Journal Entry: Nipple Discharge

Answer

Journal Entry: Nipple Discharge

Nipple Discharge

Nipple discharge, also known as Nipple Aspirate Fluid (NAF), refers to the fluid that flows from the mammary ducts. These fluids are normally as a result of by-products of epithelial cells undergoing cellular turnover.  According to Schuiling & Likis (2013), the physiologic secretions may not be evident for most women since they are generally blocked by the keratin plug and end up reabsorbed in the body. The discharge is often classified as normal when it occurs in both nipples and released only when the nipples are squeezed or compressed. Besides, normal nipple discharge is often caused by pregnancy where some women may notice clear discharge from their nipples. Also, stopping breastfeeding may similarly lead to milk-like discharge to persist for a while. Moreover, the stimulation of the nipples may also cause discharge from the nipples. Abnormal discharge, on the other hand, is evidenced by a discharge that only occurs from one breast and its occurrence may be spontaneous without any stimulation. Some of its causes include mammary duct ectasia and fibrocystic breast changes (Schuiling & Likis, 2013). Studies reveal that the patients with nipple discharge exhibit higher chances of cancer as opposed to an asymptomatic population. This paper gives a detailed an analysis of a patient who was diagnosed with abnormal nipple discharge. It also gives essential strategies of conducting patient education in an effort to prevent breast related infections. What is more, some of the ways through which patients can perform self-breast examinations are also discussed.

Patient's Personal and Medical History

Stacy in a 30-year-old African-American female living with her daughter aged 12. She is working as a taxi driver. She neither smokes nor drinks alcohol. Both of her parents are alive and live in fair health. Her two brothers aged 36 and 28 are both in good health.  Stacy has no family history of breast cancer, malignancies or cystic disease. The patient reports that she has been in her usual state of health until the last three weeks when she started experiencing some drops of sticky and gray discharge from her left breast in the absence of a dominant lump. Also, she observes that the discharge could occur spontaneously without any form of stimulation or touching of the breast. She indicates that her breasts have never been examined by a practitioner.

Drug Therapy and Treatment

For effective drug therapy and treatment, adequate tests and analysis had to be performed on Stacy to confirm the infection.  Some of the tests included placing the sample of the discharge fluid on a glass slide and examining the sample in the lab to rule out the presence of any breast related infections such as breast cancer and cysts, which are also known to produce breast discharge. Additionally, special blood tests were conducted to rule out possibility of hormonal imbalance which could also be responsible for the discharge. The test results revealed that she is suffering from abnormal breast discharge. A surgical excision of the discharging duct was then performed on the patient by the use of breast ductoscopy so as to enable a careful excision which would retain the ability of the patient to lactate and the removed tissue sent to the pathology laboratory for other tests. She was recommended Bromocriptine tablets be taken twice a day at 0.8 mg for one month. She was also issued with creams which she is to apply around nipple area to treat skin changes that may occur. 

Patient's Follow-Up Care

The patient was adequately advised to avoid squeezing her nipples so as to avoid stimulating hormones which in turn would cause more discharge. The patient was also advised to change breast pads frequently and avoid using pads which hold moisture against the skin. Instead, a well-fitting bra was recommended to help minimize her pain. Moreover, the patient was advised to avoid shampoos and soaps on the nipples during showering. She was also advised to ensure she visits for more breast examinations so as to facilitate monitoring of her breast and by so doing, prevent future abnormalities. 

Patient Education Strategies

Providing patients with adequate knowledge on ways of managing their own health is essential in promoting their general well-being. This is because it not only facilitates timely detection and timely intervention, but also prevents further infections and minimizes suffering   (Riley et al., 2012). Some of the strategies that health practitioners may embrace in efforts to enlighten patients at risk of breast conditions including teaching them through guidance and counseling on the variety of ways in which they can manage their condition. Such teachings may entail the significance of following doctor's instructions and the need to embrace a healthy lifestyle. Additionally, seminars, as well as health conferences, can also offer avenues to pass information based on the need to visit health facilities for regular checkups and screening (Riley et al., 2012).

Description on how to Perform Breast Self-Examinations

There are major steps that women ought to follow monthly at the comfort of their homes to conduct breast self-examinations. First, one can begin by closely looking at her breasts in the mirror by standing straight with arms on the hips. While in the mirror, one ought to check and ensure that the breasts are evenly shaped with no visible swelling. Besides, the breasts should be in their usual size and color. Secondly, they should raise their hand while still in the mirror to check for any signs of fluids coming out. Finally, they can also feel their breasts especially when the skin is wet and slippery to ensure there are no swellings any abnormalities (Corcoran, Corcoran & Fischer, 2013).