Question

Which of the following exercises in the mastectomy client is most appropriate as initial therapy during the immediate postop period? A. Self-feeding and hair combing B. Passive/active flexion and extension on elbow and wrist C. Abduction and external rotation of right shoulder D. Early ambulation and active extension on the elbow

Short answer

Answer: A. Self-feeding and hair combing

Step-by-step solution

Review the options

The exercise provides four alternatives of exercises for initial therapy in a mastectomy client right after surgery: A. Self-feeding and hair combing B. Passive/active flexion and extension on elbow and wrist C. Abduction and external rotation of right shoulder D. Early ambulation and active extension on the elbow

Eliminate inappropriate options

Upon analyzing the options, C (abduction and external rotation of the right shoulder) can be eliminated because it might put strain on the surgical site and exacerbate pain. Additionally, D (early ambulation and active extension on the elbow) places direct stress on the upper body, which is not recommended for a mastectomy client during the immediate post-op period.

Compare remaining options

Now we are left with options A (self-feeding and hair combing) and B (passive/active flexion and extension on elbow and wrist). We need to determine which exercise is a better fit for a mastectomy client in the immediate postoperative phase. Option A promotes upper body mobility without directly affecting the surgical site, whereas option B focuses on joint mobility of the elbow and wrist. Both options may help the recovery process, but option A involves lower risk of complications and can help promote a gradual recovery.

Choose the most appropriate therapy

Considering the analysis above, we can conclude that: The most appropriate initial therapy for a mastectomy client during the immediate post-op period is: A. Self-feeding and hair combing

Key concepts

Postoperative Nursing Care

After a mastectomy, postoperative nursing care is crucial to ensure the patient's recovery process is smooth and complication-free. Nursing care involves assessing the surgical site for signs of infection or complications, pain management, and emotional support.

Patients are encouraged to engage in exercises that enhance circulation and prevent stiffness without exerting stress on the affected area. Self-feeding and hair combing, as mentioned in the exercise, are simple activities that serve as an initial step in regaining mobility while promoting independence. The nurse must also educate the patient on the importance of these exercises and how to perform them safely. Furthermore, regular monitoring of vital signs, wound care, and the management of drains if present are also integral parts of postoperative nursing care.

Mastectomy Recovery

Recovery after a mastectomy is a gradual process that requires careful attention to physical and emotional well-being. Initially, exercises should be gentle and focused on areas away from the surgical site to prevent complications such as lymphedema or seroma.

As the patient progresses, exercises can transition from passive to more active movements, always ensuring they are pain-free and within a safe range of motion. It is advisable to communicate the exercise plans with the healthcare provider and have regular follow-ups for the best recovery outcomes. Besides exercises, recovery also encompasses other aspects, such as proper nutrition, rest, and psychological support to address any concerns or anxieties related to body image changes or the diagnosis itself.

NCLEX-PN Exam Preparation

Preparation for the NCLEX-PN exam for aspiring practical nurses must encompass understanding of postoperative care strategies, inclusive of those required for mastectomy patients.

A solid study plan should include reviewing content related to surgical recovery, patient teaching, pain management, and therapeutic exercises. Candidates are encouraged to use various study resources such as textbooks, practice tests, and online learning platforms that offer realistic simulation of the testing environment. Understanding questions like the one provided, which challenge the student to apply their knowledge to specific clinical scenarios, is key to succeeding in the exam. It is beneficial for students to study these scenarios methodically and understand the rationale behind each step, to gain the critical thinking skills necessary to pass the NCLEX-PN exam.