Question

Nursing Process

FACTS Gillian Marks, 51, says she has trouble falling asleep since she had a mastectomy 2 months ago. She says that her
Fears about the prognosis get worse when she is not active and busy. You have tried to read or watch TV, but cannot fall asleep
nor relaxed. She seems to be nervous and uneasy.

Answer 1

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 postoperative 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. 15+ nursing care plans (NCP) and nursing diagnosis for a patient undergoing Mastectomy:

Fear/Anxiety
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
Fear
Other Possible Nursing Care Plans

In the case of 51 years gillian mark , after 2 months of mastectomy , she is unable to sleep due to fear . The suitable nursing interventions are mentioned below :

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 an opportunity to identify and clarify misconceptions and offer emotional support.

Determine the degree of support available to the patient. Give information about community resources, peer groups post recovery . Encourage and provide for a 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 the patient can achieve the best possible level of physical and emotional functioning.

Stress on proper handwashing , instrust on proper wound care , encourage Vitamin C rich food , closely observe signs and report accordingly ,inspect the wound for swelling , infection and further Complications .

Inform treating physician for any untoward Complication noted - early detection can lessen the extent of damage that might happen to the patient with proper diagnosis test post- operative nursing care .