A female patient had mastectomy after surgery patient complaining about shoulder pain. What would be the primary intervention by the nurse?

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

The primary nursing responsibility for expected postoperative pain is prompt pain management.
Administering or advising the use of prescribed analgesics directly addresses the patient's complaint and provides comfort.
Effective pain control is essential to facilitate early arm and shoulder exercises, which helps prevent complications like 'frozen shoulder' (adhesive capsulitis) and promotes faster recovery.

Option A: This is a secondary action, not the primary one. Consulting the doctor is necessary, but only after an initial nursing intervention (like giving an analgesic) has been attempted and failed, or if there are signs of a serious complication.
Option C: Waiting is inappropriate and potentially harmful. Unmanaged pain causes unnecessary suffering and can lead to guarding, which limits shoulder movement.
Option D: Ignoring a patient's complaint of pain is considered nursing negligence. Pain is the 'fifth vital sign' and must be assessed and managed.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Primary nursing intervention for post-mastectomy shoulder pain in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Always perform a thorough pain assessment (e.g., using a 0-10 scale, asking about location, quality, and duration) before and after administering analgesics to evaluate effectiveness.
A critical nursing role is patient education on lymphedema prevention: strictly no blood pressure measurements, injections, or blood draws on the affected arm for life.
What if? If the patient's shoulder pain was accompanied by sudden-onset shortness of breath and chest pain, the priority would immediately shift. The nurse should suspect a pulmonary embolism (a potential post-op complication), raise the head of the bed, apply oxygen, and call for immediate medical assistance, rather than just giving an analgesic.

How to Approach the Question

First, identify the patient's clinical situation: she is postoperative from a mastectomy.
Next, identify the chief complaint: shoulder pain.
Recognize that some level of pain is an expected finding after this type of surgery.
The question asks for the 'primary intervention.' This means the first, most immediate, and appropriate action the nurse should take.
Evaluate the options based on the nursing process (Assess, Intervene, Evaluate) and the nurse's scope of practice. Administering a prescribed medication is a core nursing intervention.
Eliminate options that represent a delay in care (Wait for 4-5 days), inappropriate escalation (Consult to doctor before trying a basic intervention for an expected problem), or negligence (No intervention).

Concept Tested & Keywords

Concept Tested: Primary nursing intervention for post-mastectomy shoulder pain.
Stem keywords: mastectomy, shoulder pain, post-surgery, primary intervention
Lead-in keywords: primary intervention
Clinical cues: The patient is postoperative, making pain an expected finding that requires management.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 pp. 53-55, 55-57

Practise the full NORCET 3 - 2022 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.