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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Deficient Knowledge

Nursing Diagnosis

May be related to

  • Lack of exposure/recall
  • Information misinterpretation

Possibly evidenced by

  • Questions/request for information; statement of misconception
  • Inaccurate follow-through of instructions, development of preventable complications

Desired Outcomes

  • Client will verbalize understanding of disease process and potential complications.
  • Client will perform necessary procedures correctly and explain reasons for actions.
  • Client will initiate necessary lifestyle changes and participate in the treatment regimen.
Nursing InterventionsRationale
Review disease process, surgical procedure, and future expectations.Provides knowledge base from which patient can make informed choices, including participation in radiation and chemotherapy programs.
Have patient demonstrate care of drains and wound sites.Shorter hospital stays may result in discharge with drains in place, requiring more complex care by patient or caregivers. Drains may be removed 7–10 days after surgery.
Encourage continuation of exercises, increasing program as healing progresses, for at least a year.Enhances development of collateral lymphatic channels, reduces the tightening of scar tissue, and maintains muscle strength and function. Note: Moderation is important because strenuous activity and exercise increases heart rate and body temperature, which can potentially increase edema.
Discuss necessity for well-balanced, nutritious meals and adequate fluid intake.Provides optimal nutrition and maintains circulating volume to enhance tissue regeneration and healing process.
Suggest alternating schedule of frequent rest and activity periods, especially in situations when sitting or standing is prolonged.Prevents or limits fatigue, promotes healing, and enhances feelings of general well-being. Positions in which arm is dangling and extended intensify stress on affected structures, creating muscle tension and stiffness, and may interfere with healing.
Instruct patient to protect hands and arms by wearing long sleeves and gloves when gardening; use thimble when sewing; use potholders when handling hot items; use plastic gloves when doing dishes; avoid lifting or moving heavy objects; and do not carry a purse or wear jewelry and wristwatch on the affected side.Compromised lymphatic system causes tissues to be more susceptible to infection or injury, which may lead to lymphedema.
Demonstrate holding affected arm appropriately by not dangling the arm, swinging arms with elbows bent when walking, placing arm above heart level when sitting or lying down.Helps prevent or minimize lymphedema and “frozen shoulder.”
Warn against having blood withdrawn or receiving IV fluids, medications or BP measurements on the affected side.May restrict the circulation and increase the risk of infection when the lymphatic system is compromised.
Recommend wearing of a medical identification device.Prevents unnecessary trauma (BP measurements, injections) to affected arm in emergency situations.
Demonstrate the use of intermittent sequential pumping or low-stretch compression custom-made garments, as appropriate.Occasionally used in managing lymphedema by promoting circulation and venous return.
Suggest gentle massage of the healed incision with emollients.Stimulates circulation, promotes elasticity of the skin, and reduces discomfort associated with phantom breast sensations.
Recommend use of sexual positions that avoid pressure on the chest wall. Encourage alternative forms of sexual expression (cuddling, touching) during the initial healing process while operative area is still tender.Promotes feelings of femininity and sense of ability to resume sexual activities.
Encourage regular self-examination of remaining breast. Determine the recommended schedule for mammography.Identifies changes in breast tissue indicative of recurrent or new tumor development.
Stress importance of regular medical follow-up.Other treatment may be required as adjunctive therapy, such as radiation. Recurrence of malignant breast tumors also can be identified and managed by an oncologist.
Identify signs and symptoms requiring medical evaluation (breast or arm red, warm, and swollen; edema, purulent wound drainage; fever or chills).Lymphangitis can occur as a result of infection, causing lymphedema.
Address additional concerns as indicated like ongoing therapies and expected adverse side effects.Medications, such as tamoxifen (Nolvadex) used as a follow-up to surgery and radiation require ongoing involvement in care.
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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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