Cancer disorders: Planning discharge teaching for a client who is postoperative following a modified radical mastectomy-AMS Chapter 92
• Modified
... [Show More] radical mastectomy: lymph nodes removed
• Nursing Actions:
➢ Have the client sit with the head of the bed elevated 30° when awake and support her arm on a pillow. Lying on the unaffected side can relieve pain.
➢ Have the client wear a sling while ambulating (to support arm).
➢ Avoid administering injections, taking blood pressure, or obtaining blood from the client’s affected arm. Please a sign above the client’s bed regarding these precautions.
➢ Emphasize the importance of well-fitted breast prosthesis for a client who had a mastectomy.
➢ Provide emotional support to the client and her family
➢ Encourage the client to express feelings related to perception of sexuality and body image.
• Client education:
➢ Teach the client how to care for her incision and drainage tubes (drains are usually left in for 1 to 3 weeks)
➢ Advise the client to avoid placing her arm in a dependent position. This position will interfere with wound healing.
➢ Encourage early arm and hand exercises (squeezing a rubber ball, elbow flexion and extension), and hand-wall climbing to prevent lymphedema and to regain full range of motion
➢ Teach the client not to wear constrictive clothing and to avoid cuts and injuries on the affected arm.
Continuity of care: Interventions promoting independence- CH Chapter 7
• Community health nurses play a large role in maintaining continuity of care for clients as they transition from acute to outpatient settings and promote independence.
• Group partnering to elicit needed change in the community are more powerful than a nurse working independently with an individual.
• Nursing interventions:
➢ Initiate necessary consults, or notify the provider of the client’s needs so the provider can initiate a consult.
➢ Seek expertise from health care professionals representing a variety of disciplines.
➢ The nurse educates clients about community resources and self-care measures
➢ Coordinate all health care services and resources.
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