Mastectomy Care

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Mastectomy Care
Prepared by Dr. Manal Moussa Ibrahim
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• Outlines
• Postoperative Interventions.
• Hand and Arm Care.
• Exercises After Breast Surgery.
• Drain Management.
• Nursing Interventions.
• Reduce anxiety.
• Measures to relieve pain.

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Postoperative Interventions

• Inform patient regarding common
• postoperative sensations.
• Maintain privacy.
• Provide bra with breast form.
• Provide information.
• Support coping and adjustment.
• Provide counseling and referral.
• Monitor for potential complications.

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Hand and Arm Care

• Potential for lymphedema formation after
  auxiliary lymph node dissection (ALND).
• Patient education.
• Prevention is vital follow guidelines for the
  rest of life.
• No blood pressure, injections, or blood draws in
  the affected arm.
• Perform exercises 3X a day for 20 minutes to
  increase circulation and muscle strength, prevent
  stiffness and contractures.
• A mild analgesic or a warm shower may be helpful
  prior to exercise.
• Initial limitation of lifting (over 5) and
  activity.

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Exercises After Breast Surgery
Wall climbing
Rod lifting
Pulley tugging
Rope turning
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Drain Management

• May need home care referral to assist with drain
  management.
• Drains are usually removed when drainage is less
  than 30 mL in a 24-hour period usually occurs in
  7 to 10 days.
• Drain site and incision care.

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Question

• Which of the following would be an appropriate
  nursing diagnosis for an uncomplicated
  postoperative patient who has undergone a
  mastectomy?
• Altered nutrition.
• Disturbed body image
• Ineffective airway clearance.
• Risk for injury.

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Answer

• Disturbed body image
• Rationale Disturbed body image related to loss
  or alteration of the breast is the appropriate
  diagnosis.

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Nursing Interventions

• Discuss nursing interventions to
• Relieve pain.
• Facilitate urinary elimination.
• Reduce anxiety.
• Educate patient.

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Reduce anxiety - Be sensitive to potentially
embarrassing and



culturally charged issues. - Establish a
professional, trusting relationship
Provide privacy. - Allow the patient to
verbalize concerns. - Provide and reinforce
information. - Provide patient teaching
including explanations of anatomy and function,
diagnostic tests and surgery, and the surgical
experience.
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• Measures to relieve pain
• - Monitor urinary drainage and keep catheter
  patent.
• Assessment of pain.
• - Bladder spasms cause feelings of pressure and
  
  
  
  
  fullness, urgency to void, and bleeding from the
  urethra around the catheter.
• - Medication and warm compresses or baths relieve
  spasms.
• - Administer analgesics and antispasmodics as
  needed.
• - Encourage patient to walk but to avoid sitting
  for prolonged periods.
• - Prevent constipation.
• - Irrigate catheter as prescribed.

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