Lumpectomy and sentinel lymph node dissection

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Reference no: EM133912128

Question

A.K., a 68-year-old married Asian American woman, has been diagnosed with breast cancer. She is scheduled for surgery in the morning for a lumpectomy and sentinel lymph node dissection with possible axillary dissection. Collaborative Care Preoperative

• When she is seen in the preoperative clinic 1 week before surgery, she is crying uncontrollably and says, "My husband does not want to look at me anymore. He is afraid of what I am going to look like with a flat chest."

• She says, "I cannot sleep and I just pace the floor at night."

• Expresses concern that her two daughters (34 and 32) and their daughters are going to get "this horrible disease." Operative Procedure

• A lumpectomy and sentinel lymph node dissection is performed.

• A.K. has cancer cells in her sentinel lymph node.

• Axillary node dissection is then done involving the removal of 12 to 20 nodes. Postoperative

• Does not want to leave the hospital. She wants to stay in bed.

• Fever with swelling and restricted range of motion in the right arm.

• Pain not controlled well with pain medication. Follow-up Findings and Treatment

• Two positive lymph nodes are found.

• Scheduled for outpatient chemotherapy followed by external beam radiation.

Discussion Questions

1. What information would you provide to A.K. about her surgery?

2. What complication did she develop after her surgery?

3. Which common postoperative exercises will A.K. need to practice after her surgery?

4.Which of the following personnel should provide this instruction to A.K.: registered nurse, licensed practical/vocational nurse, unlicensed assistive personnel?

5. What community resources are available to help A.K. and her family adjust to the change in her body and to cope with the diagnosis of cancer? How can you access these resources?

6. What information is important for you to provide to A.K. about her radiation treatment and chemotherapy?

7. Based on the assessment data, what are the priority nursing diagnoses? Are there any collaborative problems?

8. What information is important for you to provide to A.K. and her daughters? What early detection measures are important for them to know?

Reference no: EM133912128

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