A 38-year-old client presents to the clinic office complaining of ...

[dalyningkenk]

A 38-year-old client presents to the clinic office complaining of increased bilateral tenderness of her breasts prior to the onset of menses. On questioning the client, this presentation has occurred off and on for several years,
 
  but the pain has increased. Physical examination reveals lumpy areas bilaterally on the upper outer quadrants of each breast tissue. The areas of concern are approximately 2 cm in size. Based on this assessment, what diagnostic testing would be required? (Select all that apply.)
 
  a. Ultrasound examination
  b. Open biopsy
  c. Fine-needle aspiration (FNA) biopsy
  d. CBC with differential
  e. Mammogram

Question 2

You are taking care of a client who has had a colporrhaphy. Which option would indicate a priority assessment during the postoperative period?
 
  a. Documentation of a pessary in the operative procedure notes by the physician
  b. Removal of vaginal packing as ordered by the physician
  c. Use of a cell saver for transfusion therapy in the postoperative period
  d. Order for removal of staples 2 to 3 days post-procedure

[chloejackso]

Answer to Question 1

ANS: A, C, E
Based on the clinical presentation, the client may have fibrocystic breast disease. Although this condition is typically benign, the fact that the client has noted a change in tenderness should be evaluated. Ultrasound, FNA, and mammography may be indicated to provide a baseline for comparison and rule out any malignancy. An open or surgical biopsy is not indicated at the present time but may be needed if the other test results indicate any pathology. Blood work is not indicated at this time relative to the diagnosis.

Answer to Question 2

ANS: B
Vaginal packing is typically used in this type of pelvic surgery so it is a priority assessment that its removal be verified and documented. A pessary would be used as a nonsurgical intervention for a client who has had uterine prolapse and was not a surgical candidate based on medical history. A cell saver is used in orthopedic surgeries that are at risk for blood loss so that the client's own blood can be re-infused based on established protocol. There are no staples used in this type of surgical procedure, which is also known as an A & P (anterior and posterior) repair.

[dalyningkenk]

Thank you

[chloejackso]

No problemo