Care of Post Mastectomy PatientIs the care rendered towards patients who have under gone breast mastectomy. Care is rendered not just post operatively but also for rehabilitative and long term purposes also.Mastectomy is the excision or removal of the breast. This is usually the procedure of choice for operating in invasive cancer.

Types of Breast SurgeryLumpectomy- removal of lump or mass. Also known as tylectomy.Partial or Simple Mastectomy- which includes wide excision, quadrantectomy, or segmental mastectomy is removal of the portion of the breast that contains the tumor.Modified Radical Mastectomy- the affected breast is completely removed.

PurposesPrevent post operative complicationsPromote adequate tissue perfusion and integrity.Preventing infections from occurringAcceptance of self and body imageContinuous medical careGaining adequate knowledge on operation, complications and post mastectomy activities.Rehabilitation and health promotion

AssessmentIdentify patient properly and read the patients chart to review dataAssess patients vital signs to obtain dataAssess the patients psychological status and level of consciousnessAssess wound (noting the color and status) and drainage and presence of clinical manifestationsAssess for any pain and discomfort

Expected OutcomePatient will not experience any post operative complications (bleeding, infection, lymphedema etc.)Patient will tolerate procedure well.Continuous medical management and compliance to treatment regimen.Understanding on procedures and Perform properly the exercises

PlanningDetermine what supplies or materials are neededWash hands for infection controlPrepare equipments and materials to be used

Equipments

BP apparatusThermometerDisposable clean glovesCottonballs wet with alcohol and dry cotton ballCottonballs with betadineOS and micropore

EvaluationExpected Outcome:No complications post operatively (bleeding, infection etc.)Patient understands breast mastectomy and compliance of medical regimen.Regain full range of motion, strength and tolerates activities of daily living.Verbalizes positive outlook on breast mastectomy and self image

Unexpected outcomes:1. Bleeding observe and measure accordingly and document and report2. Pain and numbness give medications as ordered, exercise3. Lymphedema arm placed on pillow with each joint higher that of the proximal jointDont sleep on involved armExercise the armWear loose clothing to prevent constriction and circulation.BP is taken on the opposite limb

Procedures that should not be performed on the affected armBlood Pressure monitoringIV infusionsVaccination or sensitivity testingBlood drawingsInjections

A pink highlighted area indicates tissue removed at mastectomyB axillary lymph nodes: levels IC axillary lymph nodes: levels IID axillary lymph nodes: levels IIIE supraclavicular lymph nodesF internal mammary lymph nodes*A dark area indicates tumorB light pink highlighted area indicates tissue removed at lumpectomy*A pink highlighted area indicates tissue removed at mastectomyB axillary lymph nodes: levels IC axillary lymph nodes: levels IID axillary lymph nodes: levels III*