Screening Sam — Cancer Warning Signs and Screening Teaching
The finding that gets reported is the one that changed, and the one that does not hurt
The magnifying glass is for the mole. The calendar is for everything that should have been checked already.
Sam teaches people what to notice: a change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump, indigestion or difficulty swallowing, an obvious change in a wart or mole, and a nagging cough or hoarseness. Painless is not reassuring — a painless lump or painless hematuria is exactly what gets reported. For moles he uses asymmetry, irregular border, uneven color, diameter over 6 mm and any evolution. Screening teaching covers colonoscopy, mammography, Pap and HPV testing, and prostate discussion on the schedule the provider sets, plus sun protection and tobacco cessation.
Read Screening Sam's full story →The story arc
The setup
A client mentions in passing that a mole on his back looks different than it did last summer.
The turn
Another client reports stools that have been narrow for two months and an unplanned 15-pound weight loss.
The crisis
A woman describes painless blood in her urine and assumes it is nothing because it does not hurt.
The save
Sam turns each concern into a scheduled appointment and reviews what screening each client is due for.
NCLEX study section — Cancer Warning Signs and Screening Teaching
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Health Assessment
Take this chapter into practice questions on the same topic.