Fear related to surgical procedure of Modified Radical Mastectomy AEB increased alertness, avoidance Assessment S> O> patient

t may manifest: -increased alertness -avoidance -increased pulse rate - muscle tightness - increased respiratory rate -Dyspnea -increased blood pressure Nursing diagnosis Fear related surgical procedure of Modified Radical Mastectomy AEB increased alertness, avoidance Scientific Explanation MRM is a surgical removal of the entire breast and the lymph node around it. Fear is the most common feeling that the woman may feel before the surgery. Fear is a distressing emotion aoused by a perceived threat. It is a basic survival mechanism occurring in response to a specific objectives Short term: After 4 hours of nursing intervention the patient will able to acknowledge and discuss fears, recognizing healthy versus unhealthy fears and will able to verbalize sense of safety related to current situation Long term: After 2 days of nursing Nursing intervention >establish rapport to the patient assess general condition of the patient rationale Expected outcome Short term: to obtain The patient patients shall have trust and cooperatio acknowledge d and n discussed fears and recognizing to assess healthy and patient unhealthy general fears and condition shall have and to monitor if verbalized sense of there is safety any related to deviation on patient current situation health to monitor if there is alleviation on patient vital sings to assess

obtain patients vital signs

observe patient behavior

Long term: the patient shall have demonstrate

stimulus such as pain or the threat of danger. Women may think a lot of things that would be a result of the surgery such as being less physically attractive after the removal of her breast or even fear related to increasing local reoccurrence and decreasing survival rate.

intervention the patient will able to demonstrate understandin g through use of effective coping behaviors and resources, and will able to display appropriate range of feelings and lessened fear.

compare verbal and nonverbal responses be alert of signs of denial depression

patient degree of fear to note congruenc ies or mispercep tions to assess degree of fear and reality of threat perceived by the patient to provide usual support and this would help to diminish feeling of fear. To

stay with the patient or make arrangement

d understandin g through use of effective coping behaviors and resources and shall have displayed appropriate range of feelings and lessened fear.

provide opportunity for questions and answer

 provide presence/phys ical contact encourage patient to express feeling provide information about the current situation

enhances sense of trust and nursepatient relationshi p To soothe fears and provide assurance To identify feeling of the patient To help patient identify what is reality based

Knowledge deficit related to lack of information resource, information misinterpretation Assessment S> O>patient may manifest: Inappropriate behaviors inappropriate response to the Nursing Diagnosis Knowledge deficit related to lack of information resource, information misinterpreta tion Scientific Explanation In MRM a removal of the entire breast and lymph nodes are involve. Some pre operative patient may have knowledge deficit about Objectives Short term After 4 hours of nursing intervention the patient will able toverbalize understandin g of condition and to the process treatment, Nursing intervention >establish rapport >assess general condition of the patient rationale >to achieve patient trust >to monitor if there is any alleviation on patient health Expected outcome Short term: The patient shall have verbalized understandin g of condition and to process treatment and shall have exhibit increased

> obtain vital signs >to monitor changes in

instruction -apathetic -hostile

the situation of procedure. Some patient are too afraid and may not be coping emotionally after knowing her treatment required, which may cause the patient to just focus on the things she just want to believe and sometimes to those negative effect of a surgery. Sometimes knowledge deficit may be related to routines, surgical

and will able to exhibit increased interest for won learning by beginning to lack for information and ask question Long term: After 2 days of nursing intervention the patient will able to identify relationship of signs and symptoms of the disease process and will able to perform necessary procedures correctly and explain

vital signs >determine patient ability to learn >assess patient capabilities to cope up >motivate patient by providing information relevant to the situation >provide active role for the patient in learning process >provide information about the surgical process >to knows patient level of ability >to know patient ability toward coping >to help patient acquire relevant information

interest for own learning by beginning to lack for information and ask question

>promote sense of control over the situation >to inform patient about the real treatment

Long term: The patient shall have identified relationship of the signs and symptoms of the disease process and shall have perform necessary procedures correctly and explain reasons for

procedures, reason for or outcome actions expectations this condition may be result from impaired communicati on ability, a language barrier, a patients insufficient mental capacity or a lack of information regarding the surgical procedure.

regimen

action.