Nursing Care of Lower Rectal Cancer Patients with Colostomy with Comorbid Hypertension

Abstract

ABSTRACT
Rectal cancer is a major public health concern. While colostomy improves survival, it causes significant physical, psychological, and social impacts. For patients with comorbidities like hypertension, strict preoperative control is crucial to minimize complications such as infection or cardiovascular issues. Integrating the surgical nursing process with the Enhanced Recovery After Surgery (ERAS) program prepares patients and families, reduces risks, and promotes effective adaptation to living with a colostomy, thereby improving overall quality of life. This study aimed to analyze and evaluate the nursing care process for patients with lower rectal cancer undergoing colostomy surgery and presenting with comorbid hypertension, establishing evidence-based guidelines for healthcare professionals. This descriptive case study purposively selected one patient with lower rectal cancer undergoing colostomy surgery and presenting with comorbid hypertension (January to April 2026). Data were collected from the patient, caregivers, and medical records. A holistic nursing plan was developed, supported by literature reviews concerning patients with lower rectal cancer who underwent colostomy surgery and had comorbid hypertension. Consultations with multidisciplinary specialists and nurses caring for patients with lower rectal cancer undergoing colostomy surgery and presenting with comorbid hypertension guided continuous evaluation from outpatient visits to home care. The findings reveal that outpatient surgical nurses are pivotal in the comprehensive care of patients with lower rectal cancer undergoing colostomy surgery and having comorbid hypertension. Tailored interventions address physical limitations and psychological stressors, empowering patients in self-care. Promoting active family involvement and providing emotional support significantly boosts patient confidence and stoma acceptance, facilitating optimal quality of life. In conclusion, nursing care for this specific group is complex due to cancer treatments, comorbid hypertension, and lifestyle modifications. Outpatient nurses are critical in planning safe, continuous care to prevent complications. To enhance comprehension, developing visual teaching aids, such as illustrated handbooks or QR codes, is highly recommended over verbal instructions alone.