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Published by: Princess Sison Landingin on Jun 10, 2012
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Modified Radical Mastectomy

In a modified radical mastectomy, the entire breast is removed, including the skin, areola and nipple, as well as most of the lymph nodes in the armpit area. Modified radical mastectomy is usually recommended if the tumor is large and cancer has already spread to the lymph nodes.

http://www.mayoclinic.org/breast-cancer/radicalmastectomy.html
MOA: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) chemically related to indomethacin and tolmetin. Ketorolac tromethamine is a racemic mixture of [-]S- and [+]R-enantiomeric forms, with the S-form having analgesic activity. Its antiinflammatory effects are believed to be due to inhibition of both cylooxygenase-1 (COX-1) and cylooxygenase-2 (COX-2) which leads to the inhibition of prostaglandin synthesis leading to decreased formation of precursors of prostaglandins and thromboxanes from arachidonic acid. The resultant reduction in prostaglandin synthesis and activity may be at least partially responsible for many of the adverse, as well as the therapeutic, effects of these medications. Analgesia is probably produced via a peripheral action in which blockade of pain impulse generation results from decreased prostaglandin activity. However, inhibition of the synthesis or actions of other substances that sensitize pain receptors to mechanical or chemical stimulation may also contribute to the analgesic effect. IND: For the short-term (~5 days) management of moderately severe acute pain that requires analgesia at the opioid level, usually in a postoperative setting.
Cefoxitin Antibiotic, Cephalosporin (Second Generation) I: MOA: Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested. NR:Administer around-the-clock rather than 4 times/day, 3 times/day, etc, (ie, 12-6-12-6, not 9-1-5-9) to promote less variation in peak and trough serum levels; modify dosage in patients with renal insufficiency; can be administered IVP over 3-5 minutes at a maximum concentration of 100 mg/mL or I.V. intermittent infusion over 10-60 minutes at a final concentration for I.V. administration not to exceed 40 mg/mL

http://drugsarea.com/Dets-Drugs/Cefoxitinpd.html Ciproloxacin
I: Treatment of documented or suspected infections Antibiotic, Ophthalmic; Antibiotic, Quinolone

first parenteral NSAID for analgesia. respiratory depression. Accelerates intestinal transit and gastric emptying by preventing relaxation of gastric body and increasing the phasic activity of antrum. this action is accompanied by relaxation of the upper small intestine. prevention of nausea associated with chemotherapy or postsurgery and facilitates intubation of the small intestine MOA: Dopaminergic blocking agents—Gastrointestinal emptying (delayed) adjunct. gastroesophageal reflux. preoperative analgesia. Decreases .MOA:Inhibits DNA-gyrase in susceptible organisms. implement safety measures. 30 mg provides the analgesia comparable to 12 mg of morphine or 100 mg of meperidine MOA:Inhibits prostaglandin synthesis by decreasing the activity of the enzyme. causing inhibition of ascending pain pathways. resulting in an improved coordination between the body and antrum of the stomach and the upper small intestine. peristaltic stimulant: Exact mechanism of action is unknown. cyclo-oxygenase. assist with ambulation. such as an increased appetite and activity Nubain Analgesic. Prokinetic Dopaminergic blocking agent— gastrointestinal emptying (delayed) adjunct— peristaltic stimulant— antiemetic— I: Symptomatic treatment of diabetic gastric stasis. Narcotic I:Relief of moderate to severe pain. it is believed that metoclopramide inhibits gastric smooth muscle relaxation produced by dopamine. altering the perception of and response to pain. however. postoperative and surgical anesthesia. and obstetrical analgesia during labor and delivery Observe patient for excessive sedation. which results in decreased formation of prostaglandin precursors Nursing Implications Monitor for signs of pain relief. At the same time. inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA NR: Hold antacids for 2 hours after giving Ketorolac Nonsteroidal Anti-Inflammatory Agent (NSAID) I:Short-term (<5 days) management of pain. produces generalized CNS depression Metoclopramide Gastrointestinal Agent. thus enhancing cholinergic responses of the gastrointestinal smooth muscle. observe for narcotic withdrawal NR: MOA: Binds to opiate receptors in the CNS.

” .000 participants from 30 countries. These alarming statistics. it is 1 in 18. the Philippines has the highest incidence rate of breast cancer and is considered to have the ninth highest incidence rate in the world today. Using detailed analysis of 47 published studies with nearly 150. were cited by the World Health Organization (WHO) in a statement over the weekend. the organization said. It also cited a study by Cancer Research UK that had found a significant explanation. and almost 500. 2008 Philippines’ breast-cancer incidence rate Asia’s highest Breast cancer is the leading killer of women ages 35 to 54 worldwide. Today. “reinforces the long held view that hormonal and reproductive factors are vital in the development of breast cancer. {61} {62} Sunday. According to the WHO.reflux into the esophagus by increasing the resting pressure of the lower esophageal sphincter and improves acid clearance from the esophagus by increasing amplitude of esophageal peristaltic contractions Antiemetic—Dopamine antagonist action raises the threshold of activity in the chemoreceptor trigger zone and decreases the input from afferent visceral nerves. approximately 70 percent of breast cancers occur in women with none of the known risk factors. the WHO said. particularly in developing countries. the risk for breast cancer was 1 in 22. supposed authorities in the field are baffled why. Only about 5 percent of breast cancer are inherited.000 women die from it every year. More than a million develop the disease without knowing it. In Asia. researchers found that the increase in incidence rate of the disease in Western countries is caused by women having fewer children and breastfeeding for shorter periods of time. With the prevalence of breast cancer consistently rising for the past 30 years. October 05. In the 1940s. obtained from reports of the International Agency for Research on Cancer. {01} High doses of metoclopramide have been found to antagonize 5-hydroxytryptamine (5-HT) receptors in the peripheral nervous system in animals. This conclusion.

age group. getting the facts. . tubular carcinoma cells have a distinctive tubular structure when viewed under a microscope. and finding hope. Ductal Carcinoma In-Situ (DCIS) DCIS is a type of early breast cancer confined to the inside of the ductal system. This breast cancer type represents 5% of all diagnosis. Women in the United States get breast cancer more than any other type of cancer except for skin cancer. Typically this type of breast cancer is found in women aged 50 and above. including mammography. It can be the beginning of learning how to fight. Obviously no woman wants to receive this diagnosis. Often positive for estrogen and progesterone receptors. Infiltrating Ductal Carcinoma (IDC) IDC is the most common type of breast cancer representing 78% of all malignancies. It is second only to lung cancer as a cause of cancer death in women. presenting with cells that resemble the medulla (gray matter) of the brain. these tumors respond well to hormone therapy.000 women will be diagnosed with breast cancer and more than 40. It is considered a heterogeneous disease—differing by individual. Medullary Carcinoma Medullary carcinoma accounts for 15% of all breast cancer types.000 will die. TYPES OF BREAST CANCER Types of Breast Cancer Breast cancer type is categorized by whether it begins in the ducts or lobules. It has an excellent 10-year survival rate of 95%.700 men will also be diagnosed with breast cancer and 450 will die each year. It most frequently occurs in women in their late 40s and 50s.http://archives.net/national/2008/oct/05/yehey/metro/20081005met6. Each year it is estimated that nearly 200.html What is Breast Cancer? Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. the organs responsible for breast milk production. These lesions appear as stellate (star like) or well-circumscribed (rounded) areas on mammograms. Tubular Carcinoma Making up about 2% of all breast cancer diagnosis. Understanding the specific type of breast cancer can help you ask better questions and work with your physicians to get the best breast cancer treatments. Approximately 1. and even the kinds of cells within the tumors themselves. The evaluation of men with breast masses is similar to that in women. The stellate lesions generally have a poorer prognosis. but hearing the words “breast cancer” doesn’t always mean an end.manilatimes. Infiltrating Lobular Carcinoma (ILC) Infiltrating lobular carcinoma is a type of breast cancer that usually appears as a subtle thickening in the upper-outer quadrant of the breast.

it is more common as women grow older. According to the American Cancer Society.V.aspx Invasive ductal carcinoma (IDC). According to the American Cancer Society.Mucinous Carcinoma (Colloid) Mucinous carcinoma represents approximately 1% to 2% of all breast carcinoma. IBC accounts for 1% to 5% of all breast http://www. This type of breast cancer's main differentiating features are mucus production and cells that are poorly defined. higher doses to be administered IVPB. about two-thirds of women are 55 or older when they are diagnosed with an invasive breast cancer. Invasive ductal carcinoma also affects men. Over time. About 80% of all breast cancers are invasive ductal carcinomas. Most of them are diagnosed with invasive ductal carcinoma. rapid boluses cause transient anxiety and restlessness followed by drowsiness. All together. invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body.org/symptoms/types/idc/ NR: Parenteral doses of up to 10 mg should be administered I. Although invasive ductal carcinoma can affect women at any age. http://www.000 women in the United States find out they have invasive breast cancer each year. push over 1-2 minutes. which are the “pipes” that carry milk from the milk-producing lobules to the nipple. is the most common type of breast cancer. more than 180. dilute to 0. This type of breast cancer is called "inflammatory" because the breast often looks swollen and red. Inflammatory Breast Cancer (IBC) Inflammatory breast cancer is a rare and very aggressive type of breast cancer that causes the lymph vessels in the skin of the breast to become blocked.breastcancer. Ductal means that the cancer began in the milk ducts.nationalbreastcancer. Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues.org/About-Breast-Cancer/Types. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. “invasive ductal carcinoma” refers to cancer that has broken through the wall of the milk duct and begun to invade the tissues of the breast. sometimes called infiltrating ductal carcinoma. or "inflamed". It also has a favorable prognosis in most cases.2 mg/mL (maximum concentration: 5 mg/mL) and infuse over 15-30 minutes (maximum rate of .

the enzyme involved in protecting the stomach from ulcers. an enzyme in the body. . as soon as is practical. Non-narcotic I: Relief of moderate to moderately severe medical pain MOA: Binds to -opiate receptors in the CNS causing inhibition of ascending pain pathways.infusion: 5 mg/minute). rapid I. stop your treatment with Arcoxia and consult a doctor. COX-1. altering the perception of and response to pain. which also modifies the ascending pain pathway NR: Avoid driving or operating machinery until the effect of drug wears off. also inhibits the reuptake of norepinephrine and serotonin. among other functions. tramadol has not been fully evaluated for its abuse potential. while COX-2 plays a role in joint inflammation and pain. chest pains or ankle swelling appear or worsen. Arcoxia does not block COX-1. Arcoxia reduces pain and inflammation by blocking COX-2. If any of the following symptoms: shortness of breath. The body produces two similar enzymes called COX-1 and COX-2. is involved with protecting the stomach. report cravings to your physician immediately Arcoxia is used for the following:      acute and chronic treatment of the signs and symptoms of osteoarthritis and rheumatoid arthritis management of ankylosing spondylitis relief of chronic musculoskeletal pain relief of acute pain to treat acute gouty arthritis Your doctor will prescribe Arcoxia for you only after you have used other medicines for your condition and they have not been suitable for you Arcoxia belongs to a group of medicines called cyclooxygenase-2 (COX-2) specific inhibitors (also known as coxibs).V. followed by drowsiness Monitor periodic renal function test Tramadol Analgesic. administration is associated with a transient but intense feeling of anxiety and restlessness.

Ineffective Role Performance | Nursing Care Plan (NCP) Rheumatoid Arthritis) Add This To Del. Ascertain how client views self in usual lifestyle functioning. impaired mobility Possibly evidenced by Change in structure or function of affected parts Negative self-talk.icio. Formulate realistic goals and plans for future. focus on past strength and function. increased energy expenditure. physical ability to resume roles.usTweet/ReTweet ThisShare on FacebookStumbleUpon ThisAdd to TechnoratiDigg This Nursing diagnosis: ineffective Role Performance related to changes in ability to perform usual tasks. and possible limitations. Encourage verbalization about concerns of disease process and future expectations. . hopelessness Desired Outcomes/Evaluation Criteria—Client Will Psychosocial Adjustment: Life Change Verbalize increased confidence in ability to deal with illness. dependence on significant other (SO) for assistance Change in social involvement. including sexual aspects. 2. loss of employment. changes in lifestyle. sense of isolation Feelings of helplessness. appearance Change in lifestyle. Rationale: Provides opportunity to identify fears or misconceptions and deal with them directly. Discuss meaning of loss or change to client and SO. Nursing intervention with rationale: 1.

7. Acceptance provides feedback that feelings are normal. Give positive reinforcement for accomplishments. 10. Refer to psychiatric counseling. such as psychiatric clinical nurse specialist. Assist with grooming needs. Rationale: Verbal and nonverbal cues from SO may have a major impact on how client views self. Rationale: Allows client to feel good about self. Involve client in planning care and scheduling activities. Rationale: Helps client maintain self-control. 9. Rationale: May suggest emotional exhaustion or maladaptive coping methods. 8. and feelings of anger and hostility are common. Rationale: Enhances feelings of competency and self-worth and encourages independence and participation in therapy. Assist client to identify positive behaviors that will aid in coping. Rationale: Constant pain is wearing. 5. or overconcern with body and changes. Note withdrawn behavior. Acknowledge and accept feelings of grief. Rationale: Maintaining appearance enhances self-image. psychiatrist/psychologist.Rationale: Identifying how illness affects perception of self and interactions with others will determine need for further intervention or counseling. enhancing self-esteem. Discuss client’s perception of how SO perceives limitations. and dependency. 4. hostility. requiring more in-depth intervention and psychological support. Set limits on maladaptive behavior. Reinforces positive behavior. 6. 3. as necessary. . Enhances confidence. use of denial. Rationale: Client/SO may require ongoing support to deal with long-term debilitating process. and social worker.

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