Outpatient Nursing Care for a Breast Cancer Patient with Hypertension Who has Undergone Surgery: A Case Study

Abstract

Nursing care for breast cancer patients who have undergone surgery and also have high blood pressure is a complicated nursing issue. Nurse role is important in preoperative preparation, utilizing their knowledge and effective communication skills to ensure the safety of patients and help them cope with the reality of their situation.

Objective: To study the nursing process for breast cancer patients who had undergone surgery with hypertension in the outpatient department.

Methodology: One case study involved a 64-year-old Thai female patient who reported a painless lump in her left breast for three months. She was diagnosed with left breast cancer and subsequently admitted in Chaiyaphum Hospital. Data collection between September 13 - 19, 2023, through interviews with the patient and her relatives, physical examinations, observations, and a review of the patient's medical records. Assess the patient's health condition using Gordon's model of 11 functional health patterns. Applying the nursing process for data collection and care planning, followed by D-METHOD-guided evaluation and discharge planning for optimal patient outcomes.

Result: The case study patient had left-sided breast cancer and hypertension. She underwent a surgery, Modified Radical Mastectomy (MRM), which involved the removal of the entire breast, lymph nodes, and a portion of the chest muscle. After a six-day hospital stay, the patient experienced nursing problems related to 1) anxiety about the disease, surgery, and postoperative self-care; 2) concern about body image changes after breast surgery; and 3) insufficient understanding of self-care instructions for discharge. During the subsequent follow-up examination, there were no physical complications, and the patient demonstrated adaptation on the mental side.

Conclusion: The patient in this case study had anxiety related to her post-surgery body image, economic situation, and self-care. Providing advice and emotional support from nurses, caregivers, and relatives should be given special attention.