If a patient reports a recent breast infection the nurse would expect to find

Breast cancer can affect one or both breasts and is usually found through an exam or mammogram and then diagnosed through a biopsy to determine if cells are malignant. 

The stage of the breast cancer determines the prognosis and treatment options. Breast cancer stages range from 0 to IV. Stage IV breast cancer means it has spread to other areas of the body and carries a poor prognosis. 

While breast cancer occurs mostly in women, men can get breast cancer as well. The majority of breast cancer occurs in women who are 50 years of age or older. 

The Nursing Process  

Nurses can expect to encounter patients with breast cancer in a variety of settings. Women are routinely assessed for breast cancer and nurses may be involved in performing mammograms. Once diagnosed, nurses will have roles in the patient’s treatment including both outpatient and in the hospital. Nurses provide support and education to their patients before, during, and after treatment for breast cancer. 

Nursing Care Plans Related to Breast Cancer 

Acute Pain Care Plan

Pain associated with breast cancer can be caused by tissue damage from the cancer. It can also be caused by the treatment measures used to fight the cancer. 

Nursing Diagnosis: Acute Pain

Related to: 

• Tumor advancement causing inflammation and compression on nerves and bones 
• Chemotherapy  
• Radiation 
• Surgery 

As evidenced by: 

• Verbalization of pain 
• Body language/guarding behavior 
• Facial grimacing 
• Changes in vital signs 
• Agitation/restlessness 

Expected Outcomes: 

• Patient will verbalize pain is reduced or controlled 
• Patient will demonstrate the ability to perform ADLs due to improved comfort 

Acute Pain Assessment

1. Assess pain appropriately.
Breast cancer can cause pain due to the tumor(s) or from the cancer treatments. The nurse can assess pain by asking the patient their pain level on a 0-10 scale or using a nonverbal pain scale if the patient is unable to rate.

2. Assess pain with vital signs.
Elevated blood pressure, tachycardia, and tachypnea are often seen along with complaints of pain. The nurse can assess if pain is controlled or not by assessing for changes in vital signs. Of course, pain is always subjective and the nurse will treat for pain based on the patient’s report.

3. Examine the patient’s cultural norms regarding pain expression.
Some cultures display pain openly, while others do not. The nurse can address this by assessing for pain often, using verbal and nonverbal pain scales, and remaining understanding and nonjudgmental towards the patient’s beliefs.

Acute Pain Interventions

1. Administer pain medication as prescribed.
Patients being treated for breast cancer often require a combination of opioids and NSAIDs along with antiemetics for nausea caused by chemotherapy to relieve pain and discomfort.

2. Evaluate the effectiveness of pain medication.
After pain medications are administered, evaluate the effectiveness regularly. The dosage and type of medications may need to be adjusted by the physician if the patient’s pain is not controlled.

3. Provide nonpharmacological pain management.
Participating in activities such as distraction, massage, hot/cold compresses, and acupuncture may provide the patient with pain relief and relaxation.

4. Educate patients about side effects and treatment.
Inform the patient about what to expect regarding side effects of chemotherapy, radiation, and other treatments which are often uncomfortable. Educate and encourage patients to be honest about their pain and communicate regularly with their provider.

Fear/Anxiety Care Plan

Fear and anxiety can be caused by the unknown that comes with a breast cancer diagnosis.

Nursing Diagnosis: Anxiety

Related to: 

• Crisis (breast cancer diagnosis) 
• Threat of death 
• Lack of knowledge 
• Unfamiliarity with treatments 
• Change in health status 

As evidenced by: 

• Verbalization of fear or worry 
• Distressed appearance: shaking, hand wringing, restlessness 
• Insomnia 
• Shortness of breath or heart-pounding sensation (acute panic) 
• Crying 
• Difficulty concentrating 
• Lack of appetite 

Expected Outcomes: 

• Patient will verbalize anxiety is decreased to a manageable level 
• Patient will verbalize ways to cope with increasing anxiety/fear 
• Patient will demonstrate ways to recognize symptoms of anxiety and fear at the onset to avoid reaching a panic state 

Fear/Anxiety Assessment

1. Assess expressions of fear/anxiety.
Assess the patient’s verbal and nonverbal expressions of fear/anxiety. Inquire about how they are feeling and evaluate nonverbal expressions.

2. Determine the cause of fear/anxiety.
Actively listen to the patient to show them they can be open about what they are feeling and will not be judged or dismissed. Support but do not provide false reassurances.

3. Assess coping strategies.
Assess the patient’s coping strategies in response to their anxiety/fear. Ask questions about what strategies are or aren’t working. Determine if new strategies need to be implemented.

Fear/Anxiety Interventions

1. Provide a calm environment.
A chaotic or stimulating environment can cause an increase in anxiety. Use a calm and supportive voice when talking with the patient. Patients can pick up on anxiety from the nurse and the surrounding environment.

2. Promote relaxation techniques.
There are a variety of relaxation techniques that may work to help a patient’s anxiety and fear. These include meditation, yoga, deep breathing, guided imagery, and talk therapy. Encourage the patient to try multiple techniques to determine what works best for them.

3. Educate patients on their diagnosis.
The fear of the unknown can come from a lack of information regarding their diagnosis. Evaluate the patient’s understanding of their diagnosis, treatment, and prognosis. Answering questions accurately and addressing misconceptions can ease fear and anxiety.

4. Evaluate support systems.
Determine what kind of support system the patient has. Encourage family support along with support groups. Support groups can include other breast cancer patients, breast cancer survivors, and caregiver groups. Support helps reduce feelings of isolation, which can cause anxiety and fear.

Impaired Skin Integrity Care Plan

Treatments for breast cancer can affect the patient’s skin integrity causing irritation, pain, and other complications as well as increasing the susceptibility to infection. 

What would be an abnormal finding when inspecting the breasts?

Which of the following are normal findings of the breast when examined?

What would be an abnormal finding when inspecting the breasts quizlet?

Which assessment finding in a patient may indicate breast cancer?