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NUR 2502 / NUR2502 Exam 1: Multidimensional Care III / MDC 3 Exam 1 Study Guide (2022/2023) Rasmussen
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NUR2502 Multidimensional Care III / MDC 3 Exam 1 Study Guide
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NUR 2502 MDC III – Exam 1 Study GuideReview the following diseases/disorders:
• Breast Cancer:
o Description
▪ 1. Breast cancer is classified as invasive when it penetrates the tissue surrounding the
mammary duct and grows in an irregular pattern.
▪ 2. Metastasis occurs via lymph nodes.
▪ 3. Common sites of metastasis are the bone and lungs; metastasis may also occur to the
brain and liver.
▪ 4. Diagnosis is made by breast biopsy through a needle aspiration or by surgical removal
of the tumor with microscopic examination for malignant cells.
o Risk factors
▪ 1. Age
▪ 2. Family history of breast cancer due to genetic predisposition
▪ 3. Early menarche and late menopause
▪ 4. Previous cancer of the breast, uterus, or ovaries
▪ 5. Nulliparity, late first birth
▪ 6. Obesity
▪ 7. High-dose radiation exposure to chest
o Assessment
▪ 1. Mass felt during BSE (usually felt in the upper outer quadrant, beneath the nipple, or
in axilla)
▪ 2. Presence of the lesion on mammography
▪ 3. A fixed, irregular nonencapsulated mass; typically painless except in the late stages
▪ 4. Asymmetry
▪ 5. Bloody or clear nipple discharge
▪ 6. Nipple retraction or elevation
▪ 7. Skin dimpling, retraction, or ulceration
▪ 8. Skin edema or peau d’orange skin
▪ 9. Axillary lymphadenopathy
▪ 10. Lymphedema of the affected arm
▪ 11. Symptoms of bone or lung metastasis in late stage
o Self-screening and mammogram recommendations
• Fibrocystic Breast Disorder: Noncancerous changes that give a breast a lumpy or ropelike texture.
The condition is likely due to hormone changes during the menstrual cycle that affect breast tissue.
Symptoms include a change in breast texture, pain or tenderness, and lumpiness. These may be more
bothersome before a period. Most fibrocystic breast changes are normal. Medical evaluation is needed
for new changes.
• Endometrial Cancer:
o Description
▪ 1. Endometrial cancer is a slow-growing tumor arising from the endometrial mucosa of
the uterus, associated with the menopausal years.
▪ 2. Metastasis occurs through the lymphatic system to the ovaries and pelvis; via the
blood to the lungs, liver, and bone; or intra-abdominally to the peritoneal cavity.
o Risk factors
, ▪ 1. Use of estrogen replacement therapy (ERT)
▪ 2. Nulliparity
▪ 3. Polycystic ovary disease
▪ 4. Increased age
▪ 5. Late menopause
▪ 6. Family history of uterine cancer or hereditary nonpolyposis colorectal cancer
▪ 7. Obesity
▪ 8. Hypertension
▪ 9. Diabetes mellitus
o Assessment
▪ 1. Abnormal bleeding, especially in postmenopausal women
▪ 2. Vaginal discharge
▪ 3. Low back, pelvic, or abdominal pain (pain occurs late in the disease process)
▪ 4. Enlarged uterus (in advanced stages)
o Nonsurgical interventions
▪ 1. External or internal radiation is used alone or in combination with surgery, depending
on the stage of cancer.
▪ 2. Chemotherapy is used to treat advanced or recurrent disease.
▪ 3. Progesterone therapy with medication may be prescribed for estrogen-dependent
tumors.
▪ 4. Antiestrogen medication may also be prescribed.
o Surgical interventions
▪ Total abdominal hysterectomy
▪ Bilateral salpingo-oophorectomy
• Cervical Cancer:
o Description
▪ 1. Preinvasive cancer is limited to the cervix (Box 44-9).
▪ 2. Invasive cancer is in the cervix and other pelvic structures.
▪ 3. Metastasis usually is confined to the pelvis, but distant metastasis occurs through
lymphatic spread.
▪ 4. Premalignant changes are described on a continuum from dysplasia, which is the
earliest premalignancy change, to carcinoma in situ, the most advanced premalignant
change.
o Risk factors
▪ 1. Human papillomavirus (HPV) infection (vaccination against HPV is effective to avoid
HPV infection, and thus cervical cancer)
▪ 2. Cigarette smoking, both active and passive
▪ 3. Reproductive behavior, including early first intercourse (before age 17 years), multiple
sex partners, or male partners with multiple sex partners
▪ 4. Screening via regular gynecological examinations and Pap test, with treatment of
precancerous abnormalities, decreases the incidence and mortality of cervical cancer.
o Assessment
▪ 1. Painless vaginal postmenstrual and postcoital bleeding
▪ 2. Foul-smelling or serosanguineous vaginal discharge
▪ 3. Pelvic, lower back, leg, or groin pain
▪ 4. Anorexia and weight loss
▪ 5. Leakage of urine and feces from the vagina
▪ 6. Dysuria
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