• drawing blood
• Monitoring of vital signs
• Care of drainage tubes
• Comfort measures
• Mobility and diet
• Breast reconstruction

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Adjuvanat Therapy

• To decrease the risk of recurrence, adjuvant
  therapy consists of
• Radiation therapy
• Chemotherapy
• Hormonal therapy
• Stem cell transplantation
• Targeted therapy