Disorders of the Lymphatic System

Question 1

• Patho: accumulation of lymphatic fluid from impaired lymph circulation. When the vol. exceeds capacity of the vessels→ enters interstitial spaces in soft tissue
  -Types: primary (congenital) or secondary (complication of burns, insect bite, phlebitis, lymph node removal (mastectomy), etc.)
  -S/S: swelling of affected area; skin is tight, firm, shiny, brawny; weeping or oozing
  -Medical Management:
  -Symptomatic; elevation; compression sleeve or stocking, complex decongestive physiotherapy
  -Complex decongestive physiotherapy: massage
  -Nursing Management: Skin assessment, exercises; elevation; elastic compression garments; mechanical devices, emotional support

Answer 1

Lymphedema

Question 2

A woman undergoing a modified radical mastectomy is at risk for ineffective tissue perfusion and lymphedema. A nursing intervention to prevent compromised flow of lymphatic fluid to the upper extremities includes

Answer 2

Supporting and elevating the arm on the side of the mastectomy

Question 3

(inflammation of lymph vessels

Answer 3

Lymphangitis

Question 4

inflammation of lymph nodes

Answer 4

Lymphadenitis

Question 5

-Patho: streptococcal microorganisms
-S/S: red streaks; fever; tender, enlarged lymph nodes (shouldn’t feel lymph nodes unless they are swollen or tender)
-Medical Management: broad-spectrum antibiotic therapy (IV or oral)
-Nursing Management: Assist with ADLs; elevate extremity; provide warmth(heat packs or warm cloths on the area to help with swelling or tenderness); Monitor temperature, swelling
-Teaching: elastic sleeve and stocking application (ted stocking, may need help getting them on)

Answer 5

Lymphangitis and Lymphadenitis

Question 6

-Patho: Epstein-Barr virus mutates some lymphocytes, creating Reed–Sternberg cells (these are not in the non-hodgkins does not) (nearly immortal and invisible to NK)
-S/S: Painless lymph node enlargement (start with cervical nodes which is in your neck), Epigastric pain, fullness, Weight loss, anorexia, fatigue, weakness, Low-grade fever, pruritus, night sweats, Anemia, thrombocytopenia, Poor resistance to infection, Death results from resp obstruction, malnutrition or 2nd infections (if we aren’t not getting fluid where it should be going then there is more opportunities to getting infections)
-Diagnostics: CBC, blood chemistry tests, CT, MRI, lymphangiography, chest radiography, Bone marrow aspiration, biopsy, Staging: I to IV
-Medical Management: Localized radiation, Chemotherapy, antineoplastic drugs, antibiotics, Transfusions; stem cell transplant (it is a cancer so how would you care for these patients, I would care for nausea, vomiting, and mental health)
-Nursing Diagnosis and Planning: Risks: ineffective airway clearance (o2 is within normal limit and they are breathing probably); impaired gas exchange; infection; impaired skin integrity
-Interventions: Assess respiratory status, administer oxygen, prepare for intubation, infectious disease precautions(limit visitation if they have had a cold within the last week), support and protect bony prominences (turn every 2 hours, float the heels and give support pillows)

Answer 6

Hodgkin Disease

Question 7

Cancer of the lymphatic System

Answer 7

Hodgkin Disease

Question 8

-Patho: malignant diseases that originate in lymph glands
-Causes: genetic link, environmental triggers. Chromosomal changes occur in affected lymphocytes and lymphoid tissues enlarge to accommodate malignant cells
-Classifications: indolent (asymptomatic and responsive to tx) or aggressive (symptoms)
-S/S: Lymph node enlargement, Lymphoid tissue biopsies; additional tests for staging
-Medical Management: Radiation, chemotherapy, immunotherapy; monoclonal antibody therapy (MAB), Bone marrow transplant, Stem cell transplants, Autologous; allogenic
-Nursing Management: Chemotherapy and radiation therapy: Encourage extra fluid intake. They are nausea and vomiting so dehydration is a problem also their mental health

Answer 8

Non-Hodgkin’s Lymphoma

Question 9

Cancer of the lymphatic system (Remember this one doesn’t have the Reed-Sternberg cells)

Answer 9

Non-Hodgkin’s Lymphoma

Question 10

A client diagnosed with Hodgkin disease is at risk for infection related to immunosuppression and drug or radiation therapy. To assist the client to remain free of infection, the nurse should implement which of the following?

Answer 10

Restrict visitors with infections from contact with clients.

Question 11

A client with non-Hodgkin disease is admitted to the hospital. In discussing the client’s care with the nursing assistant, which nursing explanation is most correct in relation to the medical management of the disease?

Answer 11

Radiation and chemotherapy