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.
- 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
Situational Low Self-Esteem
- Situational Low Self-Esteem
May be related to
- Biophysical: disfiguring surgical procedure
- Psychosocial: concern about sexual attractiveness
Possibly evidenced by
- Actual change in structure/body contour
- Verbalization of fear of rejection or of reaction by others, change in social involvement
- Negative feelings about body, preoccupation with change or loss, not looking at body, nonparticipation in therapy
- Client will demonstrate movement toward acceptance of self in situation.
- Client will recognize and incorporate change into self-concept without negating self-esteem.
- Client will set realistic goals and actively participate in a therapy program.
|Encourage questions about the current situation and future expectations. Provide emotional support when surgical dressings are removed.||Loss of the breast causes many reactions, including feeling disfigured, fear of viewing scar, and fear of the partner’s reaction to change in the body.|
|Identify role concerns as woman, wife, mother, career woman, and so forth.||May reveal how patient’s self-view has been altered.|
|Encourage patient to express feelings like anger, hostility, and grief.||Loss of body part, disfigurement, and perceived loss of sexual desirability engender grieving process that needs to be dealt with so that patient can make plans for the future. Note: Grief may resurface when subsequent procedures are done (fitting for prosthesis, reconstructive procedure) if postponed.|
|Open up about signs and symptoms of depression with the patient and SO.||Common reaction to this type of procedure that needs to be recognized and acknowledged to seek timely intervention as indicated.|
|Provide positive reinforcement for gains or improvement and participation in self-care and treatment program.||Encourages the continuation of healthy behaviors.|
|Review possibilities for reconstructive surgery or prosthetic augmentation.||If feasible, reconstruction provides less disfiguring or “near-normal” cosmetic result. Variations in skin flap may be done for facilitation of reconstructive procedure, which is often performed at the same time as the mastectomy. The associated emotional boost may help patient get through the more complex surgical recovery process and adjunctive therapies. Note: On occasion, reconstruction may not be done for 3–6 mo. A prolonged delay may result in increased tension in relationships and impair patient’s incorporation of changes into self-concept.|
|Ascertain feelings and concerns of partner regarding sexual aspects, and provide information and support.||Negative responses directed at patient may actually reflect partner’s concern about hurting patient, fear of cancer or death, difficulty in dealing with personality and behavior changes in patient, or inability to look at the operative area.|
|Discuss and refer to support groups, including Men in Our Lives for SO, as appropriate.||Provides a place to exchange concerns and feelings with others who have had a similar experience, and identifies ways SO can facilitate patient’s recovery.|
|Provide temporary soft prosthesis, if indicated.||Prosthesis of nylon and Dacron fluff may be worn in bra until incision heals if reconstructive surgery is not performed at the time of mastectomy. This may promote social acceptance and allow patient to feel more comfortable about body image at the time of discharge.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans and nursing diagnoses related to reproductive and urinary system disorders:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Renal Failure | 6 Care Plans
- Benign Prostatic Hyperplasia (BPH) | 5 Care Plans
- Chronic Renal Failure | 11 Care Plans
- Hemodialysis | 3 Care Plans
- Hysterectomy (TAHBSO) | 6 Care Plans
- Mastectomy | 14+ Care Plans
- Menopause | 6 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Peritoneal Dialysis | 6 Care Plans
- Prostatectomy | 6 Care Plans
- Urolithiasis (Renal Calculi) | 4 Care Plans
- Urinary Tract Infection | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans