The nurse is caring for a patient who has just had a mastectomy. Which exercise should the nurse assist the patient in doing during the first 24 hours after surgery?

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This question was previously asked in

SGPGI Staff Nurse Official Paper (Held On: 28 Feb, 2024 Shift 1)

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Answer 1

Correct Answer: Pendulum arm swing

Rationale:

Pendulum arm swing is an appropriate exercise for the first 24 hours following a mastectomy. This exercise involves gentle movements where the arm hangs freely and swings back and forth, mimicking the motion of a pendulum. It is specifically chosen because it promotes circulation, reduces stiffness, and minimizes the risk of lymphedema without requiring extensive effort or strain on the surgical site.
During the immediate postoperative period, exercises should focus on gentle movements to prevent complications like shoulder stiffness and promote gradual recovery. Pendulum arm swings are simple, low-impact, and effective in achieving these goals.
This exercise also helps to initiate passive movement in the shoulder joint, which is essential for maintaining mobility while ensuring that the surgical site is not overstressed.

Explanation of Other Options:

Hand wall climbing

Rationale: Hand wall climbing is a more advanced exercise that involves moving the fingers up a wall to stretch and strengthen the shoulder and arm muscles. While beneficial later in the recovery process, this exercise is not recommended within the first 24 hours post-surgery as it could strain the surgical site or cause discomfort.

Elbow flexion and extension

Rationale: Although elbow flexion and extension involve simple movements, they are not as effective as pendulum arm swings in promoting circulation and reducing stiffness in the shoulder area immediately after a mastectomy. These exercises can be incorporated later as part of a broader rehabilitation plan.

Shoulder abduction and external rotation

Rationale: Shoulder abduction and external rotation require more advanced movement of the shoulder joint, which may stress the surgical site and surrounding tissues during the immediate postoperative period. These exercises are typically introduced gradually as healing progresses.

Conclusion:

Pendulum arm swing is the recommended exercise within the first 24 hours after a mastectomy because it facilitates gentle movement, reduces stiffness, promotes circulation, and supports recovery without straining the surgical area. The other options listed are valuable but are introduced at later stages of postoperative rehabilitation to avoid complications and ensure a gradual return to normal function.