15+ Mastectomy Nursing Care Plans

January 25, 2012

Mastectomy is the surgical removal of one or both breasts either partially or completely. A mastectomy is usually carried out to treat or prevent breast cancer. Surgical management for patients with breast cancer usually involves lumpectomy or mastectomy. In many cases, radiation therapy is combined with surgery.

Types of breast surgery include:

Total (simple) mastectomy – removal of breast tissue and nipple
Modified radical mastectomy – removal of the breast, most of the lymph nodes under the arm, and often the lining over the chest muscles
Lumpectomy – surgery to remove the tumor and a small amount of normal tissue around it

Nursing Care Plans

Providing perioperative nursing care for patients who are to undergo Mastectomy is an integral part of the therapeutic regimen. The nursing goal is to provide support, alleviating anxiety, managing pain, and providing information.

Here are 15+ nursing care plans (NCP) and nursing diagnosis for a patient undergoing Mastectomy:

Fear/Anxiety

Fear: Response to perceived threat that is consciously recognized as a danger.

Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.

May be related to

Threat of death, e.g., extent of disease
Threat to self-concept: change of body image; scarring, loss of body part, sexual attractiveness
Change in health status

Possibly evidenced by

Increased tension; apprehension; feelings of helplessness/inadequacy
Decreased self-assurance
Self-focus; restlessness; sympathetic stimulation
Expressed concerns regarding actual/anticipated changes in life

Desired Outcomes

Client will acknowledge and discuss concerns.
Client will demonstrate appropriate range of feelings.
Client will report fear and anxiety are reduced to a manageable level.

Nursing Interventions	Rationale
Check out and explore what information the patient has about diagnosis, expected surgical intervention, and future therapies. Note presence of denial or extreme anxiety.	Provides knowledge base for the nurse to enable the reinforcement of needed information, and helps identify patient with high anxiety, low capacity for information processing, and need for special attention. Note: Denial may be useful as a coping method for a time, but extreme anxiety needs to be dealt with immediately.
Ascertain purpose and preparation for diagnostic tests.	More understanding of procedures and what is happening increases feelings of control and lessens anxiety.
Implement an ambiance of concern, openness, and availability, as well as privacy for patient and SO. Suggest that SO be present as much as possible.	Time and privacy are needed to provide support, discuss feelings of anticipated loss and other concerns. Therapeutic communication skills, open questions, listening, and so forth facilitate this process.
Encourage questions and provide time for expression of fears. Tell patient that stress related to breast cancer can persist for many months and to seek help and support.	Provides an opportunity to identify and clarify misconceptions and offer emotional support.
Determine the degree of support available to the patient. Give information about community resources, such as Reach to Recovery, YWCA Encore program. Encourage and provide for a visit with a woman who has recovered from a mastectomy.	Can be a helpful resource when patient is ready. A peer who has experienced the same process serves as a role model and can provide validity to the comments, hope for recovery and normal future.
Consider role of rehabilitation after surgery.	Rehabilitation is an essential component of therapy intended to meet physical, social, emotional, and vocational needs so that the patient can achieve the best possible level of physical and emotional functioning.