Presentation on theme: "Care modalities after mastectomy"— Presentation transcript:
1Care modalities after mastectomy Umm Al-Qura UniversityApplied Medical Sciences CollageNursing DepartmentMedical & surgical nursing course 2Care modalities after mastectomyMs. Ahdab Faisal Eskandar
2Objectives: Define mastectomy List types of mastectomy Describe post operative nursing interventionsEnumerate possible complication and its nursing managementsPatient teachingDemonstrate exercise after mastectomy
3What is the meaning of mastectomy? It is surgical operation done to remove malignant breast tissues
4Types Simple mastectomy Partial mastectomy Radical mastectomy (the entire breast is removed, but the lymph nodes and surrounding muscle are left intact)Partial mastectomy(a larger amount of breast tissue and some skin are removed with the tumor.)Radical mastectomy(to remove all affected tissues and even the surrounding one as well ). used in cases of extensive tumors
6Post operative nursing interventions Reliving pain and discomfortMany patients tolerate the breast surgery quite well and have minimal pain during the postoperative periods.N.I : Analgesic medication, warm bath or relaxation and distraction methods .
7Post operative nursing interventions Managing post operative sensationCommon sensation such as tenderness , numbness , tightness , , and pulling.Phantom sensation( feeling post mastectomy that breast \ and or nipple are still present).May persist for 2 years or longer .N.I: reassure the patient and these sensations are not indication of problem
8Post operative nursing interventions Promoting positive body imageN.I :Emotional distress patient need (Conversation treatment)or-Breast reconstructions- Temporary breast form to place in her bra
10Post operative nursing interventions Promoting positive adjustment and copingN.I : Identifying supporting system and providing information-Anxiety related to treatment (e.g. chemotherapy)Ineffective coping need consultation of mental health practitioner
11Monitoring and managing potential complications Complications post mastectomy are:LymphedmaHematoma or seroma formationInfection
12complications Lymphedma: It results if functioning lymphatic channels are inadequate to ensure a return flow of lymph fluids to general circulation .-Performing exercises can help reduce transient edema
13complications Hematoma or seroma formation: Hematoma :is collection of blood inside cavityUsually develops within first 12 hours after surgeryThe nurse should assessSign & symptoms : swelling, tightness, pain and bruising of skinPatient may take warm shower or apply warm compressor
14complications Hematoma or seroma formation: Seroma :collection of serous fluid under mastectomy incision .If drain being removed or obstructedSign and Symptoms: swelling , discomfort , heaviness and sloshing of fluidIf large amount doctor manually aspirating fluid with needle and syringe
15complications Infection Risk factor for infection such as: Diabetes , older age, poor hygiene and immune disorder.Sign and symptoms :RednessTendernessFoul smelling drainageFever and chills
171- Patient should report infection , arm swelling , hematoma or seroma 1- Patient should report infection , arm swelling , hematoma or seroma . 2- Hygiene is important to prevent infection ( shower can be on 2nd day post operative) 4- The drains usually removed when the output is less than 30 ml in 24 hours
18Home care:* Patient can empty and measure fluids from drainage devices.*Patient should contact her doctor if ( sudden change in color of drainage or sudden cessation of drainage )*Patient know how to milk clots through tubing of drainage devices.
201- Avoid blood pressure , injections & blood extraction in affected extremity. 2- Avoid insect bites.3- Avoid lifting objects greater than 5-10 pounds4- Use sunscreen for extended exposure to sun.
21Exercises after breast surgery Range of motion exercies are initial on the 2nd day post op.Goals of exercises:1- increase circulation and muscles strength2- Prevent joint stiffness and contractures3- Restore full range of motionExercise done 3 times a day for 20 minutes at a time (4-6 weeks)
22Exercises after breast surgery Rod broomstick liftingRope turningWall hand climbingPulley tugging
26Wall hand climbingStand facing wall with feet apart and toes as close as possibleBalm slightly bent , place palms of the hand on the wall at shoulders levelBy flexing fingers works hand up the wall until arm are fully extendedReverse process, working hands down to starting point.
31Pulley tugging1. Toss light rope over a shower curtain rod or doorway curtain rod. 2. Stand as nearly under rope as possible. 3. Grasp end in each hand 4. Extend arm straight and away from body 5. Pull the left arm up by tugging down with right arm , continue in see- sawing motion.