Problem: A 31 years old African American female presents to the primary care provider and reports "I have lumps in both my breasts and they are very, very tender. "She reports having had lumpy breast tissue bilaterally for years; however, for the past 2 months, she has noticed that the lumps are increasing in size and breasts have become more tender. States increased breast tenderness begins 2-3 days before menses, rating pain as 5-6 on a scale of 1-10, and continues for 2-3 days into menses. Takes acetaminophen with no relief, and ibuprofen with slight relief. She reports no personal history of breast cancer, breast surgeries, or breast trauma. Menarche age 12. Gravida 3 Para 3. Birth of first child at age 21. The last menstrual cycle began 2 weeks ago, with a duration of 5 days. Denies taking any hormones, contraceptives, or antipsychotic medications. Denies exposure to radiation, benzene, or asbestos. The last clinical breast examination was performed 1 year ago. Denies ever having had a mammogram.
She reports no history of breast cancer in her sisters, mother, or maternal grandmother. Her maternal aunt died from breast cancer. She has smoked 1 pack of cigarettes per day for the past 10 years. Drinks approximately 50-60 oz. of caffeinated beverages per day. Denies a regular exercise program but tries to walk as much as she can.
Reports performing BSEs every month but that sometimes it is difficult to do because of bilateral breast tenderness. States that she is happy with the size of her breasts but does not like how they have sagged since the birth of her children.
1. Identify a minimum of three subjective cues (risk factors) that are clinically significant and provide a brief rationale for each cue.
2. Based on the clinically significant data, what health condition is the client experiencing.
3. Using your words, describe the pathophysiology consistent with this condition.
4. Describe a minimum of three objective signs you will anticipate on inspection and palpation.
5. Discuss one health promotion teaching topic- relevant to the identified health condition.
6. Discuss one older adult teaching topic relevant to the identified health condition.