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lymphedema

WOCN program

QuestionAnswer
true or false: chronic lymphedema is not reversible and requires a lifetime management true
what are the most common causes of secondary lymphedem obstruction of lymphatic drainage system- cancer therapy (RT, node dissection) trauma, venous reconstruction, obesity, infection, malignancy
explain the difference between lymphedema and lipedema lymphedema-unilateral, lipedema bilateral
what is the Stemmer sign? inablilty to pinch skin into a fold on dorsal aspect below second metatarsal
identify areas for effective management of lymphededa manual lymphatic drainage(therapeutic massage is what book says, not current guidelines) skin care compression
effective compression bandagin requires ___mmHg pressure 40-60
what is the gold standard for lymphedema treatment complete decongestive therapy (CDT)
list components of CDT Manual lymphatic drainage (MLD) compression, therapeutic exercises, skin care, pt education
what are absolute contraindications to CDT thrombosis, uncompensated heart failure
what are "use CDT with caution" conditions arterial insufficiency, HTN, asthma, decreased sensation (DM, paralysis)
adjuvant therapies to CDT pneumatic compression, compression strapping devices, kinesis tape, low level laser therapy
what are the features of lipedema bilateral, spares hands or feet, doesn't respond to elevation, non pitting, may have hyperkeratinosis or papillomatosis
risk factors for lymphedema longstanding CVI, cancer treatment (RT, surgery) obesity, infection, severe trauma, circulatory reconstruction, burns
what is primary lymphedema congenital (dx within first year of life) Milroy disease, Meige disease (lymph. praecox) Lymph. Tarda (>35y/o)
what is mechanical insufficiency low volume, is a result of altered function of lymph system
what is dynamic insufficiency high volume, lymph load exceeds transport capacity (CHF hypoproteinemia CVI, dependency)
what is combined insufficiency hemodynamic insufficiency AND lymphovenous (caused by CVI)
describe latent stage of lymphedema no clinical signs, limb may feel heavy or tight
describe stage I of lymphedema edema is observable, resolves with elevation, may be pitting, tissue soft negative or borderline Stemmers sign
describe stage II of lymphedema edema is pitting and/or nonpitting, doesn't decrease whit elevation decreased ROM, +stemmers sign, fibrosis present, hyperkeratinosis, papillomatosis may be present
describe stage III of lymphedema fibrosis, no pitting, disfigurement/elephantiasis, subcutaneous hypertrophy, ongoing infections likely
what labs may be pertinent serum albumin, UA to assess for other causes of edema (renal/hepatic) lymph fluid protein level
what are the treatment goals limb size reduction and preservation, alleviate sx's, prevent infection, improve limb function, ROM, improve QOL
Explain lipedema Occurs in Women during or after puberty, nonpitting, tender to palpating, bruising common, always bilateral, ends at ankles, skin changes uncommon
Created by: Beth Perry