Table Group 3- Skin Cancer Case Study Patient Profile SN., a 30-year-old whitewo
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Question
Table Group 3- Skin Cancer Case Study Patient Profile SN., a 30-year-old whitewoman, comes to the clinic for·phrical ram u on-wanned eyes. She works as a waitress and loves outdoor sports. i t- Subjective Data Wants a "checkup" because her father recently died of melanoma . Wants to know if she will get this cancer Loves the "outdoors" and swims every day Objective Data . Blood pressure 112/68, pulse 60, temperature 97.6 F, respirations 16 . Height 5'5, weight 125 Ibs eArms, legs, and face are darkly tanned Skin examination within normal limits, no evidence of lesions, rashes, or pigment changes Discussion Questions 1. What is the priority of care for S.N. and why? 2. Along with the physical examination, what other form of nursing assessment is indicated? 3. How do you distinguish between a normal mole and malignant melanoma? 4. List 7 risk factors for the development of skin cancer. What factors does S.N. have? What would you include in a teaching plan for S. N. to reduce her risk of developing precancerous and cancerous lesions? 5. 6. What treatment is indicated for melanoma?Explanation / Answer
1. The main cause of melanoma is over exposure to sunlight and ultraviolet light. MS. S N is developing darkly tanned skin due to this. certain skin cancers are caused by factors other than UV — such as genetics or environmental influences — and may occur on parts of the body rarely exposed to the sun. The priority care for MS. SN is avoidance of exposure to sunlight and use of sunscreens to an extend prevent causing skin cancer.
2. Along with physical examination, nurse should record her family history of melanoma and skin cancer, lifestyle and habit such as duration of time spend outdoors, any habits of smoking or exposure to any chemicals etc.
3.Normal mole is round in shape and symmetrical while a melanoma is asymmmetrical. Normal mole doesn't change its size and shape but it is usually in melanoma.
This melanoma tumor has a border that is uneven, ragged, or notched. This is another way to distinguish melanoma from normal moles, which typically have borders that are smooth.
4.
Age: Skin cancer risks increase as you age, which is likely due to accumulated exposure to UV radiation. But skin cancers may also be found in younger individuals who spend a lot of time in the sun. Frequent sunburns, especially when they occurred during childhood, increases the risk of developing melanoma.
Immune suppression: Conditions that weaken the immune system, such as viruses, diseases or immune suppression therapy associated with organ transplantation, may increase skin cancer risks.
Gender: Men are approximately two times more likely to develop basal cell carcinomas and three times more likely to develop squamous cell carcinomas than women.
BODY
Skin tone: Caucasians have a greater risk of developing skin cancer than non-whites. The risk is also higher in individuals with blond or red hair, blue or green eyes, or skin that burns or freckles easily.
Moles: Most moles are harmless and may never develop into cancer, but having a large number of moles may increase the risk for developing melanoma. The presence of dysplastic nevi (moles that may resemble melanoma) may also increase risk, by 10 percent. Although most dysplastic nevi will not develop into melanomas, a small percentage may, and individuals with these types of moles should see a dermatologist regularly for thorough skin exams.
GENETICS
Family and/or personal history:Individuals with one or more parents or siblings with skin cancer may be at increased risk. Individuals who have previously been diagnosed with skin cancer are also at increased risk for developing the disease again.
Inherited conditions: Conditions such as xeroderma pigmentosum, an inherited disease that affects the skin’s ability to repair UV damage, are at increased risk for developing skin cancers, and may develop them at an earlier age.
LIFESTYLE
Smoking: Smokers are more likely to develop squamous cell skin cancers, particularly on the lips.
Chemical exposure: Certain chemicals, including arsenic, industrial tar, coal, paraffin and certain types of oil, may increase the risk for certain types of non-melanoma skin cancers.
UV exposure: People who work outdoors during the day or who choose to spend much of their leisure time outdoors and are exposed to UV light are at an increased risk. People who choose to use tanning beds increase their risk of skin cancer.
MS. SN is having the risk factors such as over exposure to sunlight due to outdoor activities, family history of skin cancer as her father died of due to that.
5. In teaching plan for MS. SN, it should be important to include about the abstinence from extreme sunlight as well as urine radiation which cause melanoma and skin cancers. Also educate her about the importance of regular checkups.
6. In case of Ms. SN, the melanoma is in stage 0.
melanomas have not grown deeper than the top layer of the skin (the epidermis). They are usually treated by surgery (wide excision) to remove the melanoma and a small margin of normal skin around it. The removed sample is then sent to a lab to be looked at with a microscope. If cancer cells are seen at the edges of the sample, a repeat excision of the area may be done.
Some doctors may consider the use of imiquimod cream (Zyclara) or radiation therapyinstead of surgery, although not all doctors agree with this.
For melanomas in sensitive areas on the face, some doctors may use Mohs surgery or even imiquimod cream if surgery might be disfiguring, although not all doctors agree with these uses.
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