Reply To Jennifer Breast

Question 2: When is the ideal time to complete a clinical breast exam?  What steps would you follow for concerning findings on the clinical breast exam? What age or risk factors indicate the need for a mammogram?

           Clinical breast exams are normally done during a woman’s annual vaginal exam.  Normally performed by a healthcare provider with proper training.  The National Comprehensive Cancer Network recommends that a trained provider carefully feel the breast, underarm and the breast bone area for any concerns such as a lump.  Clinical breast exams should be performed every one to three years starting at the age of 20 and every year starting at the age of 40 (Susan G. Komen Staff, 2018).

           The American Cancer Society does not recommend CBE for screening of breast cancer.  Clinical breast examinations lack the evidence to be an effective screening for breast cancer according to The American Academy of Family Physician’s.  The clinical breast exam is a time burden for clinicians, rather it is recommended that more time is spent on the comprehensive assessment of family history and counseling on mammograms and breast changes (Bredemeyer, 2016). 

           If there are abnormal findings during the CBE, it is important to follow with a mammogram or breast ultrasound to identify the concern, if there is a long family history and/or the patient is over 30 years of age. If the patient is under thirty with no family history the physician may decide to watch the area for growth or pain.  Normally that time frame is approximately one or two menstrual periods.  Once the concern is located, and deemed a true concern, biopsy and further testing will be needed.  It is important to note that most abnormal findings are found to be benign, however it is vital to pay close attention to changes in the area of concern and work with the physician to determine course (Bredemeyer, 2016).

           When a patient has a lengthy family history of cancer, either breast or other cancer, yearly mammograms are necessary to determine concerns early.  In recent years there is also Breast magnetic resonance imaging (MRI) that gives a three dimensional look of the breast, this test can also be used after a positive mammogram comes back (Susan G. Komen Staff, 2018).

           It is important to note that if there is a positive screen for breast cancer, it is important to receive a second opinion to ensure that it is not a false positive.  Normally a biopsy will be done to ensure the pathology.

References

Bredemeyer, M. (2016). ACS Releases Guideline on Breast Cancer Screening. American Family Physician, 711-712.

Susan G. Komen Staff. (2018, July 6). Clinical Breast Exam. Retrieved from Susan G. Komen: ww5.komen.org/breastcaner/clinicalbreastexam

 
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Reply To Vivian 19138717

Vivian Hamilton 

Monday 

Feb 18 at 12:08am

 

Manage Discussion Entry 

       Nephrolithiasis is also known as kidney stones. This is typically a hard deposit of material that forms insides the kidneys. The deposits are made of minerals and salts and they can affect any part of the urinary tract. It is common for the stones to form when the urine becomes concentrated which helps make it easier for the minerals to crystallize and stick together forming the stones. Passing these stones is known to be very painful (Mayo Clinic, 2018). 

       More than 5% of adults are affected by kidney stones in the US and most of these stones are calcium with an association to metabolic disorders. Some risk factors for getting kidney stones could be related to a genetic tendency, obesity, and diet (Worcester & Coe, 2009). The change in diet is believed to be a major factor in the rise of kidney stone occurrence. There appears to be a proportional relationship between the increase in kidney stones and the rate of obesity. The obesity increase is thought to be related to an increase in the consumption of starchy foods and corn. The growing consumption of fast-food and high fructose corn syrup is also related to this change. Other changes to diet include a decrease in the amount of fluid that is consumed (Romero, Akpinar, & Assimos, 2010). Having a digestive disease and surgery like a gastric bypass can also contribute to kidney stones (Mayo Clinic, 2018). Knowing the kind of diet that is commonly found in the US, it is no surprise that the US is affected by kidney stones and that this prevalence is increasing. 

Reference

Mayo Clinic. (2018). Kidney Stones. Retrieved from https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755

Romero, V., Akpinar, H., & Assimos, D. (2010). Kidney stones: a global picture of prevalence, incidence, ad associated risk factors. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931286/

Worcester, E. & Coe, F. (2009). Nephrolithiasis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518455/

 
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Reply W4

  

Need help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA style needs to be followed.

4- Each response should have reference at the end

5- Reference should be within last 5 years

 
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Reply W8 Research Reflection

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Report And Summary

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Required Uniform Assignment National Patient Safety Goals

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