RLE 19

• The instructor should recapitulate the previously learnt about the assessment of gastrointestinal and renal system.
• The question(s) I have as we end this session are...
• I will collect the responses as students leave.
• I will respond to students’ feedback during the next class meeting or as soon as possible.
• The most useful or meaningful thing I learned this session was...
• The ribs and intercostal muscles are attached to the scapular fascia.
• The ribs and intercostal muscles are attached to the pectoral and scapular muscles.
• The main lesson discusses the anatomy of chest walls and structures, and the instructor should discuss the topics.
• The ribs and intercostal muscles are attached to the pectoral fascia.
• The review of anatomy of chest walls is identified and the structures are discussed with detailed illustrations.
• The nurse can utilize OLD CART mnemonic to ask questions in order to obtain a full description of the condition.
• Symptoms such as lump mass, pain or discomfort, change in shape, discharge, edema, rashes or scaling, dimpling, retractions and gynecomastia for males are common in the health care setting.
• Lymphatic obstruction, inflammation, cyst, and fibrocystic disease are potential diagnoses when a patient presents with thickening of the skin and unusually prominent pores on their right breast.
• The best time for examination of the breast is 3 to 5 days after the onset of menstruation.
• A mobile mass that becomes fixed when a patient's arm relaxes can indicate that the mass is benign.
• Breast discomfort is a symptom that can be considered in breast examination.
• Edema is a condition that can be present in breast examination.
• The supra to infra pattern is the best validated technique for detecting breast masses.
• Infraclavicular nodes are a common concern in breast examination.
• Scaling refers to thin flakes of keratinized epithelium.
• During breast palpation, the breast tissue should be examined carefully for dimples, nodules, tenderness, consistency, rash, and other abnormalities.
• A common or concerning symptom in breast examination is bilateral green nipple discharge.
• Leaning forward during breast examination can reveal retraction of the nipple and areola.
• A nurse must learn how to assess carefully patients presenting these symptoms.
• For detailed discussion and examples employing the “ OLD CART ”, please refer to page 541 - 543.
• The health history includes gathering information about the onset, location, duration, characteristics, associated manifestations, relieving/exacerbating factors, and treatment of symptoms.
• Inspect the left axilla for rash, infection, unusual pigmentation, and palpate the axilla for nodes.
• Palpate in small, concentric circles at each examining point, applying light, medium, and deep pressure.
• The pectoral nodes are the most often palpable axillary nodes.
• High impact facts and tables are also part of health promotion and counselling.
• One or more soft, small (>1 cm), nontender nodes are frequently felt in the axilla.
• Use the fingerpads of the 2nd, 3rd, and 4th fingers, keeping the fingers slightly flexed.
• Assessment of nipple discharge, examination of the mastectomy or breast augmentation patient, and self-awareness and instruction for BSE are special techniques in health promotion and counselling.
• Inspect the nipple and areola for nodules, swelling, or ulceration, and palpate the areola and breast tissue for nodules.
• If the breast appears enlarged, distinguish between the soft fatty enlargement of obesity and the firm disc of glandular enlargement, called gynecomastia.
• For detailed explanation, please refer to page 549-550.
• The nursing student is learning to palpate the axillary nodes during a breast examination.
• Malignant cells from a breast cancer may spread directly to the medial nodes.
• Examine the breast tissue carefully for consistency, tenderness, nodules, and document the characteristics of any nodule.
• The vertical strip pattern is the best validated technique for detecting breast masses.