K.T., 35, is a white, fair-skinned, rural mail carrier. He is married with a 1 year old son. He comes to the clinic for evaluation of a changing lesion on his scalp.
- History of a melanotic lesion on his scalp recently noted to be changing in size and color
- Mother and older brother treated for malignant melanoma in the last 10 years
- Anxious that the lesion might be cancer and require extensive, disfiguring surgery
Objective Data - Physical Exam:
- Has a 6-mm lesion, lacking in color, scalloped with vaguely defined borders
- Has a large number of small nevi (more than 50) on back, legs, and arms
- Four dysplastic nevi found on back
Objective Data - Diagnostic Studies
- Excisional biopsy confirmed malignant melanoma
- Sentinel node biopsy results were negative
- Diagnostic tests indicate melanoma stage I
- Identify the categories of the health history that have been addressed and those for which additional data must be obtained.
- What risk factors for malignant melanoma does he have?
- What health promotion concepts would you incorporate when performing an assessment of K.T.'s skin?
- Discuss the developmental (physical, cognitive, psychosocial, behavioral), age, socioeconomic, and cross-cultural considerations that should be considered during the gathering of subjective and objective data and the provision of health care.
- Relate expected (normal) findings to those described for this patient and discuss any additional information that might be needed before a judgment or diagnosis can be made.
- Based on the assessment data presented, what are the priority health needs?
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