University of Texas, Rio Grande Valley - NURSING 3505ATI Capstone Focus Review.

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Focused Review: RN ATI Capstone Proctored Comprehensive Assessment A Cancer disorders: Planning discharge teaching for a client who is postoperative following a modified radical mastectomy-AMS Chapt... er 92  Modified 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. [Show More]

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