14 Mastectomy Nursing Care Plans

Nursing Care Plans |

NCP-Mastectomy Mastectomy is the surgical removal of the breast which is usually a surgical management for patients with breast cancer. This is done to prevent the metastasize of the cancer cells. Breast cancer is the most common malignancy experienced by women. Breast cancer is the uncontrolled growth of breast cells.

The nursing goal for a patient who underwent mastectomy can be: pain management, counseling due to disturbed body image, and preventing infection due to surgical incision.

This post contains 14 nursing care plans for patients who underwent mastectomy.

1. Risk for Injury

Areas involving the neck are considered to be the most vascularized parts of a person’s body. We all know that the most common complication of a surgery is excessive bleeding or hemorrhage, this was brought about by excessive blood loss intra or post operatively.

Assessment

Diagnosis

Objectives

Nursing Interventions

Rationale

Desired Outcomes

S: ØO:The patient may manifest:>edema>muscle weakness>aleter mobility>sensory and perceptual disturbances due to anesthesia>Apprehension, restlessness

>thirst; cold , moist, pale skin

>increase in pulse rate, respiration rate

>drop in temperature

>decrease in urinary output

Risk for Injury related to change in center of gravity secondary to extensive removal of chest tissue

Short term:After 3-4 hours of nurse-patient interaction, the patient will verbalize understanding of individual factors that contribute to possibility of injury and take steps to correct situations.Long Term:After 3-4 days of nurse-patient interaction, the patient will demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.

>Establish pt. Rapport> Monitor vital signs frequently.> Access mood, coping abilities and personality styles>Identify interventions and safety devices

> Encourage participation in self-help programs, such as assertiveness training, positive self image

> Provide bibliotherapyand written resources

> Assist client during periods of ambulation

> Walk lient’s unaffected side

> Instruct the client to keep the shoulders level and the muscle relaxed when walking

>To gain trust and cooperation of the pt.> VS could indicate possible bleeding> That may result in carelessness and increased risk-taking without consequences.> To promte safe physical environment and individual safety> To enhance self-esteem and sense of self-worth

> For later review and self-pced learning

> The nurse supports the client when or if client loose balance

> The lient is more likely to drift toward the side of the body that is heavier

> Clients tend to accommodate for the change in the center of gravity by leaning to the side

Short term:The patient shall verbalize understanding of individual factors that contribute to possibility of injury and take steps to correct situations.Long Term:The patient shall demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.