Patient Profile:

• Name: Sarah Johnson
• Age: 54
• Diagnosis: Metastatic breast cancer, Stage IV, diagnosed six months ago with metastasis to the liver and bone

Treatment Plan:

• Surgery: Lumpectomy with axillary lymph node dissection
• Chemotherapy: Adriamycin and Cyclophosphamide (AC) regimen
• Radiation Therapy: Targeted treatment to the chest wall post-surgery

Clinical Presentation:

Subjective Data:

• Reports of nausea and vomiting, especially after chemotherapy sessions
• Expresses feelings of sadness and fear regarding her prognosis and the impact on her family
• States she has lost 10 pounds in the last month due to decreased appetite and nausea
• Describes pain in the surgical area and generalized body pain that worsens at night
• Mentions experiencing a red, itchy rash on her chest from radiation therapy

Objective Data:

• Vital signs: HR 78 bpm, BP 120/80 mmHg, Temp 98.6°F
• Weight: 135 lbs (down from 145 lbs)
• Physical examination reveals tenderness in the left breast and axilla

True or False: Emotional distress can decrease treatment adherence.

Choice A reason: Improving public transportation to the clinic would indeed make it easier for residents to access healthcare services. However, this strategy alone does not directly address the cultural and specific health needs of the Hispanic community.

Choice B reason: Obtaining low-cost medications for clinic patients can alleviate some financial burdens and improve access to necessary treatments. While this is beneficial, it does not tackle the root of health disparities related to cultural differences and health beliefs.

Choice C reason: Teaching clinic staff about cultural health beliefs is crucial for reducing health care disparities and promoting health equity. Understanding the cultural background, health beliefs, and practices of the Hispanic community allows healthcare providers to deliver more culturally competent and patient-centered care, building trust and improving health outcomes.

Choice D reason: Updating equipment and supplies at the clinic can enhance the quality of care provided. However, without addressing the cultural competency of the healthcare staff, this strategy does not directly impact health equity or reduce disparities specific to the Hispanic community.

Choice A reason: Asking the patient to try bearing weight on the injured ankle is not appropriate at this stage. Bearing weight can cause further injury or exacerbate the swelling and pain. The initial treatment should focus on reducing swelling and providing support.

Choice B reason: Elevating the ankle above heart level is appropriate because it helps to reduce swelling by promoting venous return and decreasing fluid accumulation in the affected area. Elevation is a standard first aid measure for managing acute injuries and swelling.

Choice C reason: Applying a warm moist pack to the ankle is not advisable immediately after an injury. In the acute phase, cold therapy (ice) is recommended to reduce swelling and pain. Warm therapy is more appropriate during the recovery phase, once swelling has subsided.

Choice D reason: Assessing the ankle's passive range of motion (ROM) may be necessary later, but not immediately upon arrival. The priority is to manage pain and swelling first. ROM assessments can be painful and might worsen the injury if conducted too soon.