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    Assessment of The Breast: Subjective Data

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    Yousef Khalifa
    This document provides guidelines for assessing the breast through obtaining a patient history and performing a physical examination. It outlines topics to discuss in the patient history including breast manifestations, general health information, and gynecologic/obstetric history. The physical examination should follow outlined guidelines. It provides recommendations for early detection of breast issues based on a woman's risk level, including annual mammograms starting at age 40 and clinical breast exams.

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    Assessment of The Breast: Subjective Data

    Uploaded by

    Yousef Khalifa
    89 views2 pages
    This document provides guidelines for assessing the breast through obtaining a patient history and performing a physical examination. It outlines topics to discuss in the patient history including breast manifestations, general health information, and gynecologic/obstetric history. The physical examination should follow outlined guidelines. It provides recommendations for early detection of breast issues based on a woman's risk level, including annual mammograms starting at age 40 and clinical breast exams.

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    This document provides guidelines for assessing the breast through obtaining a patient history and performing a physical examination. It outlines topics to discuss in the patient history including breast manifestations, general health information, and gynecologic/obstetric history. The physical examination should follow outlined guidelines. It provides recommendations for early detection of breast issues based on a woman's risk level, including annual mammograms starting at age 40 and clinical breast exams.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    89 views2 pages

    Assessment of The Breast: Subjective Data

    Uploaded by

    Yousef Khalifa
    This document provides guidelines for assessing the breast through obtaining a patient history and performing a physical examination. It outlines topics to discuss in the patient history including breast manifestations, general health information, and gynecologic/obstetric history. The physical examination should follow outlined guidelines. It provides recommendations for early detection of breast issues based on a woman's risk level, including annual mammograms starting at age 40 and clinical breast exams.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    ASSESSMENT OF THE BREAST

    SUBJECTIVE DATA

    Obtain a nursing history about specific breast complaints and general health
    information from the patient to plan care and appropriate patient teaching.

    Breast Manifestations

     Palpable lumps—date noted; affected by menstruation; changes noted since


    detection.
     Nipple discharge—date of onset, color, unilateral or bilateral, spontaneous or
    provoked.
     Pain or tenderness—localized or diffuse, cyclic or constant, unilateral or
    bilateral.
     Date of last mammogram and result.
     Patient's practice of breast self-examination (BSE).

    History

    General Information

     Age.
     Past medical-surgical history; injuries; bleeding tendencies.
     Medications, including current or prior use of hormonal contraceptives and
    hormones, over-the-counter (OTC) products, vitamins, and herbal
    supplements.

    Gynecologic and Obstetric History

     Menarche.
     Date of last menses.
     Pregnancies, miscarriages, abortions, deliveries.
     Lactation history.
     Prior breast history, including previous history of irradiation involving breast
    region.
     Family history of breast cancer.

    PHYSICAL EXAMINATION

    Perform a breast examination, as outlined in Procedure Guidelines 23-1. Remind all


    women of the importance of routine checkups with breast examination. Although BSE
    is a first step in prevention of breast cancer, it has not been shown to be effective in
    reducing mortality. However, it does allow women to become more comfortable and
    familiar with their own bodies.
    Guidelines for Early Detection

    Women at Average Risk

     Begin annual mammography at age 40. Annual clinical breast examination


    should be performed prior to mammography.
     For women in their 20s and 30s, it is recommended that clinical breast
    examination be part of a periodic health examination, preferably at least every
    3 years. Asymptomatic women age 40 and older should continue to receive a
    clinical breast examination as part of a periodic health examination, preferably
    annually.
     Beginning in their 20s, women should be told about the benefits and
    limitations of BSE. The importance of prompt reporting of any new breast
    symptoms to a health care professional should be emphasized. Women who
    choose to do BSE should receive instruction and have their technique
    reviewed on the occasion of a periodic health examination. It is acceptable for
    women to choose not to do BSE or to do BSE irregularly.

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