15+ Mastectomy Nursing Care Plans

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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:

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  1. Fear/Anxiety
  2. Impaired Skin Integrity
  3. Acute Pain
  4. Situational Low Self-Esteem
  5. Impaired Physical Mobility
  6. Deficient Knowledge
  7. Risk for Injury
  8. Impaired Skin Integrity
  9. Activity Intolerance
  10. Risk for Ineffective Breathing Pattern
  11. Risk for Infection
  12. Ineffective Therapeutic Management
  13. Risk for Dysfunctional Grieving
  14. Ineffective Peripheral Tissue Perfusion
  15. Fear
  16. Other Possible Nursing Care Plans
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Impaired Physical Mobility

Nursing Diagnosis

May be related to

  • Neuromuscular impairment; pain/discomfort; edema formation

Possibly evidenced by

  • Reluctance to attempt movement
  • Limited range of motion (ROM); decreased muscle mass/strength

Desired Outcomes

  • Client will display a willingness to participate in therapy.
  • Client will demonstrate techniques that enable resumption of activities.
  • Client will have an increase in strength of affected body parts.
Nursing InterventionsRationale
Elevate affected arm as indicated.Promotes venous return, lessening the possibility of lymphedema.
Facilitate passive ROM (flexion and extension of elbow, pronation, and supination of the wrist, clenching and extending fingers) as soon as possible.Early postoperative exercises are usually started in the first 24 hr to prevent joint stiffness that can further limit movement and mobility.
Have patient move fingers, noting sensations and color of hand on affected side.Lack of movement may reflect problems with the intercostal brachial nerve, and discoloration can indicate impaired circulation.
Encourage patient to use affected arm for personal hygiene (feeding, combing hair, washing face).Increases circulation, helps minimize edema, and maintains strength and function of the arm and hand. These activities use the arm without abduction, which can stress the suture line in the early postoperative period.
Help with self-care activities as necessary.Conserves patient’s energy, prevents undue fatigue.
Assist with ambulation and encourage correct posture.Patient will feel unbalanced and may need assistance until accustomed to change. Keeping back straight prevents shoulder from moving forward, avoiding permanent limitation in movement and posture.
Advance exercise as indicated such as active extension of arm and rotation of shoulder while lying in bed, pendulum swings, rope turning, elevating arms to touch fingertips behind the head.Prevents joint stiffness, increases circulation, and maintains muscle tone of the shoulders and arm.
Teach patient proper breathing technique of slow, deep breaths during exercise.Contraction of abdominal muscles helps push fluid out of the cisterna chyli (a lymphatic reservoir) and through the thoracic duct, creating a vacuum effect enhancing drainage.
Progress to hand climbing (walking fingers up the wall), clasping hands behind head, and full abduction exercises as soon as the patient can manage.Because this group of exercises can cause excessive tension on the incision, they are usually delayed until the healing process is well established.
Evaluate the presence and degree of exercise-related pain and changes in joint mobility. Measure upper arm and forearm if edema develops.Monitors progression and resolution of complications. May need to postpone increasing exercises and wait until further healing occurs.
Discuss types of exercises to be done at home to regain strength and enhance circulation in the affected arm.Exercise program needs to be continued to regain optimal function of the affected side.
Coordinate exercise program into self-care and homemaker activities (dressing self, washing, dusting, mopping) and leisure activities, such as swimming.Patient is usually more willing to participate or finds it easier to maintain an exercise program that fits into the lifestyle and accomplishes tasks as well.
Assist patient to identify signs and symptoms of shoulder tension (inability to maintain posture, burning sensation in post scapular region). Instruct patient to avoid sitting or holding the arm in dependent position for extended periods.Altered weight and support put tension on surrounding structures.
Administer medications as indicated:
  • Analgesics
Pain needs to be controlled before exercise or patient may not participate optimally and incentive to exercise may be lost.
May be useful in treating and preventing fluid accumulation and lymphedema.
Maintain integrity of elastic bandages or custom-fitted pressure-gradient elastic sleeve.Promotes venous return and decreases the risk of edema formation.
Refer to physical or occupational therapist.Provides individual exercise program. Assesses limitations and restrictions regarding employment requirements.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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