Case Study
Catherine is a 45-year-old woman who has been admitted to your ward and is scheduled for a left radical mastectomy. She is currently peri menopausal and has no family history of breast cancer. She began taking the oral contraceptive pill when she was 19 years old. Catherine lives a sedentary lifestyle, and her only exercise is the 5-minute walk to the bus stop every day. Catherine eats a healthy diet of varied organic foods. Catherine does not conduct regular self-breast examinations. During a recent doctor’s visit, a lump was found on palpation by her GP in the upper left quadrant of Catherine’s left breast. An urgent breast ultrasound and biopsy was ordered. The sentinel node biopsy returned a positive result. Catherine was diagnosed with a stage IIIA breast adenocarcinoma. After consultation with the breast surgeon and the breast care Clinical Nurse Consultant (CNC), Catherine elected to have a left radical mastectomy. Catherine’s surgery went as planned and she has not experienced any postoperative complications. Catherine has been ordered I.V. 2.5mg to 5mg Morphine every 4-6 hours for pain relief. Catherine reports she has a pain level of 5/10 resting, that increases to 8/10 when moving. The Breast Care CNC has visited Catherine on several occasions to offer support and clinical education.
Three (3) Short Answer Questions
In addressing the Australian National Health Priority Area of breast cancer prevention and treatment use a person centred care approach to respond to the following:
Question 1 (500 words):
Discuss one (1) non-pharmacological nursing comfort measure a Registered Nurse can undertake to help manage Catherine’s postoperative pain (in combination with the pharmacological management discussed in the case study)
Question 2 (700 words):
a) Explain the pathogenesis of lymphoedema that may occur postoperatively for Catherine who has undergone axillary lymph node removal during her breast cancer surgery.
b) Explain how applying a compression bandage on Catherine’s left arm assists in the management of lymphoedema.
References
A minimum of 5 references are to be used for this assessment.
Marking criteria – please refer to the criteria when answering questions
1. Accurately, clearly and comprehensively discusses one (1) non-pharmacological nursing comfort measure a Registered Nurse can undertake to help manage Catherine’s postoperative pain
2. Accurately, clearly and comprehensively explains the pathogenesis of lymphoedema that may occur postoperatively for Catherine, who has undergone axillary lymph node removal during her breast cancer surgery.
3. Accurately, clearly and comprehensively discusses how the application of a compression bandage on the left arm can assist in the management of Lymphoedema for Catherine
