The nurse is caring for a client that has undergone a modified left radical mastectomy with lymph node removal. Which intervention would assist in preventing lymphedema?

Avoiding arm exercise in the immediate post-op period

Instruct the client to sleep in the left lateral side lying position

Placing cool compresses on the affected arm

Elevating the affected arm on a pillow above the level of the heart

Answer and Explanation

The Correct Answer is D

A.   This statement is not advisable. While it is essential to avoid strenuous activity initially, gentle arm exercises and range-of-motion activities are generally encouraged as soon as possible to promote circulation and help prevent lymphedema. Immobilization can actually increase the risk of lymphedema.
B.   This intervention is not recommended for preventing lymphedema. Sleeping on the side of the surgery (in this case, the left side) can put pressure on the affected arm and may not promote proper lymphatic drainage. Clients are often advised to sleep on their back or to position themselves in a way that does not compress the affected arm.
C.   This intervention can provide temporary relief if there is swelling or discomfort, but it does not effectively prevent lymphedema. While cool compresses might help reduce inflammation, they are not a primary measure for lymphedema prevention.
D.   This is the most effective intervention for preventing lymphedema. Elevating the affected arm helps facilitate lymphatic drainage and reduces the risk of fluid accumulation. Keeping the arm elevated above heart level encourages proper circulation and helps manage swelling.

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Correct Answer is A

Explanation

A. Petechiae (small red or purple spots caused by bleeding under the skin) and epistaxis (nosebleeds) result from thrombocytopenia, which is a low platelet count often seen in leukemia. The compromised bone marrow function leads to inadequate production of platelets, resulting in bleeding and bruising.
B. While generalized edema and rash can occur in various conditions, they are not specific to ALL and are not common initial findings. Edema might be seen in certain contexts (e.g., renal involvement or fluid overload), but it is not a hallmark of ALL.
C. Alopecia (hair loss) and pallor (paleness) can occur in clients undergoing chemotherapy for ALL, but they are not typically initial findings at the time of diagnosis. Pallor may result from anemia, which can develop as a consequence of the disease, but it is not the most immediate or characteristic symptom of ALL.
D. Bradycardia (slow heart rate) and lethargy are not typical initial findings of ALL. Lethargy could be present due to anemia or other systemic effects, but bradycardia is not commonly associated with the disease and would require further investigation for other underlying causes.

A. ovarian cancer occurs primarily among women over age 70 that also have other complicating health problems. B. the causative cancer cell is resistant to chemotherapy or radiation. C. there are no obvious symptoms or problems during the early stages of this disorder. D. radiation therapy is ineffective because the ovaries are located so deep within the pelvis.

Correct Answer is C

Explanation

A. Many women diagnosed with ovarian cancer are indeed older, but the presence of other health problems is not a primary factor in explaining the high death rates. The key issue is more related to late- stage diagnosis rather than age alone.
B. While some ovarian cancer cells can develop resistance to treatment, it is not universally true for all cases. The high mortality rate is more often due to the late stage at which the cancer is diagnosed rather than inherent resistance to treatment. Thus, this option does not fully explain the high death rates.
C. Ovarian cancer often presents with vague symptoms that can be easily overlooked in the early stages, such as bloating, abdominal discomfort, or changes in bowel habits. As a result, many women do not receive a diagnosis until the cancer has progressed to a more advanced stage, contributing significantly to the high mortality rates associated with the disease.
D. While it is true that the ovaries are located deep in the pelvis, the main treatment for ovarian cancer typically involves surgery and chemotherapy rather than radiation therapy. Radiation is not a primary treatment for this cancer type, and this statement does not accurately reflect why the death rates are high.

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The nurse is caring for a client that has undergone a modified left radical mastectomy with lymph node removal. Which intervention would assist in preventing lymphedema?

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Correct Answer is C

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