Breast Cancer Exemplar Table
Medical Diagnosis/Concept
(List the concept)
(Define the
diagnosis/exemplar in your
own words)
Cancer is when cells lose control of their standard growth-controlling mechanism, and the growth of cells is
uncontrolled. It is a malignant/benign neoplastic disorder and might involve all body organs, with manifestations
varying depending on the body system affected and the type of tumor cells.
Clinical Manifestations
(List the display or
disclosure of characteristic
signs or symptoms of the
diagnosis and include
prioritized Nursing
Interventions for each
manifestation or group of
findings)
Diagnostic Studies
(List and prioritize the
studies required to diagnose
this condition and define in
your own words each one
and why study is necessary)
(List panel or panels and
state which lab would be
most significant and include
prioritized Nursing
Finding: Any sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast or elsewhere,
mammographic abnormality in the breast.
Nursing Interventions: Assist client and significant other in dealing with the stress of the situation and prognosis
and prevent complications. Assess pain and sensory alterations reports, noting location, duration, and intensity.
Note reports of stiffness, swelling, numbness, burning sensations, and identify verbal/nonverbal cues.
1. Screening imaging can visualize internal structures and detect nonpalpable cancers or tumors in the early
stages of development.
2. Biopsies are removing a sample of suspicious tissue for examination by a pathologist.
3. Gene assays reveal that genes have some association with breast cancers.
4. The human epidermal growth factor receptor 2 (HER2) tumor test is a growth-promoting protein. Too many
copies of this gene tend to grow and spread more aggressively than other breast cancers.
Nursing Interventions: Explain procedure purpose and preparation for diagnostic tests or procedures and ascertain
what the client understands about diagnostics that have already been performed. Obtain specimens, monitor vital
signs, and notify critical results.
Interventions/responsibility
for each)
Collaborative Care
(List other healthcare
professionals and describe in
your own words how they
would assist your patient and
any prioritized Nursing intercollaborative care)
Pharmacologic Interventions
(List priority medications
required with mechanism of
action, adverse effects, and
what diagnostics if any
should be reviewed before
and after medication is
administered/Nursing
intervention)
Nursing Diagnosis
(List 3 priority nursing
diagnosis based on clinical
findings and define in your
own words the rationale)
Patient Education




Surgical therapy is indicated to diagnose, stage, and treat certain types of cancer.
Radiation Therapy destroys cancer cells with minimal exposure of normal cells to the damaging effect of
radiation.
Chemotherapy kills or inhibits the reproduction of neoplastic cells and kills normal cells.
Drug Therapy includes hormone therapy, immunotherapy, and targeted therapy. If drugs are given before
surgery, treatment is often used to shrink the tumor size enough to make surgical removal possible; if
medications are given after surgery, it decreases the recurrence rate and increases the survival length.
1. Aromatase Inhibitors: Prevents estrogen production by inhibiting aromatase such as anastrozole,
exemestane, and letrozole. It may use only estrogen receptor-positive breast cancer in postmenopausal
women.
2. Estrogen Receptor Blockers, such as fulvestrant, tamoxifen, and toremifene, are used to block Estrogen
Receptors in ER-positive breast cancer in postmenopausal women.
3. Estrogen Receptor Modulars, such as raloxifene, block estrogen's effect on bone and prevent bone loss.
4. Immunotherapy and Targeted Therapy, such as everolimus, lapatinib, abemaciclib, and neratinib used in
ER-positive and HER-2 negative/positive breast cancer postmenopausal women.
Nursing Interventions: Monitor vital signs, establish an effective medication schedule, and provide
education and resources.
1. Death of Anxiety may be related to a situational crisis, a threat to the current situation, a change in selfconcept, or loss of body part.
2. Ineffective Coping is related to alteration in body image, fear of rejection or reaction by others, and
unrealistic self-expectations.
3. Sexual Dysfunction is possibly evidenced by perceived sexual limitation, undesired change, a threat to selfconcept, and change in health status.
1. Assist clients and significant others in dealing with the stress of the situation and prognosis.
2. Prevent complications.
(List 3 priority education
points you would discuss
with patient and defend in
your own words your
selection of the points)
Interrelated Concepts
(List ALL interrelated
concepts and describe in
your own words how it
interrelates with exemplar)
3. Establish an individualized rehabilitation program.
4. Provide information about the disease process, procedure, prognosis, and treatment needs.
5. Discuss feelings about the changes in physical appearance.
1. Anxiety, stress, and coping significantly impact patients with cancer due to changes in physical and
psychosocial adaptation.
2. Pain is a common symptom in cancer patients.
3. Sexuality is affected due to changes in health status and body image.
4. Immunity might be compromised due to chemotherapy.
References
Doenges, M. E., Murr, A. C., & Moorhouse, M. F. (2019). Nursing care plans: Guidelines for individualizing client care across the life span. F.A.
Davis Company.
Giddens, Jean F. Concepts for Nursing Practice, 3rd Edition. Elsevier (HS-US), 022020. VitalBook file.
Harding, Mariann, Dottie Roberts, Courtney Reinisch, Debra Hagler, Jeffrey Kwong. Lewis's Medical-Surgical Nursing, 11th Edition. Elsevier (HSUS), 102019. VitalBook file.