15+ Mastectomy Nursing Care Plans

Fear/Anxiety

Nursing Diagnosis

• Fear
• Anxiety

May be related to

• The threat of death, e.g., the 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

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

Nursing Assessment and Rationales

1. Check out and explore what information the patient has about diagnosis, expected surgical intervention, and future therapies. Note the presence of denial or extreme anxiety.
Provides a knowledge base for the nurse to enable the reinforcement of needed information, and helps identify patients 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.

2. Ascertain the purpose and preparation for diagnostic tests.
More understanding of procedures and what is happening increases feelings of control and lessens anxiety.

Nursing Interventions and Rationales

1. Implement an ambiance of concern, openness, and availability, as well as privacy for patients and SO. Suggest that SO be present as much as possible.
Time and privacy are needed to provide support, and discuss feelings of anticipated loss and other concerns. Therapeutic communication skills, open questions, listening, and so forth facilitate this process.

2. Encourage questions and provide time for the expression of fears. Tell the 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.

3. Determine the degree of support available to the patient. Give information about community resources, such as Reach to Recovery, and the YWCA Encore program. Encourage and provide for a visit with a woman who has recovered from a mastectomy.
Can be a helpful resource when the 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 a normal future.

4. Consider the 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.