1 / 37

ASSESSING THE BREASTS

ASSESSING THE BREASTS. NUR211 Kathleen Hancock. Outcomes. Obtain a breast history. Perform a breast physical assessment. Document breast assessment findings . Identify pertinent breast history questions. (Continued). Outcomes.

bailey
Download Presentation

ASSESSING THE BREASTS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. ASSESSING THE BREASTS NUR211 Kathleen Hancock

  2. Outcomes • Obtain a breast history. • Perform a breast physical assessment. • Document breast assessment findings. • Identify pertinent breast history questions. (Continued)

  3. Outcomes • Identify actual/potential health problems stated as nursing diagnosis. • Differentiate between normal and abnormal findings.

  4. Breast Composition • 3 types of tissue: • *Glandular • *Fibrous • *Adipose

  5. Structures • Lobes and lobules • Lactiferous ducts and sinuses • Areola • Montgomery’s glands

  6. Structures • Nipple • Cooper’s ligament • Pectoralis major and serratus anterior muscles

  7. FunctionsWhat are the functions of… Lobes & lobules: Contain acini cells that produce milk Lactiferous ducts & sinuses: Carry and store milk Areola: Dark tissue surrounding nipple (Continued)

  8. FunctionsWhat are the functions of… Montgomery’s glands: Sebaceous gland Nipple: Nursing and sexual stimulation Cooper’s Ligament: Ligament attached to chest wall muscles that supports breasts (Continued)

  9. FunctionsWhat are the functions of… Pectoralis major & serratus anterior muscles: Breast overlies these muscles Lymph nodes: Drain breast, chest, and arms

  10. Breast Health:Cancer Prevention • Self Breast Exam (SBE) • Every month • Mammogram • After age 50 every year • More frequent if personal or family history • 40-49 years every 1-2 years • Breast Exam by nurse or doctor every year

  11. DevelopmentalVariations What developmental breast variations might be seen with: • Children • Pregnant clients • Older adults

  12. HistoryWhat can the history tell you about the breast? • Biographical data • Current health status • Past health history • Family history • Review of systems • Psychosocial history

  13. SymptomsWhat symptoms signal a problem with the breasts? • Breast lump or mass • Pain or tenderness • Nipple discharge

  14. Physical Assessment Anatomical landmarks: quadrants of the breast, include Tail of Spence Approach: inspection, palpation (vertical, wedge, or circular) light, medium, and deep (Continued)

  15. Physical Assessment Position: sitting, hands on hips, hands over head, leaning forward, and supine with pillow under shoulder Tools: small pillow or towel, ruler, gloves, slide, and culture slide. General survey and head-to-toe scan

  16. Sitting, arms at sides

  17. Arms overhead

  18. Arms pressing on hips

  19. Leaning forward

  20. Inspection Breasts: size, shape, symmetry, color, lesions, venous pattern, dimpling, or retraction Nipple and areola: nipple position and direction; discharge Axillae: color, lesions, rashes

  21. Palpation Lymph nodes: axillary, epitrochlear, clavicular while sitting Breasts: consistency, masses, tenderness in supine position Nipple: elasticity, masses, tenderness, discharge

  22. Supraclavicular Nodes

  23. Infraclavicular Nodes

  24. Axillary Nodes

  25. Palpate Epitrochlear Nodes

  26. Supine with shoulder support –Use pads of fingers of dominant hand

  27. Strip Method of Palpation • Cover all of breast • Use 3 middle finger pads, not tips • Use sliding motion • Overlapping dime size circles • 3 pressure levlels: light, medium, deep • Include nipple and areola

  28. Large Breasts • Bimanual palpation to adequately examine all areas • Often have an intramammary ridge

  29. Male Breast • Palpation • Inspection • Lymph nodes while sitting • Breast while sitting or if large while lying down

  30. Male Breast Enlargement: • Gynecomastia

  31. Characteristics of Masses Note: • Size  Shape • Mobility  Tenderness • Consistency  Delimitation • Temperature  Redness

  32. Example: Pertinent Physical Findings • Right breast larger than left • No dimpling, retraction • Small, pea size (0.5cm), movable, rubbery, smooth-edged lesion in right breast at 2 o’clock in RUQ • No palpable nodes

More Related