NR602 Week 1 IHuman Nursing

Nursing: NR602 Week 1 IHuman

A woman of age 42 tells about two breast lumps for which clinical examination is to be conducted. Breast lumps are sometimes not serious as they go away on their own if they are not painful, mainly because of a benign breast condition. However, in this patient’s case, the woman has a family history of breast cancer and has been diagnosed personally for her medical breast illnesses. This paper aims to deliver three differential diagnoses and actual prescriptions for the patient’s final diagnosis, along with patient education prospects.

Three Differential Diagnoses

The three differential diagnoses that could be the reasons for lumps in the patient’s breasts are as follows:

i. Ductal hyperplasia, for which the patient has a history as well. The overgrowth of the cells with fluid inside, mainly not painful, inside the breast could be possible for the current condition and now had reoccurred. Though it has been studied that ductal hyperplasia does not regularly cause breast lumps, since the patient has a medical history, there are chances of alterations in the breast formation with age progression that could be better detected through a mammogram (American Cancer Society, n.a.).

ii. Anorexia and similar eating disorders could be related to the occurrence of breast lumps since changes in diet could pose serious health risks to the reproductive abilities of a woman’s body (O’Brien et al., 2018). The intervening influences of these associating factors should also be probed before reaching a final diagnosis.

iii. It is appropriate to look for numerous factors like the use of the type of bra, pain in the breast, contraception methods, and hospitalization of the case’s patient; however, the stage of menopause should also be taken into consideration since it has been known that women’s advancement in age cause different hormonal changes in her body, especially when there is a family history of the related condition as well (Watson, 2019).

Actual Prescription Appropriate For Final Diagnosis

Although Ductal hyperplasia is not prone to causing breast cancer, since the patient has a family background in breast cancer, the use of Tamoxifen is recommended for reducing the chances of developing cancer in later stages of life as the condition has reoccurred (Johns Hopkins, n.a.). The dosage for this medicine could be 20 mg tablet, twice daily (morning and night) for six months.

Since the patient has not mentioned pain, the home treatment for breast lump or cysts could be done with the help of heat treatment (Stoppler, 2019). A warm wet cloth should be applied to the affected area to remove them gradually. The cloth could be warmed in a microwave to put on the affected area of the breast.

Patient Education

The patient must be educated regarding breast lumps or cysts, especially those with an associated history with Ductal hyperplasia, that fluid-filled lump is not painful (Staradub, 2020). Suppose they occur again when a woman ages 30 years or above. In that case, they must be examined via mammography or ultrasound, through which the physician would be able to understand its physical anatomy. Also, the needle treatment would be required to determine if the lump is firm or fluid-filled and soft. If the lump is found to be firm and solid, then those women have suggested a biopsy.

A biopsy would be further needed for examining the newly formed lump so that the small sample of the newly emerging tissue could be taken with a needle for core examination (Staradub, 2020). If the abnormal condition of the breast lump is not detected via the bare eye, then a needle biopsy would be needed for examination under a microscope.

Patient Education Regarding Prescribed Medications

The patient should be given detailed knowledge about the prescribed medicine to be aware of its side effects, if any, and her previous physical conditions like anorexia. Tamoxifen is mainly given to breast cancer patients or those at high risk of developing breast cancer (National Cancer Institute, 2021). It is recommended for decreasing the probability of invasive cancer, especially when the patient has a background of such a condition. The medicine is tested to stop the growth of tumor cells and swellings created in the form of cysts or lumps within the breast area. It helps in blocking the enzymes producing the outgrowth of lumps and its associated cell growth. The primary function of the medicine is to kill the cells, stop them from multiplying, and spreading to other body parts. Additionally, its prolonged use can cause side-effects like skin rash, fatigue, headaches, vaginal discharge, nausea, swelling in the legs, cause irregularities in the menstrual cycle or alterations in menopause periods, weight gain, and sweating during the night, etc. (Cleveland Clinic, 2020).

Just as heat or thermal radiation therapy helps eradicate breast cancer, it is advised that the patient must apply a warm towel or cloth to the affected area at home. Although breast lump is not serious but avoids its aggravation to cancer development, it should be properly treated in the initial stages. The blood flow would improve through heat pack treatment that would regulate the oxygen and reduce the size of the lump (Cancer Connect, 2018).