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Special Clientele > Mastectomy > Flashcards

Mastectomy Flashcards

1
Q

Occurance

A
  • Breast cancer is the most common form of cancer in while females over 40
  • 1 out of 6 women will develop
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2
Q

Reach to Recovery

A
  • One-to-One pt education program sponsored by American Cancer Society
  • Provides emotional support
  • Also provides pt’s with information
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3
Q

Surgical Mastectomy Procedures

A
  • Radial Mastectomy
  • Modified Radical
  • Simple
  • Breast conserving surgery may be possible
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4
Q

Radial Mastectomy

A
  • Breast, pectoralis mm, chest fascia and lymph nodes are removed
  • Chemotherapy and radiation follow
  • Some nerve tissue may be distrubed
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5
Q

Modified Radical

A
  • Breast, chest fascia, and lymph nodes removed
  • Pectoralis mm remain intact
  • May be followed by radiation and chemotherapy
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6
Q

Simple

A
  • Breast only removed

- Usually followed by radiation which can lead to lymphatic problems

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7
Q

Clinical problems or symptoms

A
  • Post-op Pain
  • Lymphedema
  • Weakness of the involved UE
  • Chest wall adhesions
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8
Q

Post-op Pain

A
  • Incisional
  • Posterior cervical and shoulder girdle pain secondary to mm guarding
  • Decrease use of UE’s secondary to pain
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9
Q

Incisional

A
  • Can lead to decreased ROM, postural deformities, pulmonary complications
  • Healing may be delayed with radiation therapy
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10
Q

Posterior cervical and shoulder girdle pain secondary to mm guarding especially in…

A
  • Levator scapulae
  • Teres major and minor
  • Infraspinatus
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11
Q

Decrease use of UE’s secondary to pain may lead to..

A
  • Frozen shoulder

- Increased likelihood of lymphedema in the hand and arm

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12
Q

Lymphedema Symptoms

A
  • Increase size of extremity
  • Taut skin and increase risk of skin breakdown
  • Stiffness and decrease ROM fingers
  • Sensory distrubances in hand
  • Decrease overall function UE
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13
Q

Weakness with radical mastectomy

A
  • horizontal adductors, scapular protraction. scapular depression and downward rotation, internal rotation, adduction ,extension on fixed hand
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14
Q

Weakness serratus anterior

A
  • due to removal of lymph nodes and/or scarring post radiation therapy causing possible trauma to the thoracic nerve which supplies serratus anterior
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15
Q

There for decrease active ______ and ______ due to decreased stabilization and movement of _______. Can also lead to faulty _______, ______, and increase risk of ______ ________.

A
  • Flexion
  • Abduction
  • Scapula
  • Biomechanics
  • Impingement
  • Frozen Shoulder
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16
Q

Chest wall adhesion’s secondary to..

A
  • Scarring
  • Infection
  • Radiation
17
Q

Chest wall adhesion’s contribute to

A
  • Decrease in function of the involved UE
  • Increased risk of post-op pulmonary complications
  • Postural Dysfunction
  • Pain in neck, shoulder girdle, and upper back
18
Q

What type of massage is important to chest wall adhesion’s

A
  • Cross fiber massage
19
Q

Initially prevent..

A
  • Postoperative pulmonary complication’s
  • USE
    Breathing Ex’s and Effective Coughing
20
Q

Prevention or minimizing postoperative lymphedema

A
  • Elevation of UE in bed and sitting (ie: sling)
  • Wrapping UE with elastic bandages or wearing an elastic pressure-gradient sleeve and/ or glove
  • Massage distal to proximal with arm elevated (open nodes 1st)
  • Pumping exercises for involved UE
  • Daily use of a mechanical pneumatic pump for at least 1 1/2-2 hours twice a day
  • Early ROM ex’s and UE ergometry
  • Encourage light functional use of involved UE
21
Q

Prevent Postural Deformities

A
  • Instructions in proper bed positioning preoperatively or on the first postoperative day, emphasize midline and symmetrical positioning of the shoulders and trunk
  • Carryover of symmetric posture to sitting and standing
  • Postural training with emphasis on scapular retraction and correct posturing
22
Q

Prevent muscle tension in cervical musculature

A
  • AROM ot cervical spine to promote relaxation
  • Scapular mobility and UE ex’s
  • Gentle massage to cervical and upper thoracic musculature
23
Q

Maintain or increase strength in the involved shoulder

A
  • Isometric ex’s to the shoulder musculature, initiated on the first postoperative day with the pt in bed
  • Isotonic ex’s may be initiated 3-4 days postoperatively
24
Q

Improve exercise tolerance, sense of well-being and reduce fatigue

A
  • Graded low intensity ex’s

- Walking, cycling

25
Q

Prepare pt for home program and possible participation in support group

A
  • Pt/Significant other education
26
Q

Post-op Precautions

A
  • Do not put undue stress on incision and sutures
  • Watch for blanchin
  • Avoid dependent positioning
  • Be aware of possible poor wound healing post radiation

Special Clientele (34 decks)

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