Question 2: Explain the pathogenesis of Lymphoedema that may occur postoperatively for Anne who has undergone axillary lymph node removal during her breast cancer surgery.

Case Study

Anne is a 45-year-old woman who has been admitted to your ward and is scheduled for a left radical mastectomy. Anne's mother died from breast cancer aged 62 years. Anne began menstruating at the age of 11 years. She is currently peri menopausal. She began taking the oral contraceptive pill when she was 19 years old. Anne lives a sedentary lifestyle. Her BMI is 34 kg/m². Anne eats a healthy diet of varied organic foods. Despite her family history Anne does not conduct regular self-breast examinations. She has infrequent mammograms, not annually as recommended. During a recent doctor's visit, a lump was found on palpation by her GP in the upper left quadrant of Anne's left breast. An urgent breast ultrasound and biopsy was ordered. The sentinel node biopsy returned a positive result. Anne was diagnosed with a stage IIIA breast adenocarcinoma. After consultation with the breast surgeon and the breast care Clinical Nurse Consultant (CNC), Anne elected to have a left radical mastectomy. Anne's surgery went as planned and she has not experienced any postoperative complications. Anne was ordered I.V. 2.5mg to 5mg Morphine every 4-6 hours for pain relief. Anne reports she has a pain level of 2/10. Anne's expected hospital length of stay is 5 days if no complications occur. The Breast Care CNC has visited Anne 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: Discuss one (1) non-pharmacological nursing comfort measure you can undertake to help manage Anne's acute postoperative pain during the first 72 hours after surgery.

Question 2: Explain the pathogenesis of Lymphoedema that may occur postoperatively for Anne who has undergone axillary lymph node removal during her breast cancer surgery.

Question 3: Discuss one (1) nursing care intervention that you can undertake to help minimise Lymphoedema symptoms for Anne.