Nursing Care for Esophageal Carcinoma Patient (Case study)

Abstract

Background: Incidence of esophageal carcinoma worldwide is the eighth of overall cancer and also be the top rank cause of death in cancer patient. Treatment by esophagectomy cause high risk of complication. Good nursing practice after operation will therefore improve patient safety.
Objective: To create nursing care guideline for esophagectomy patient and to promote self care, and family participation.
Study Design: Descriptive study (2 cases of esophagectomy patients in Surgery Intensive Care Unit, Buriram hospital admitted during January to March 2006 were studied their received nursing care.)
Result: Two patients, underwent operation of thoracotomy and laparotomy for 3.5 hours and 5 hours respectively, had risk of respiration and circulation system alteration were closely monitor for changing in blood pressure level through aterial line. Post-operative pain was managed by administration of continuous analgesia via epidural catheter. The first case developed hypertension and respiratory tract infection which treated by anti-hypertensive drugs and antibiotics. The second case developed malnutrition and was treated by partial parenteral nutrition. Integrated nursing practice was introduced to solve complications of these patients along with clinical care plan, self care promotion and family participation. Patients were referred from Surgery Intensive Care Unit after recovered from critical stage at the 5th and 3rd day after operation. Patients were discharged with improved clinical outcome (total length of stay were 17 and 21 days respectively).
Conclusion: The preparation process, self care promotion and family participation at stage of admission, Comprehensive knowledge in disease and treatment including appropriated patient monitoring will prevent and reduce severity of patient’s clinical complication.
Key words: Post-operative care, Esophageal Carcinoma, Family participation