Especialidad de higiene oral conquistadoresDescripción completa
Full description
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Oral Revalida Rectal Cancer Colorectal cancer is cancer that develops in the tissues of the colon and/or rectum. he colon and the rectum are !oth found in the lo"er part of the gastrointestinal gastrointestinal #digestive$ s%stem. he% form a long& muscular tu!e called the large intestine #or large !o"el$. he colon a!sor!s food and "ater and stores "aste. he rectum is responsi!le for passing "aste from the !od%. 'f the cancer !egan in the colon& "hich is the (rst four to (ve feet of the large intestine& it ma% !e referred referred to as colon cancer. cancer. 'f the cancer !egan in the rectum& "hich is the last several inches of the large intestine leading to the anus& it is called rectal cancer. Colorectal cancer starts in the inner lining of the colon and/or rectum& slo"l% gro"ing through some or all of its la%ers. 't t%picall% starts as a gro"th of tissue called a pol%p. ) particular t%pe of pol%p& called an adenoma& can then develop into cancer.
*tiolog% +*N*R),
)ge- )lthough colorectal cancer can occur at an% age& the chances of developing the disease dramaticall% increase after the age of 0. Racial and ethnic !acground- )frican )mericans have the highest incidence of this disease in the nited States. )shenai e"s also have a higher ris of developing colorectal cancer. 3O5
6amil% histor% of colorectal cancer- )lthough the reasons are not clear in all cases& inherited genes& shared environmental factors& or a com!ination of these factors can increase %our colorectal cancer riss. 'nherited s%ndromes- he t"o most common inherited s%ndromes lined lined "ith colorectal cancers are familial adenomatous pol%posis #6)7$ #6)7$ and hereditar% non8pol%posis colorectal cancer #9N7CC$. Other s%ndromes that can increase the ris of developing colorectal cancer include ,%nch ,%nch S%ndrome& urcot S%ndrome and 7eut8eghers S%ndrome. ,'6*S5,*
iet- iets that are high in red and processed meats #e.g.& !eef& lam!& hot dogs$ can increase %our colorectal cancer riss. 6r%ing& grilling& !roiling or other methods of cooing meats at ver% high temperatures create chemicals that ma% also contri!ute to an increased ris.
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'nactive lifest%le- 'ndividuals that live a sedentar% lifest%le "ithout ph%sical activit% have an increased chance of developing colorectal cancer. Smoing- Some of the cancer8causing su!stances associated "ith smoing are s"allo"ed and can increase the ris of developing this disease. )lcohol use- 9eav% alcohol use can lead to an increased ris of colorectal cancer. O9*R CON''ONS
7ersonal histor% of colorectal cancer or pol%ps- 'f %ou have had colorectal cancer !efore& %ou are more liel% to develop cancer in other areas of the colon and rectum. 9istor% of in:ammator% !o"el disease #'3$- 9aving '3& including ulcerative colitis and Crohn;s disease& increases %our chances for developing colorectal cancer. %pe '' dia!etes- here ma% !e an increased ris for rectal cancer associated "ith t%pe '' dia!etes. his condition ma% also a
'ncidence Rate Colorectal cancer is a ma=or cause of mor!idit% and mortalit% throughout the "orld. 't accounts for over >? of all cancer incidence. 't is the third most common cancer "orld"ide and the fourth most common cause of death.
7h%sical )ssessment and Revie" of S%stems Rectal cancer signs he development of tumors in the rectum or anal canal ma% change the consistenc%& shape or fre@uenc% of !o"el movements. he severit% of the s%mptoms ma% increase or more s%mptoms might arise as the cancer spreads throughout the rectum or into the colon. Rectal !leeding ma% mae the stool !right red. ) !leeding tumor ma% also change the color of the stools& sometimes maing the stool ver% dar or tarr% looing. Rectal cancer signs related to !o"el ha!it changes ma% include
iarrhea
Constipation
Not !eing a!le to completel% empt% the !o"el
Change in the sie or shape of stools #narro"er than usual$
3lood% stool #either !right red or ver% dar$ +eneral rectal cancer s%mptoms
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*arl% stages of rectal cancer ma% have no s%mptoms. 9o"ever& more s%stemic #!od%8"ide$ changes ma% result as the tumor goes deeper into the la%ers of tissues lining the rectum or if the cancer spreads #metastasies$ throughout the !od%. +eneralied s%mptoms of rectal cancer ma% include
7ain in the rectum
)!dominal pain or discomfort
Bore fre@uent gas pains or stomach cramps
6eeling !loated or full
Change in appetite
nintended "eight loss
6atigue or tiredness )natom% and 7h%siolog% 7athoph%siolog%
iagnostic ests 7rimar% tumor #$ he primar% tumor can !e categoried as 0 up to 4 for colorectal cancer. 3elo" is a further description of ho" tumors are de(ned using the NB staging s%stem.
- he main tumor cannot !e assessed. 0- here is no evidence of a primar% tumor. is #carcinoma in situ$- 'n situ means that the cancer is in the earliest stage& and it has not gro"n !e%ond the lining of the colon or rectum. 1- he tumor has gro"n through the lining #muscularis mucosa$ of the colon or rectum. 2- he tumor has eDpanded through the second la%er of lining #su!mucosa$ of the colon or rectum and into the outer la%er #muscularis propria$. A- he cancer has gro"n through the muscularis propria and into the outer la%ers of the colon or rectum& !ut not all the "a% through. he cancer has not spread to an% near!% organs or tissue. 4a- he cancer has gro"n all the "a% through the "all of the colon or rectum& and has eDpanded to the surface of near!% organs. 4!- he cancer has gro"n through the "all of the colon or rectum and has no" a
Regional l%mph nodes #N$
N0- he cancer has not spread into the l%mph nodes. N1- he cancer has spread to 1 to A regional l%mph nodes. N2- he cancer has spread to more than 4 regional l%mph nodes.
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N2a- Cancerous cells have !een located in 4 to E regional l%mph nodes. N2!- Cancerous cells have !een found in more than F l%mph nodes.
istant metastasis #B$
B0- he cancer has not spread to distant organs. B1- he cancer has spread to distant organs. B1a- Cancerous cells have spread to one distant organ. B1!- Cancerous cells have spread to more than one distant organ.
)cute pain )nDiet% Constipation e(cient :uid volume iarrhea 6ear 'm!alanced nutrition- ,ess than !od% re@uirements Ris for infection
ischarge 7lan 7rognosis Stage
5-year Observed Survival Rate
I
74%
IIA
65%
IIB
52%
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IIC
32%
IIIA
74%*
IIIB
45%*
IIIC
33%
IV
6%
Hodgkin’s and Non-Hodgkin’s Disease 9odgin;s l%mphoma G formerl% no"n as 9odgin;s disease G is a cancer of the l%mphatic s%stem& "hich is part of %our immune s%stem. 'n 9odgin;s l%mphoma& cells in the l%mphatic s%stem gro" a!normall% and ma% spread !e%ond the l%mphatic s%stem. )s 9odgin;s l%mphoma progresses& it compromises %our !od%;s a!ilit% to (ght infection. 7resence of Reed8 Stern!erg cells in !iops%. Non89odgin;s l%mphoma& also called non89odgin l%mphoma& is cancer that originates in %our l%mphatic s%stem& the disease8(ghting net"or spread throughout %our !od%. 'n non89odgin;s l%mphoma& tumors develop from l%mphoc%tes G a t%pe of "hite !lood cell.
*tiolog% octors no" that most 9odgin;s l%mphoma occurs "hen an infection8 (ghting cell called a 3 cell develops a mutation in its N). he mutation tells the cells to divide rapidl% and to continue living "hen a health% cell "ould die. he mutation causes a large num!er of oversied& a!normal 3 cells to accumulate in the l%mphatic s%stem& "here the% cro"d out health% cells and cause the signs and s%mptoms of 9odgin;s l%mphoma. 6actors that increase the ris of 9odgin;s l%mphoma include
5our age. 9odgin;s l%mphoma is most often diagnosed in people !et"een the ages of 1 and A0& as "ell as those older than . ) famil% histor% of l%mphoma. 9aving a close famil% mem!er "ho has 9odgin;s l%mphoma or non89odgin;s l%mphoma increases %our ris of developing 9odgin;s l%mphoma. 5our seD. Bales are slightl% more liel% to develop 9odgin;s l%mphoma. 7ast *pstein83arr infection. 7eople "ho have had illnesses caused !% the *pstein83arr virus& such as infectious mononucleosis& are more liel% to develop 9odgin;s l%mphoma than are people "ho haven;t had *pstein83arr infections. ) "eaened immune s%stem. 9aving a compromised immune s%stem& such as from 9'H/)'S or from having an organ transplant re@uiring medications to suppress the immune response& increases the ris of 9odgin;s l%mphoma.
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Non89odgin;s l%mphoma occurs "hen %our !od% produces too man% a!normal l%mphoc%tes G a t%pe of "hite !lood cell. Normall%& l%mphoc%tes go through a predicta!le life c%cle. Old l%mphoc%tes die& and %our !o d% creates ne" ones to replace them. 'n non89odgin;s l%mphoma& %our l%mphoc%tes don;t die& !ut continue to gro" and divide. his oversuppl% of l%mphoc%tes cro"ds into %our l%mph nodes& causing them to s"ell. Some factors that ma% increase the ris of non89odgin;s l%mphoma include
Bedications that suppress %our immune s%stem. 'f %ou;ve had an organ transplant& %ou;re more suscepti!le !ecause immunosuppressive therap% has reduced %our !od%;s a!ilit% to (ght o< ne" illnesses. 'nfection "ith certain viruses and !acteria. Certain viral and !acterial infections appear to increase the ris of non89odgin;s l%mphoma. Hiruses lined to increased non89odgin;s l%mphoma ris include 9'H and *pstein83arr virus. 3acteria lined to an increased ris of non8 9odgin;s l%mphoma include the ulcer8causing 9elico!acter p%lori. Chemicals. Certain chemicals& such as those used to ill insects and "eeds& ma% increase %our ris of developing non89odgin;s l%mphoma. Bore research is needed to understand the possi!le lin !et"een pesticides and the development of non89odgin;s l%mphoma. Older age. Non89odgin;s l%mphoma can occur at an% age& !ut the ris increases "ith age. 't;s most common in people in their E0s or older.
'ncidence Rate 9odgin disease can occur in !oth children and adults. 't is most common in earl% adulthood #ages 1 to 40& especiall% in a personIs 20s$& "here it is mostl% of the nodular sclerosis su!t%pe& and in late adulthood #after age $& "here the miDed cellularit% su!t%pe is more common. 9odgin disease is rare in children %ounger than %ears of age. )!out 10? to 1? of cases are diagnosed in children and teenagers. )lthough some t%pes of N9, are among the more common childhood cancers& more than >? of cases occur in adults. he t%pes of N9, seen in children are often ver% di
7h%sical )ssessment and Revie" of S%stems 9odgin;s l%mphoma signs and s%mptoms ma% include
7ainless s"elling of l%mph nodes in %our nec& armpits or groin 7ersistent fatigue 6ever and chills Night s"eats neDplained "eight loss G as much as 10 percent or more of %our !od% "eight ,oss of appetite 'tching 'ncreased sensitivit% to the e
Non89odgin;s l%mphoma s%mptoms ma% include-
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S"ollen l%mph nodes in %our nec& armpits or groin )!dominal pain or s"elling Chest pain& coughing or trou!le !reathing 6atigue 6ever Night s"eats Jeight loss
)natom% and 7h%siolog% 7athoph%siolog% iagnostic ests Stages of 9odgin;s l%mphoma include
Stage '. he cancer is limited to one l%mph node region or a single organ. Stage ''. 'n this stage& the cancer is in t"o l%mph node regions or the cancer has invaded one organ and the near!% l%mph nodes. 3ut the cancer is still limited to a section of the !od% either a!ove or !elo" the diaphragm. Stage '''. Jhen the cancer moves to l%mph nodes !oth a!ove and !elo" the diaphragm& it;s considered stage '''. Cancer ma% also !e in one portion of tissue or an organ near the l%mph node groups or in the spleen. Stage 'H. his is the most advanced stage of 9odgin;s l%mphoma. Cancer cells are in several portions of one or more organs and tissues. Stage 'H 9odgin;s l%mphoma a
3lood and urine tests C scan 8ra% BR' 3iops% Needle !iops% 7ositron emission tomograph% #7*$
)cute 7ain related to the in=ur% of !iological agents. 9%perthermia related to ine
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Lno"ledge e(cit related to lac of eDposure to information Ris for 'ne
ischarge 7lan 7rognosis 3ecause of advances in treatment& survival rates have improved in the past fe" decades. he 18%ear relative survival rate for all patients diagnosed "ith 9odgin disease is no" a!out >2?M the 8%ear and 108%ear survival rates are a!out K? and K0?& respectivel%. Certain factors such as the stage #eDtent$ of 9odgin disease and a personIs age a
Stage at diagnosis
8%ear relative survival #?$
,ocalied #con(ned to primar% site$
2>
K1.1
Regional #spread to regional l%mph nodes$
1
F0.
istant #cancer has metastasied$
4K
K.
nno"n #unstaged$
K
E4.1
Benign Prostatic Hyperplasia 3enign prostatic h%perplasia #379$& also no"n as !enign prostatic h%pertroph%& is a histologic diagnosis characteried !% proliferation of the cellular elements of the prostate.
*tiolog% 3enign prostatic h%perplasia #379$ is pro!a!l% a normal part of the aging process in men. 't is caused !% changes in hormone !alance and cell8gro"th factors. +enetics ma% also pla% a role. his is especiall% true for severe 379 re@uiring surger% in men %ounger than E0. Ben "ho are older than 0 have a higher chance of developing 379. 3ut "h% some men have more severe s%mptoms than others is not no"n.
'ncidence Rate 379& the actual h%perplasia of the prostate gland& develops as a strictl% age8 related phenomenon in nearl% all men& starting at approDimatel% 40 %ears of age. 'n fact& the histologic prevalence of 379& "hich has !een eDamined in several autops% studies around the "orld& is approDimatel% 10? for men in their A0s& 20? for men in their 40s& reaches 0? to E0? for men in their E0s& and is K0? to >0? for men in their F0s and K0s. No dou!t& "hen living long enough& most men "ill develop some histologic features consistent "ith 379.
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7h%sical )ssessment and Revie" of S%stems
rinar% fre@uenc% 8 he need to urinate fre@uentl% during the da% or night #nocturia$& usuall% voiding onl% small amounts of urine "ith each episode rinar% urgenc% 8 he sudden& urgent need to urinate& o"ing to the sensation of imminent loss of urine "ithout control 9esitanc% 8 icult% initiating the urinar% streamM interrupted& "ea stream 'ncomplete !ladder empt%ing 8 he feeling of persistent residual urine& regardless of the fre@uenc% of urination Straining 8 he need strain or push #Halsalva maneuver$ to initiate and maintain urination in order to more full% evacuate the !ladder ecreased force of stream 8 he su!=ective loss of force of the urinar% stream over time ri!!ling 8 he loss of small amounts of urine due to a poor urinar% stream
)natom% and 7h%siolog% 7athoph%siolog% iagnostic ests
igital Rectal *Dam 8 prostate sie and contour can !e assessed& nodules can !e evaluated& and areas suggestive of malignanc% can !e detected rinal%sis 8 *Damine the urine using dipstic methods and/or via centrifuged sediment evaluation to assess for the presence of !lood& leuoc%tes& !acteria& protein& or glucose rine culture 8 his ma% !e useful to eDclude infectious causes of irritative voiding and is usuall% performed if the initial urinal%sis (ndings indicate an a!normalit% 7rostate8speci(c antigen 8 )lthough 379 does not cause prostate cancer& men at ris for 379 are also at ris for this disease and should !e screened accordingl% #although screening for prostate cancer remains controversial$ *lectrol%tes& !lood urea nitrogen #3N$& and creatinine 8 hese evaluations are useful screening tools for chronic renal insucienc% in patients "ho have high postvoid residual #7HR$ urine volumesM ho"ever& a routine serum creatinine measurement is not indicated in the initial evaluation of men "ith lo"er urinar% tract s%mptoms #,S$ secondar% to 3791P ltrasonograph% 8 ltrasonograph% #a!dominal& renal& transrectal$ and intravenous urograph% are useful for helping to determine !ladder and prostate sie and the degree of h%dronephrosis #if an%$ *ndoscop% of the lo"er urinar% tract
Bedical8Surgical Banagement
ransurethral resection of the prostate #R7$ Radical prostatectom% 8 used "hen the prostate is ver% enlarged. 'n open surger%& the surgeon maes an incision in the a!domen or !et"een the scrotum and the anus to remove prostate tissue
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rug Studies
alpha8adrenergic !locers 8 !loc e
Nursing Care 7lans
rinar% retention )cute pain Ris for de(cient :uid volume 6ear/)nDiet%
ischarge 7lan 7rognosis he outloo for !enign prostatic h%perplasia is goodM although it can cause signi(cant discomfort& the condition is !enign. )s the prostate gland gro"s in sie& s%mptoms ma% !ecome "orse& "arranting medication or surger%. Jith appropriate medical and/or surgical management& the s%mptoms of an enlarged prostate gland can !e treated e
Dementia with Alzheimer’s disease
*tiolog% 'ncidence Rate 7h%sical )ssessment and Revie" of S%stems )natom% and 7h%siolog% 7athoph%siolog% iagnostic ests Bedical8Surgical Banagement rug Studies Nursing Care 7lans ischarge 7lan 7rognosis
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Cerebroasc!lar Accident he sudden death of some !rain cells due to lac of oD%gen "hen the !lood :o" to the !rain is impaired !% !locage or rupture of an arter% to the !rain. ) CH) is also referred to as a stroe. 'schemic Stroe )n ischemic stroe occurs "hen a !lood clot !locs a !lood vessel& preventing !lood and oD%gen from getting to a part of the !rain. here are t"o "a%s that this can happen. Jhen a clot forms some"here else in %our !od% and gets lodged in a !rain !lood vessel& it is called an em!olic stroe. Jhen the clot forms in the !rain !lood vessel& it is called a throm!otic stroe. 9emorrhagic Stroe ) hemorrhagic stroe occurs "hen a !lood vessel ruptures& or hemorrhages& "hich then prevents !lood from getting to part of the !rain. he hemorrhage ma% occur in a !lood vessel in the !rain& or in the mem!rane that surrounds the !rain. ransient ischemic attac #')$ ) transient ischemic attac #')$ G also called a ministroe G is a !rief period of s%mptoms similar to those %ou;d have in a stroe. ) temporar% decrease in !lood suppl% to part of %our !rain causes ')s& "hich often last less than (ve minutes. ,ie an ischemic stroe& a ') occurs "hen a clot or de!ris !locs !lood :o" to part of %our !rain. ) ') doesn;t leave lasting s%mptoms !ecause the !locage is temporar%.
*tiolog%
3eing over"eight or o!ese 7h%sical inactivit% 9eav% or !inge drining se of illicit drugs such as cocaine and methamphetamines
7otentiall% treata!le ris factors
9igh !lood pressure G ris of stroe !egins to increase at !lood pressure readings higher than 120/K0 millimeters of mercur% #mm 9g$. 5our doctor "ill help %ou decide on a target !lood pressure !ased on %our age& "hether %ou have dia!etes and other factors. Cigarette smoing or eDposure to secondhand smoe. 9igh cholesterol G a total cholesterol level a!ove 200 milligrams per deciliter #.2 millimoles per liter$. ia!etes. O!structive sleep apnea G a sleep disorder in "hich the oD%gen level intermittentl% drops during the night. Cardiovascular disease& including heart failure& heart defects& heart infection or a!normal heart rh%thm.
Other ris factors
7ersonal or famil% histor% of stroe& heart attac or transient ischemic attac. 3eing age or older.
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Race G )frican8)mericans have higher ris of stroe than do people of other races. +ender G Ben have a higher ris of stroe than "omen. Jomen are usuall% older "hen the% have stroes& and the% are more liel% to die of stroes than are men. )lso& the% ma% have some ris from some !irth control pills or hormone therapies that include estrogen& as "ell as from pregnanc% and child!irth.
'ncidence Rate
)ccording to the Jorld 9ealth Organiation& 1 million people su
7h%sical )ssessment and Revie" of S%stems
dicult% "aling diiness loss of !alance and coordination dicult% speaing or understanding others "ho are speaing num!ness or paral%sis in the face& leg& or arm& most liel% on =ust one side of the !od% !lurred or darened vision a sudden headache& especiall% "hen accompanied !% nausea& vomiting& or diiness
)natom% and 7h%siolog% 7athoph%siolog% iagnostic ests
3lood tests- 5our doctor ma% "ant to test %our !lood for clotting time& !lood sugar levels& or infection. hese can all a
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1A
Bedical8Surgical Banagement
*ndovascular 7rocedures 8 *ndovascular procedures ma% !e used to treat certain hemorrhagic stroes similar to the "a% the procedure is used for treating an ischemic stroe. hese procedures are less invasive than surgical treatments& and involve the use of a catheter introduced through a ma=or arter% in the leg or arm& then guided to the aneur%sm or )HBM it then deposits a mechanical agent& such as a coil& to prevent rupture. Surgical reatment 8 6or stroes caused !% a !leed "ithin the !rain #hemorrhagic stroe$& or !% an a!normal tangle of !lood vessels #)HB$& surgical treatment ma% !e done to stop the !leeding. 'f the !leed is caused !% a ruptured aneur%sm #s"elling of the vessel that !reas$& a metal clip ma% !e placed surgicall% at the !ase of the aneur%sm to secure it.
rug Studies
)nticoagulants/)ntiplatelets8 )ntiplatelet agents such as aspirin and anticoagulants& such as "arfarin& interfere "ith the !lood;s a!ilit% to clot and can pla% an important role in preventing stroe. Read more a!out anticoagulants. )ntih%pertensives8 )ntih%pertensives are medications that treat high !lood pressure. epending on the t%pe of medication& the% can lo"er !lood pressure !% opening the !lood vessels& decreasing !lood volume or decreasing the rate and/or force of heart contraction
Nursing Care 7lans
'ne
ischarge 7lan 7rognosis 'f %ou su
Breast Cancer 3reast cancer refers to a malignant tumor that has developed from cells in the !reast. 't is the most common site of cancer in "omen. 't is second onl% to lung cancer as a cause of death from cancer in "omen. 3reast cancer usuall% is discovered !% the "oman herself. She notes a single lump that is painless& non8tender and mova!le "hich is fre@uentl% found in the upper outer @uadrant.
>>? occurrence in female 'ncreasing age highl% associated "ith an increasing ris Ris of developing !reast cancer in same or opposite !reast is signi(cantl% increased 1st8degree relative increases it t"ofoldM 2 1st8degree relatives increases it (vefold 3RC)1 and 3RC)2 mutations 9ighest "hile still developing in %ounger %ears 6at tissue increases estrogen levels Bore research needed 2 to drins dail% increases the ris a!out one and a half times
'ncidence Rate 3reast cancer is the most common cancer in "omen !oth in the developed and less developed "orld. 't is estimated that "orld"ide over 0K 000 "omen died in 2011 due to !reast cancer #+lo!al 9ealth *stimates& J9O 201A$. )lthough !reast cancer is thought to !e a disease of the developed "orld& almost 0? of !reast cancer cases and K? of deaths occur in less developed countries #+,O3OC)N 200K$. 'ncidence rates var% greatl% "orld"ide from 1>.A per 100&000 "omen in *astern )frica to K>.F per 100&000 "omen in Jestern *urope. 'n most of the developing regions the incidence rates are !elo" 40 per 100&000 #+,O3OC)N 200K$. he lo"est incidence rates are found in most )frican countries !ut here !reast cancer incidence rates are also increasing.
7h%sical )ssessment and Revie" of S%stems
Sin dimpling 7eau d;orange Nipple inversion Nipple discharges 7ainless lump 3reast distortion or change in contour
)natom% and 7h%siolog% 7athoph%siolog% iagnostic ests 3reast Self8*Damination #3S*$ is "idel% taught for detection of lumps in the !reast and it should !e done monthl% in "omen older than 1K %ears of age. he )merican Cancer Societ% and National Cancer 'nstitute recommend that mammogram must !e o!tained in "oman !et"een A and A> %ears of age. Jomen !et"een 40 and 4> %ears of age should have a mammogram should have it ever% 2 %ears or annuall% if high ris "hile all "omen at 0 %ears of age or older should have a mammogram ever% %ear. Bammogram
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ltrasound of the !reast Needle aspiration !iops% is sucient if !enign c%sts are suspected& ho"ever& eDcision and !iops% of the mass is the de(nitive diagnosis for malignant tumors. Cancer Staging Q 3reast Cancer Stage 1 Q tumor 2 cm or less in diameterM N0 Q No l%mph nodes ' involvedM B0 Q No metastasis Stage 0 Q 2 Q tumor less than cm in diameterM N1 Q nodes involvedM '' B0 Q no metastasis Stage A Q tumor larger than cm in diameterM N1 or N2 Q nodes ''' involvedM tumor ma% !e (DedM B0 Q no metastasis Stage 4 Q tumor an% sie !ut (Ded to chest "all or sinM N1 Q clavicular 'H nodes involved #spread$M B1 Q metastasis present
Bedical8Surgical Banagement
Bastectom% Radical mastectom% Q Radical mastectom% is the most eDtensive t%pe of mastectom%- he surgeon removes the entire !reast& the l%mph nodes& and the chest "all muscles Bodi(ed radical mastectom% Q Bodi(ed radical mastectom% involves the removal of !oth !reast tissue and l%mph nodes Simple mastectom% Q Simple or total mastectom% concentrates on the !reast tissue itself ,umpectom%
rug Studies Nursing Care 7lans
)cute pain 3od% image distur!ance related to signi(cance of loss of part or all of the !reast )nDiet% 6ear 'm!alanced nutrition- ,ess than !od% re@uirements 'mpaired ph%sical mo!ilit% 'mpaired sin integrit%
ischarge 7lan 7rognosis Several diK.1? for a stage ' !reast cancer !ut also as lo" 2F.1? for a stage 'H cancer.
