Coaching a Patient on Breast Self Examination Summary

Nursing

Watch the video(s) for Chapter 42: Teaching Breast Self-Examination.

Summarize what you learned in the video. Be specific!

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Create a pamphlet or handout that could be given to a patient.

Review both parts of your assignment for appropriate grammar, spelling, and punctuation.

Video Transcript

[ Music ]>> Narrator: In this procedure, you will learn how to teach a patient the proper way to palpate her breasts and check for abnormality. Gather a self-examination pamphlet and shower part to give to the patient, as well as a teaching model. Before meeting with the patient, sanitize your hands. >> Speaker 1: Hi, Jennifer, I’m Julie, Dr. Anderson’s medical assistant. Can I get your full name and your date of birth? >> Speaker 2: Sure, Jennifer — >> Narrator: To make sure you have the correct patient, identify her by name and date of birth. >> Speaker 1: Dr. Anderson says that this is your first visit in, and that she’d like me to explain to you how to do a breast self-exam, have you ever been instructed on that before? >> Narrator: To the patient at ease, explain what a breast self-examination is and how you will be demonstrating it. >> Speaker 1: So, there’s really two parts to the breast self-exam. Take the first part is inspecting the axillary or your armpit region. And so, while you’re in the shower, you’ll raise your arm up, and you’re just going to palpate in that whole armpit area, feeling for any lumps. >> Narrator: Instruct the patient to examine her breasts while bathing or showering in warm water because the fingers glide more easily over wet tissue. >> Speaker 1: Why don’t you go ahead and give that a try? >> Narrator: Explain to the patient that during self-examination, she should raise one arm at a time, using the right hand to examine the left breast and the left hand for the right breast. >> Speaker 1: That looks great. And so, when you’re done with this side, you would then raise the other arm and palpate that area, as well. It’s important to do both sides for that one. >> Narrator: Using the finger pads of the middle fingers, move in a small, circular pattern up and down the breast. >> Speaker 1: We’ll use this model to do that, and what you want to do with the breast exam is you’re going to use just small, circular motions, and you’re going to work your way around the breast going in a clockwise motion, and when you get back to the top, you’re just going to come in a little bit and be feeling for any lumps or dimpling or any abnormalities you might find there. >> Narrator: Starting at the axillary region, working down the area back up again from the axillary to the ribs below the breast, back up to the clavicle, and repeatedly across the sternum bilaterally. The best time to perform this examination is immediately after the end of the menstrual period, when breast engorgement is minimal. Non-menstruating women should examine their breasts on the first of each month. Explained to the patient that shall need to perform the self-examination once a month. >> Speaker 2: Now is this something I do every day? >> Speaker 1: No, this only needs to be done once a month, and you’re going to do it shortly after your period, as your breasts less tender and swollen at that point. >> Speaker 2: There’s that one. >> Narrator: After finishing her bath or shower, the patient should continue the examination in front of a mirror with her arms at her sides. Then she should raise her arms above her head and look carefully for changes in the size, shape, and contour of each breast. She should look for puckering, dumpling, or changes in skin texture. >> Speaker 1: And the last piece of the exam on the actual breast is to pinch the nipple gently to check for any discharge that might be there. >> Narrator: Instruct the patient to squeeze both nipples gently into look for discharge. After her shower but before dressing, she should lie on a bed with a towel or pillow under her left shoulder and her left hand behind her head. She should examine her left breast again with her right hand. Instruct the patient to press gently in small circles starting at the top outermost edge, including the axillary region and spiraling in towards the nipple. She will then repeat on her right breast. >> Speaker 1: Yes, you want to do it gently. It shouldn’t hurt when you do that piece at all. And then, when you’re out of the shower, then you’re going to go in and lay down on your bed and do this exam again. So, let me show you how you would do that. And I’m going to have you lay back, and this is going to go under your shoulder. Let me pull this out for you. There you go. And with this under your shoulder, you’re going to raise this arm up and over your head, and then, you’re going to do that same breast exam that you did while you were in the shower. >> Speaker 2: Okay. >> Speaker 1: This just gives you another perspective on finding possible lumps that might be there. >> Speaker 2: Sounds good. >> Speaker 1: Okay, so, that you take care of that then. Can I help you? >> Narrator: Have the patient demonstrate on the model so you’re sure she understands. Give the pamphlet to the patient, along with the shower card, with instructions to hang it in the shower as a monthly reminder and guide. >> Speaker 2: There’s one, too. >> Speaker 1: Yeah, very good. Very good. Now I’ve got a couple of handouts for you. This one explains the whole procedure for you. Where you would be. What areas you should be looking for, those lumps or any abnormalities there. And then, this is a shower card. So, you can actually hang this in the shower, is it if shows you that process, as well, since it’s best done when you’re in the shower. >> Speaker 2: Okay, sounds good. >> Speaker 1: Okay, great. Do you have any questions for me? >> Speaker 2: No, I think this will be great. >> Speaker 1: Okay, thank you the doctor should be in to see you in just a few minutes. >> Speaker 2: Okay, thanks. >> Narrator: Sanitize your hands again when finished with the patient. Document the patient educational intervention in the patient’s health record.

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Coaching a Patient on Breast Self Examination Summary

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