MASTECTOMY AND ITS NURSING MANAGEMENT.pdf

Mastectomy definition, types, causes, risk factors, pre operative nursing management, post operative nursing management, complication.

1. PREPARED BY DOLISHA WARBI

2. MASTECTOMY:
DEFINITION:
A mastectomy is a surgical procedure involving the removal of one or both breasts, either partially or completely.
It is often performed as a treatment for breast cancer or as a preventive measure for individuals at high risk of
developing breast cancer.

3. TYPES:
•Total (simple) mastectomy. This method removes the whole breast.
•Modified radical mastectomy. The entire breast is removed. This includes the nipple, the areola, the
overlying skin, and the lining over the chest muscles. Some of the lymph nodes under the arm are also
removed.
•Radical mastectomy. The entire breast is removed, including the nipple, the areola, the overlying skin, the
lymph nodes under the arm, and the chest muscles under the breast.
•Skin-sparing mastectomy. The breast tissue, nipple, and areola are removed. But most of the skin over the
breast is saved.
•Nipple-sparing mastectomy. This is similar to the skin-sparing mastectomy. It is sometimes called a total
skin-sparing mastectomy. All of the breast tissue, including the ducts going all the way up to the nipple and
areola, is removed. But the skin of the nipple and areola are preserved.

4. CAUSES:
Breast Cancer
Preventive Mastectomy (Prophylactic Mastectomy) - Reduce their risk of developing breast cancer.
Severe Breast Trauma or Injury.
Inflammatory Breast Cancer.
Recurrent Breast Cancer - After previous treatments such as lumpectomy or radiation therapy.
Cosmetic Reasons.
Other Medical Conditions - Gender dysphoria treatment for transgender individuals etc.

5. RISK FACTORS:
ØBleeding
ØInfection
ØPain
ØSwelling (oedema) and lymphedema
ØSeroma
ØNerve damage
ØRestricted shoulder mobility
ØBlood clots (deep vein thrombosis)
ØAnaesthesia risk – Including allergic reactions, respiratory problems, and adverse reactions to medications.
ØImpact body image and self-esteem.

6. PRE OPERATIVE NURSING MANAGEMENT:
§Provide detailed information about the surgical procedure, including what to expect before,
during, and after the surgery.
§Educate the patient about potential complications, such as infection, bleeding, or
lymphedema, and how they will be managed.
§Conduct a thorough physical assessment to identify any preexisting conditions or risk
factors that may affect the surgical outcome.
§Administer preoperative medications as prescribed, including antibiotics and prophylactic
anticoagulants.
§Instruct the patient on how to perform preoperative skin preparation, including showering
with antiseptic soap, to reduce the risk of surgical site infection.
§Ensure that preoperative tests, such as blood work and imaging studies, are completed as
ordered.
§Assess the patient's emotional state and provide support as needed, addressing fears,
anxieties, and concerns about body image and self-esteem.
§Educate the patient about potential complications, such as infection, bleeding, or
lymphedema, and how they will be managed.
§Explain the importance of postoperative exercises and self-care techniques.

7. POST OPERATIVE NURSING MANAGEMENT:
§Monitor vital signs.
§Check the general condition of the patient.
§Administer pain medications as prescribed and assess their effectiveness.
§Monitor the surgical incision for signs of infection, hematoma, or dehiscence.
§Teach the patient how to care for the incision site, including proper wound cleansing and dressing changes.
§Monitor and manage surgical drains, if present, to promote proper drainage and prevent complications
such as infection or fluid accumulation.
§Encourage early mobilization and gentle exercises to prevent complications such as stiffness, muscle
weakness, and lymphedema.
§Provide emotional support and counseling to address body image concerns and psychological adjustment
to changes in physical appearance.
§Provide comfort to the patient (involving comfortable position and comfortable surrounding).
§Educate the patient about lymphedema prevention strategies, including avoiding heavy lifting, wearing
compression garments, and practicing proper skincare.
§Assess the patient's nutritional status and provide adequate nutrition to promote healing.
§Schedule follow-up appointments with the surgical team for wound checks, pathology results review, and
ongoing assessment of recovery progress.

8. COMPLICATION:
ØInjury/thrombosis of axillary vein.
ØSeroma.
ØShoulder dysfunction.
ØPain and numbness.
ØFlap necrosis and infection.
ØLymphoedema.
ØWinged scapula.