The nurse provides care for a client diagnosed with non-Hodgkin lymphoma. Which observation does the nurse expect to find during assessment of the client?

Choice A reason: Lymph structures were removed and fluid cannot move out of the area easily is the correct explanation because a radical mastectomy involves the removal of the breast, the underlying chest muscles, and the lymph nodes in the axilla. The lymph nodes are part of the lymphatic system, which is responsible for draining excess fluid from the tissues and returning it to the bloodstream. When the lymph nodes are removed, the fluid cannot be drained properly and accumulates in the affected arm and hand, causing edema.

Choice B reason: There is still too much swelling in the area of the surgery and fluid is accumulating is not the correct explanation because it does not address the underlying cause of the edema. Swelling is a normal response to surgery, but it usually subsides within a few days or weeks. The edema caused by lymph node removal is chronic and persistent, and it does not improve with time.

Choice C reason: The veins were removed from the axilla during surgery and there is poor circulation now is not the correct explanation because it is not true. The veins are not removed during a radical mastectomy, only the lymph nodes are. The veins are part of the circulatory system, which carries blood throughout the body. The blood flow to the arm and hand is not affected by the surgery, unless there is a complication such as a blood clot or an infection.

Choice D reason: You will need to wear a compression bandage to help fluids move from the area is not the correct explanation because it is a treatment, not a cause. A compression bandage is a type of elastic bandage that applies pressure to the arm and hand, which helps to reduce the swelling and prevent further fluid accumulation. However, it does not address the root cause of the edema, which is the removal of the lymph nodes.

Choice A reason: Decreased skin turgor is not the most common clinical manifestation of nephrotic syndrome because it is a sign of dehydration, not nephrotic syndrome. Dehydration is a condition where the body loses more fluid than it takes in, which can cause the skin to lose its elasticity and firmness. Dehydration can be caused by various factors, such as vomiting, diarrhea, fever, or excessive sweating.

Choice B reason: Hypoalbuminemia is the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of albumin, which is a protein that helps maintain the fluid balance in the body. Nephrotic syndrome is a kidney disorder that causes the kidneys to leak large amounts of protein into the urine, which reduces the amount of protein in the blood. Albumin is the most abundant protein in the blood, and it helps to keep the fluid in the blood vessels, preventing it from leaking into the tissues. When the albumin level is low, the fluid can escape from the blood vessels and cause edema, which is swelling of the body parts.

Choice C reason: Decreased serum cholesterol is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a low level of cholesterol, which is a type of fat that is needed for the synthesis of hormones, bile acids, and cell membranes. Decreased serum cholesterol is not a common finding in nephrotic syndrome, because the liver tends to produce more cholesterol to compensate for the loss of protein in the urine. This can lead to hypercholesterolemia, which is a condition where the blood has a high level of cholesterol, which can increase the risk of cardiovascular diseases.

Choice D reason: Increased serum sodium is not the most common clinical manifestation of nephrotic syndrome because it is a condition where the blood has a high level of sodium, which is an electrolyte that helps regulate the fluid and acid-base balance in the body. Increased serum sodium is not a common finding in nephrotic syndrome, because the kidneys tend to excrete more sodium in the urine to balance the fluid loss caused by hypoalbuminemia. This can lead to hyponatremia, which is a condition where the blood has a low level of sodium, which can cause symptoms such as confusion, weakness, seizures, and coma.