Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion
Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion
Discussion Post: R.S Case Study
Nodular melanoma is a type of skin cancer that can grow quickly and rapidly over a few weeks or months. It usually grows below and above the skin in a vertical manner. However, most of it is usually found below the skin (Cleveland Clinic, 2022). Early diagnosis and treatment of nodular melanoma has become increasingly difficult because patients with the condition usually lack identifiable risk factors. Moreover, nodular melanoma usually mimics a wide range of benign skin lesions, making it difficult to diagnose (Corneli, et al., 2018). In this discussion, we will explore some of the questions regarding the condition as provided in R.S’ case study Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion.
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Significance of the lack of clinical manifestations in the ROS provided
The review of systems is important in identifying some significant signs and symptoms that the patient may be presenting with. In the case of R.S, the review of systems revealed that there have been no clinical manifestations. This is significant because it helps in determining the prognosis of the melanoma. It indicates that the cancer may be in its early stages of development and is therefore not showing any signs. Had it progressed to some more advanced stages, R.S would have reported symptoms such as itching, fatigue, weight loss, and pain among others.
The type of melanoma based on the information provided under history, ROS, skin, and HEENT
The subtype of melanoma provided above is most likely a malignant nodular melanoma. Despite the fact that there are no significant symptoms that R.S is experiencing relating to the melanoma, there is significant evidence that the cancer is growing fast and spreading because the cervical nodes are significantly enlarged (cervical lymphadenopathy) and there is also some spread to the liver.
Some abnormal laboratory test results and what the abnormality suggests
There are some laboratory test results that are abnormal. For instance, the creatinine levels are at 0.6mg/dL. This is significantly low in comparison to the normal range for an adult male which should be between 0.74 to 1.35 (Mayo Clinic, 2022). Low blood creatinine may signify liver disease, a diet low in creatinine, muscular dystrophy, or aging which may cause a lower muscle mass.
The level of AST is also significantly high at 115IU/L. The normal range is between 5-40IU/L. This high value may signify hepatitis, liver cirrhosis, and other liver diseases. It may also signify acute pancreatitis. A fasting blood glucose level of 103mg/dL is considered mildly elevated. A range of between 100 to 125mg/dL (5.6 to 6.5mmol/L) is considered prediabetes. A HCO3 of 31 meq/L is also mildly elevated in comparison to the normal range of between 23 to 30meq/L. This may mean that there is a problem with the maintenance of acid-base balance in the body and therefore carbon dioxide is not adequately excreted through the lungs and the kidneys, perhaps due to an electrolyte imbalance, particularly potassium deficiency.
There is a total bilirubin level of 1.7mg/dL which is quite high. The normal levels should be below 0.3mg/dL. This suggests a dysfunction or injury to the liver. Alkaline phosphatase of 278IU/L is also very high being that the normal range is between 20 to 140IU/L. This may signify a dysfunction, disorder, or injury to the liver.
The current probability that the patient will be alive in 10 years
Some factors that can lead to a poor prognosis include thick tumor lesions, the presence of tumors in regional lymph nodes, a higher number of positive lymph nodes, distance metastasis (stage IV), the anatomic site of the tumor (poor prognosis if it is in the face and/or the trunk), presence of ulcerations, and the gender of the patient (poor in males) (Susok, et al., 2021). R.S has a lot of factors that predispose him to a poor prognosis. There is a very low probability that he will be alive in 10 years. The cancer lesion has spread to the liver and the brain (metastasis), bringing the probability of a 5-year survival to approximately 22.5% (Medical News Today, 2022).
References
Cleveland Clinic. (2022). Nodular melanoma. Retrieved from https://my.clevelandclinic.org/health/diseases/23313-nodular-melanoma#:~:text=Nodular%20melanoma%20is%20a%20type,primary%20cause%20of%20nodular%20melanoma.
Corneli, P., Zalaudek, I., Magaton Rizzi, G., & di Meo, N. (2018). Improving the early diagnosis of early nodular melanoma: can we do better?. Expert Review of Anticancer Therapy, 18(10), 1007-1012.
Mayo Clinic. (2022). Creatinine tests. Reterived from https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646#:~:text=The%20typical%20range%20for%20serum,52.2%20to%2091.9%20micromoles%2FL) Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion
Medical News Today. (2022). What to know about nodular melanoma. Retrieved from https://www.medicalnewstoday.com/articles/323599
Susok, L., Stücker, M., Bechara, F. G., Stockfleth, E., & Gambichler, T. (2021). Multivariate analysis of prognostic factors in patients with nodular melanoma. Journal of Cancer Research and Clinical Oncology, 147(9), 2759-2764.
Discussion Forum Sample
Discussion questions in NUR-631 are presented with a range of options.
Read the questions carefully and follow directions regarding whether to select one, two or answer multiple questions for the response. Present responses using the sample format provided below and include at least two citations from peer-reviewed journals published within the last 5 years or from the textbooks. References must be in proper APA format. A substantive responses must be at least 150 words in length and pertain to the topic as it relates to pathophysiology.
Sample DQ
Select one of the following discussion questions for your discussion response.
- What did Mark Twain mean when he said, “the difference between the right word and the almost right word is the difference between lightning and the lightning bug”? Demonstrate your answer by providing an example from your own life when “almost the right word” created confusion, misunderstanding, or adversity.
- How can knowing your fellow students and fostering a sense of community benefit your educational experience?
- Part of effective communication involves knowing how to respond rather than react to something someone has said or written. In the online classroom format, why is it important to read a classmate’s post and assess that person’s intended message before you offer a response? How can this skill of responding help you in your career?
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Sample Student DQ Response Format
What did Mark Twain mean when he said, “the difference between the right word and the almost right word is the difference between lightning and the lightning bug”? Demonstrate your answer by providing an example from your own life when “almost the right word” created confusion, misunderstanding, or adversity.
It is very important to use the right words when communicating. If you do not select your words carefully you can end up not getting your point across or miss a great opportunity. Using the right word makes sure you are understood correctly. If you are not careful about the words you use, it is easier for people to misinterpret them. This can have a negative impact in the medical field, as miscommunication affects “patients’ quality of care, health outcomes, adherence to treatment and satisfaction” and is also cited as the “most common reason for patient medical complaints” (Morgan, 2013, p. 123).
I have experienced what the difference between the “right word” and the “almost right word” can do. A couple years ago I was having a tough time. I was really busy with a lot of different things and my family could tell it was wearing me down. One day my daughter came up and handed me a picture she drew of the two of us. I was in the middle of something and just took it and said, “Oh, that’s nice, thanks.” Later, I could see she was sad. I felt terrible and thought about how much work she put into the picture for me, and how she was trying so hard to make me happy. I used almost the right words, but not the right words. We both felt much better after I took the time to express how I really felt Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion.
Reference:
Morgan, S. (2013). Miscommunication between patients and general practitioners: Implications
for clinical practice. Journal of Primary Health Care, 5(2), 123-128Improving The Early Diagnosis Of Early Nodular Melanoma Essay Discussion.