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lymphatic (14)

lmphatic disorders,

LYMPHANGITIS CLINICAL MANIFESTATIONS/ASSESSMENT Fine red streaks from the affected area in the groin or axilla Usually not localized, and edema is diffuse Chills, fever, and local pain accompany headache and myalgia Lymphadenopathy (swollen lymph nodes) Septicemia may occur
LYMPHANGITIS DIAGNOSIS Made by visual inspection and palpitation
LYMPHANGITIS MEDICAL MANAGEMENT Administration of penicillin or other antimicrobial drugs controls the infection Hot, moist heat-soaks or packs for comfort
LYMPHANGITIS NURSING INTERVENTIONS Aseptic technique promotes healing Rest and extremity elevation may relieve the pressure Inspect the area 2-3 times daily and document client’s response to antibiotic therapy
What is the cause of lymphangitis? Lymphangitis is caused by streptococcal or staphylococcal infection.
LYMPHEDEMA Etiology/pathophysiology Etiology/pathophysiology Primary or secondary disorder characterized by the accumulation of lymph in soft tissue and edema
Causes: Obstruction Increase in the amount of lymph Removal of the lymph channels and nodes May be hereditary If lymphatic drainage is disturbed, an inflammatory process may result.
LYMPHEDEMA CLINICAL MANIFESTATIONS Massive edema and tightness cause pressure and pain in the affected extremities Progresses toward the trunk and aggravated by: Pressure, as with pregnancy or premenstruation Obesity Warm, humid environments
LYMPHEDEMA ASSESSMENT Subjective data Complaints of pain and pressure Medical history of varicosities, pregnancy, or modified radical mastectomy is important Objective data Observations of the extremities for edema Palpation of distal pulses
Lymphangiograph is used to differentiate lymphedema from venous disorders
LYMPHEDEMA MEDICAL MANAGEMENT Fluid management Diuretics are not prescribed antimicrobials are administered as ordered Diet restrictions include limiting sodium and avoiding spicy foods, which would precipitate thirst
LYMPHEDEMA PREVENTION OF COMPLICATIONS Mechanical management includes use of compression pumps and elastic sleeves or stockings on the affected limb
LYMPHEDEMA NURSING INTERVENTIONSIncrease lymphatic drainage Elevation of the extremities while asleep and periodically during the day will facilitate draining the tissues Massage toward the trunk followed by active exercise decreases the edema Avoid constrictive clothing, shoes or stockings
LYMPHEDEMA NURSING INTERVENTIONS Monitor/prevent infections Avoid trauma Meticulous skin care
LYMPHEDEMA NURSING INTERVENTIONS Emotional support Body image disturbance secondary to lymphedematous extremitiesTeach/assess understanding of importance of acceptance and maintaining routine activity.
LYMPHEDEMA NURSING INTERVENTIONS Prognosis Prognosis No cure for this disorder, but signs & symptoms can be controlled
Identify two ways to increase lymphatic drainage. Elevate the extremities Massage toward the trunk Avoid restrictive clothing
MALIGNANT LYMPHOMA Etiology/pathophysiology neoplastic lymphatic tissue, unk cause herpes suspicion, includes non-Hodgkin's lymphoma, common in cauc, male, jewish, over 60 yrs, start in lymph nodes and spread to spleen, liver, gi tract, bone marrow
MALIGNANT LYMPHOMA CLINICAL MANIFESTATIONS Painless lymphadenopathy in the cervical area Fever Weight loss Anemia Pruritus
MALIGNANT LYMPHOMA CLINICAL MANIFESTATIONS Susceptibility to infection Pressure symptoms in the involved areas Pleural effusion, bone fractures, and paralysis GI malabsorption Bone lesions
MALIGNANT LYMPHOMA ASSESSMENT Subjective Complaints of fatigue, malaise and anorexia Fever and diaphoresis Objective Examination of the abdomen for splenomegaly Lympadenopathy
MALIGNANT LYMPHOMA DIAGNOSTIC TESTS Bone scan may reveal fractures, lesions, and tumor infiltration CBC-increased RBCs, WBCs, platelets, ESR and anemia Chemistry- increased calcium and alkaline phosphatase Coombs’ test- reveals a positive result for antiglobulin(anemia)
MALIGNANT LYMPHOMA DIAGNOSTIC TESTS MALIGNANT LYMPHOMA Radiographic studies Chest x-ray- to reveal mediastinal nodes CT scans of the chest, abdomen, and pelvis- to identify tumor Gallium scan Possibly a lymphangiogram Biopsies of lymph nodes, liver, and bone marrow are for pathology evidence
MALIGNANT LYMPHOMA MEDICAL MANAGEMENT Accurate staging is crucial to determine the treatment regimen Chemotherapy and radiation. Immunotherapy with monoclonal antibodies Bone marrow transplant
MALIGNANT LYMPHOMA NURSING INTERVENTIONS Supportive care of the patient during radiation and chemotherapy Monitor/prevent infection Maintain strict aseptic technique Maintain neutropenic precautions
MALIGNANT LYMPHOMA NURSING INTERVENTIONS Teach/assess understanding of treatment regimen Frequently reassess knowledge Explanations of the extensive diagnostic workup and its importance of staging the disease for determining the treatment plan are an important focus of patien
Created by: redhawk101