Please enable JavaScript.
Coggle requires JavaScript to display documents.
K.J. 68 y/o female (Medical History (Hypothyroidism (Pathophysiology:…
K.J. 68 y/o female
Medical History
Routine mammography revealed lesion in left breast. Biopsy revealed infiltrating ductal carcinoma w/ DCIS w/ central necrosis. Tumor was ER positive, PR positive, and HER2 negative. Pt elected to undergo bilateral mastectomy and immediate breast reconstruction
h/o A fibb
Pathphysiology: common heart rhythm disorder caused by degeneration of the electrical impulses in the atria resulting in a change from an organized heart rhythm to a rapid, chaotic rhythm.
Family history of breast cancer
Hypothyroidism
Pathophysiology: reduction of the basal metabolic rate and generalized myxedema
Common Clinical findings:fatigue, cold intolerance, weight gain, periorbital edema
Migraines
Pathophysiology: a form of neurovascular headache in which neural events result in dilation of blood vessels aggravating the pain and resulting in further nerve activation.
Osteoarthritis
Pathophysiology:degradation of cartilage and remodeling of bone due to an active response of chondrocytes in the articular cartilage and the inflammatory cells in the surrounding tissues.
Skin Cancer
Medications
Carvedilol
Beta blocker; check BP before administering
Cefazolin
Anti-infective; bactericidal against most gram-positive cocci
Hydrocodone-Acetaminophen
Pain, inflammaiton
Dialauded
Pain
Respiratory Depression! Monitor R, hold for low respirations
Ondansetron
Anti-emetic
For migraines, post op nausea/vomiting
Social History
Patient is a retired CICU nurse
Husband is a retired plastic surgeon
Labs
Glucose: 100
Increased, maybe due to stress from surgery
Treatments
Bilateral Mastectomy
Surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer
Post op considerations
Monitor patient for infection, bleeding, pain, atelectasis
Educate patient on managing tubes and drains
Activity restrictions
s/s of infection
when to resume wearing a bra or breast prosthesis
Pathology report education
When pt. will recieve
Next steps
Risks
Bleeding, infection, pain, lymphedema, scar tissue at surgical site, shoulder pain, stiffness, numbness form lymph removal, hematoma
Admission Diagnosis: Bilateral Mastectomy; Breast reconstruction w/ expanders and alloderm; Biopsy sentinel node