On the specimen’s right side, the skin is removed; on the left side, the breast is sagittally sectioned.
The breast extends from the 2nd to the 6th ribs. The axillary process (tail) of the breast consists of glandular tissue projecting toward the axilla.
The region of loose connective tissue between the pectoral fascia and the deep surface of the breast, the retromammary bursa, permits the breast to move on the deep fascia.
Interference with the lymphatic drainage by cancer may cause lymphedema (edema, excess fluid in the subcutaneous tissue), which in turn may result in deviation of the nipple and a leathery, thickened appearance of the breast skin. Prominent (puffy) skin between dimpled pores may develop, which gives the skin an orange-peel appearance (peau d’orange sign). Larger dimples may form if pulled by cancerous invasion of the suspensory ligaments of the breast.
Three interacting systems; individuals (personal system), groups (interpersonal system), and society (social system); the personal system is a unified, complex, whole self who perceives, thinks, desires, imagines, decides, identifies goals, and selects means to achieve them.
Adjustments to life and health are influenced by an individual;s interactions with environment. The environment is constantly changing.
A dynamic state in the life cycle; illness is an interference in the life cycle. Health implies continuous adaptation to stress in the internal and external environment through the use of one’s resources to achieve a maximum potential for daily living.
A helping profession that assists individuals and groups in society to attain, maintain, and restore health. If this is not possible, nurses help individuals die with dignity. Nursing is perceiving, thinking, relating, judging and acting a vis-avis the behavior of individuals who come to a nursing situation. A nursing situation is the immediate environment, spatial and temporal reality, in which nurse and client establish a relationship to cope with health state and adjust to changes in activities of daily living if the situation demands adjustment. It is an interpersonal process of action, reaction, interaction, and transaction whereby nurse and client share information about their perceptions in the nursing situation.
King’s Goal Attainment Theory
Imogene King’s theory of goal attainment, first published in 1971, was derived from conceptual framework of three dynamic interacting systems; (a) personal systems (individuals), (b) interpersonal systems (groups), and social systems (society). Key concepts are identified for each system as follows:
1. Personal system concepts: perception, self, body image, growth and development, space and time
2. Interpersonal system concepts: interaction, communication, transaction, role and stress
3. Social system concepts: organization, authority, power, status, and decision making.
The client ans nurse are personal systems subsystems within interpersonal and social systems. To identify problems and to establish goals, the nurse and client perceive one another, act and react, interact, and transact. Transactions are defined as purposeful interactions that lead to goal attainment. Transactions have the following characteristics:
1. They are basic to goal attainment and include social exchange, bargaining and negotiating, and sharing a frame of reference toward mutual goal setting.
2. They require perceptual accuracy in nurse-client interactions and congruence between role performance and role expectation for nurse and client.
3. They lead to goal attainment, satisfaction, effective care, and enhanced growth and development.
King postulates seven hypothesis in goal attainment theory:
1. Perceptual congruence in nurse-client interactions increases mutual goal setting.
2. Communication increases mutual goal setting between nurses and clients and leads to satisfactions.
3. Satisfaction in nurses and clients increase goal attainment.
4. goal attainment decreases stress and anxiety in nursing situations.
5. Goal attainment increases client learning and coping ability in nursing situations.
6. Role conflict experienced by clients, nurses, or both decreases transactions in nurse-client interactions.
7. Congruence in role expectations and role performance in creases transactions in nurse-client interactions.
King’s theory highlights the importance of the participation of all individuals in decision making and deals with the choices, alternatives, and outcomes of nursing care. The theory offers insight into nurses’ interactions with individuals and groups within the environment t.
Kozier, Barbara et.al Fundamentals of Nursing 5th edition