The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction?

"I need to avoid driving to and from work every day."

"Any blood pressures need to be taken in my right arm."

"I need to wear gloves when doing any gardening."

"I should wear clothing with elasticized sleeves."

Answer and Explanation

The Correct Answer is D

A. "I need to avoid driving to and from work every day."

This statement indicates a misunderstanding of how to minimize lymphedema. Driving itself does not directly contribute to lymphedema. However, activities that involve prolonged or repetitive use of the affected arm, such as gripping the steering wheel while driving for long periods, may increase the risk of developing lymphedema. The nurse should clarify that while driving is generally acceptable, the client should take breaks and perform arm exercises during long drives to promote circulation.

B. "Any blood pressures need to be taken in my right arm."

This statement demonstrates correct understanding. Taking blood pressure measurements, administering injections, or obtaining blood samples from the unaffected arm helps prevent trauma or injury to the arm at risk for lymphedema. This practice helps avoid disrupting lymphatic flow and reduces the risk of developing lymphedema in the affected arm.

C. "I need to wear gloves when doing any gardening."

Wearing gloves during gardening is a recommended precaution to minimize the risk of injury and infection, especially if the client has undergone lymph node removal. This statement reflects appropriate understanding and adherence to preventive measures to protect the affected arm from cuts, scratches, and potential infection that could exacerbate lymphedema.

D. "I should wear clothing with elasticized sleeves."

This statement indicates a misunderstanding of how to minimize lymphedema. While elasticized sleeves or compression garments can help manage lymphedema by providing gentle compression and support to the affected arm, wearing tight or constrictive clothing, including elasticized sleeves, can potentially restrict lymphatic flow and exacerbate lymphedema. The nurse should clarify that loose-fitting clothing is preferable to allow unrestricted movement and circulation in the affected arm.

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Correct Answer is A

Explanation

A. "I'm sorry you lost your baby."

This response demonstrates empathy and validation of the client's emotions. It acknowledges the client's loss and offers support during a difficult time. By expressing sympathy, the nurse shows understanding and compassion towards the client's grief.

B. "A baby still wasn't formed in your uterus."

This response may come across as dismissive or invalidating of the client's emotions. It does not acknowledge the client's loss or address their emotional needs. It focuses more on the biological aspect of the situation rather than the client's feelings.

C. "Will a pill help your pain?"

This response only addresses physical pain management and does not acknowledge the emotional distress the client is experiencing. While pain relief is important, it is equally important to address the client's emotional needs and provide support during a difficult time.

D. "Why are you crying?"

This response may come across as insensitive or intrusive. It puts the client on the spot and may make them feel uncomfortable or defensive about their emotions. It does not provide empathy or support and fails to acknowledge the client's loss or offer condolences.

A. bleeding after intercourse B. vaginal discharge C. irregular, acyclic bleeding D. bleeding between menses

Correct Answer is A

Explanation

A. Bleeding after intercourse

Endometrial polyps can cause bleeding after intercourse (postcoital bleeding) due to irritation or trauma to the polyps during sexual activity. This symptom occurs because the polyps protrude into the uterine cavity and are easily disturbed by movement or contact.

B. Vaginal discharge

While vaginal discharge can be a symptom of various gynecological conditions, it is not typically associated specifically with endometrial polyps. Instead, other conditions like bacterial vaginosis or vaginal infections are more commonly linked to vaginal discharge.

C. Irregular, acyclic bleeding

Endometrial polyps can cause irregular, acyclic bleeding, but this symptom is less specific compared to bleeding after intercourse. Irregular bleeding can occur due to hormonal changes, uterine fibroids, or other gynecological conditions as well.

D. Bleeding between menses

Bleeding between menstrual periods (intermenstrual bleeding) can occur with endometrial polyps, but it is not as specific a manifestation as bleeding after intercourse. Intermenstrual bleeding can also be caused by hormonal imbalances, cervical or uterine infections, or other underlying conditions.

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The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction?

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