Breast Exam
TEACHING PLAN
Olivia D’Amico
Client Initials: A.S age 34
Faculty: Marsha Marecki
NUR 374L
Nursing Diagnosis: Deficient Knowledge r/t importance and performance of breast self exam.
Characteristics: A.S has no children, and has used oral contraceptives to maintain a regular cycle for about 7 yrs. She is overweight, and has a family history of breast cancer. Being 34 and a smoker on OCP’s gives her an increased risk for breast problems. She has never had a mammogram, and is not on a regular schedule for doctor visits. This was the first time she had a visit in 3 years.
Subjective: “I believe my grandmother had breast cancer but why should I start doing a breast self-exam? I am not really sure how to do it myself.”
Objective: Client did not know what a breast self-exam was and stated that her grandmother had breast cancer. She got her first menstrual period when she was 11 years old, and is a white female; both of these factors increase her chances of breast cancer. She is also 5’ 6” and 204 pounds and admitted to having a diet high in fat at times, and is a smoker.
Characteristics that may affect learning: A.S is curious about learning about a BSE. She seemed worried by the fact that breast cancers runs in her family. She said she heard that smoking also may lead to breast cancer and is thinking of quitting. She lives with her girlfriend in a one-bedroom apartment, and works as a computer technician. She enjoys going for walks and maintains a healthy level of stress. She has a 4-year degree from a local college and is well educated. She is willing to learn about modifiable risk factors for breast cancer.
Teaching environment: We were in a well-lit exam room. Client was in an exam gown and the door was shut to maintain privacy.
Others involved: No one else was present in this session.
Learner Behavioral Outcomes | Content | Teaching Strategies | Evaluation | Client will understand why a breast exam in crucial for good health. |
Olivia D’Amico
Client Initials: A.S age 34
Faculty: Marsha Marecki
NUR 374L
Nursing Diagnosis: Deficient Knowledge r/t importance and performance of breast self exam.
Characteristics: A.S has no children, and has used oral contraceptives to maintain a regular cycle for about 7 yrs. She is overweight, and has a family history of breast cancer. Being 34 and a smoker on OCP’s gives her an increased risk for breast problems. She has never had a mammogram, and is not on a regular schedule for doctor visits. This was the first time she had a visit in 3 years.
Subjective: “I believe my grandmother had breast cancer but why should I start doing a breast self-exam? I am not really sure how to do it myself.”
Objective: Client did not know what a breast self-exam was and stated that her grandmother had breast cancer. She got her first menstrual period when she was 11 years old, and is a white female; both of these factors increase her chances of breast cancer. She is also 5’ 6” and 204 pounds and admitted to having a diet high in fat at times, and is a smoker.
Characteristics that may affect learning: A.S is curious about learning about a BSE. She seemed worried by the fact that breast cancers runs in her family. She said she heard that smoking also may lead to breast cancer and is thinking of quitting. She lives with her girlfriend in a one-bedroom apartment, and works as a computer technician. She enjoys going for walks and maintains a healthy level of stress. She has a 4-year degree from a local college and is well educated. She is willing to learn about modifiable risk factors for breast cancer.
Teaching environment: We were in a well-lit exam room. Client was in an exam gown and the door was shut to maintain privacy.
Others involved: No one else was present in this session.
Learner Behavioral Outcomes | Content | Teaching Strategies | Evaluation | Client will understand why a breast exam in crucial for good health. |
References: American Cancer Society. Cancer Facts and Figures 2009. Atlanta, GA: American Cancer Society; 2009. C. Jarvis. (2008). Physical examination & health assessment. St. Louis, Missouri: Saunders Elsevier. Smith RA, Cokkinides V, Brawley OW. Cancer Screening in the United States, 2008: A Review of Current American Cancer Society Guidelines and Cancer Screening Issues. CA Cancer J Clin. 2008;58:161-179. Hislop, T.G, Coldman, A.J, & Skippen, D.H. (1984). Breast self-examination: importance of technique in early diagnosis. Can Med Association, 131. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1483648/pdf/canmedaj00373-0029.pdf