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
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.
- Impaired Skin Integrity
- Acute Pain
- Situational Low Self-Esteem
- Impaired Physical Mobility
- Deficient Knowledge
- Risk for Injury
- Impaired Skin Integrity
- Activity Intolerance
- Risk for Ineffective Breathing Pattern
- Risk for Infection
- Ineffective Therapeutic Management
- Risk for Dysfunctional Grieving
- Ineffective Peripheral Tissue Perfusion
- Other Possible Nursing Care Plans
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
- Acknowledge and discuss concerns.
- Demonstrate appropriate range of feelings.
- Report fear and anxiety are reduced to a manageable level.
|Check out and explore what information 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 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 opportunity to identify and clarify misconceptions and offer emotional support.|
|Determine degree of support available to patient. Give information about community resources, such as Reach to Recovery, YWCA Encore program. Encourage and provide for 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 patient can achieve the best possible level of physical and emotional functioning.|
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