Breast cancer is one of the most common malignancy of women in recent years its incidence has shown a rising trend, a serious threat to the patient’s physical and mental health. At present, most hospitals with surgical resection as a treatment for breast cancer of instruments, from the long-term clinical work found a number of factors have great impact on postoperative recovery, a direct impact on patient recovery.
A direct impact on the psychological status of patients with their surgery and postoperative rehabilitation tolerance effect. Therefore, to do before and after surgery care and psychological guidance is very important. In particular, nurses in front of the patient should always remain calm, confident, and give patients a sense of security.
Preoperative Care
Preoperative care to patients primarily detail the significance of surgical treatment, preoperative, postoperative notes, to encourage a patient’s cough, expectoration, and bed defecation practice, provide a wide range of life care. Such as the guidance in patients with eating highly nutritious easy to digest food, develop good bowel habits, maintaining smooth stool, constipation, laxatives, when prescribed by a doctor to give.
Perfect the relevant inspection. After ipsilateral limb venous puncture should not be OK. Surgical skin preparation area do a good job, especially in the armpit Department, who need to skin graft donor site should be well prepared.
Patients admitted to hospital, including their family members for fear of results of operations, will show anxiety, frustration, nurses have to care, patient and considerate and patient to listen to patients complain and to give help in understanding the illness who want to introduce the breast cancer progress of treatment and survival of information and related diseases and surgical knowledge, enhance confidence in the treatment of patients; right pain, and they should give more comfort to provide spiritual support to meet the appropriate use of medical sedation pain medications, improve patient bad mood, ensure that their rest and sleep, so that the body is in the best condition for surgery.
Changes observed in patients with disease should be given back to the wards after the supine to monitor the patient’s blood pressure, pulse, respiration changes, blood pressure in patients after stable vital signs after a sober and to give half of supine, raising the ipsilateral upper extremity, in order to facilitate breathing and drainage to avoid or reduce the operative side limb edema. Note whether the wound exudate to keep dressing dry, clean, pay attention to limb skin color depth. Good suction drainage tube care, and properly fixed to prevent slippage. Note that suction drainage is smooth and intraoperative blood supply-side extremities. Observation of drainage fluid color, character, quantity, drainage of more than 100ml per hour, tips are active bleeding should be immediately reported to a doctor a timely manner.
Post-operative care
To prevent postoperative edema and dysfunction to patients with limb edema operative side made it clear that the possibility that, due to axillary lymph node dissection surgery to poor lymph and venous blood return and postoperative chest wound caused by pressure dressing to suit. Guidance in a timely manner ipsilateral upper extremity function in patients with exercise, to prevent the occurrence dysfunction. Activity began to elbow and upper first be developed to the shoulder. After 1 to 3 days should be tempered hand, wrist and elbow function, do extensor digitorum, make a fist and bent wrist, elbow and other exercise. After 4 to 5 days, can be practicing the same side shoulder and ear function of the Ministry, and then gradually limb of the elbow flexion exercises will push up the palm of your hand placed on the opposite shoulder, neck, and then hands over the head to the affected side and touch the right ear until the Department to promote limb blood circulation.
Encourage patients to cough, expectoration, and do deep breathing exercise will help lung expansion and prevent pulmonary complications.
Was prescribed oral tamoxifen (TAM) or drugs such as letrozole.
Postoperative dietary guidance due to loss of appetite caused by reduction in food intake, it is necessary to explain to patients in time due to surgery may lead to its nutritional disorders, mainly due to consumption of cancer due to sympathetic excitation dominate and suppress the digestive tract movement and secretion of digestive gland , cause loss of appetite. Therefore proposed that the increase in calories, with protein, vitamin and mineral-based, promote tissue growth and wound healing.
Meanwhile, the postoperative bed rest period, the decline in self-care ability, the competent nurse should be given full assistance, some assistance, support for education in various ways such as nursing, to meet their self-care needs.
