Deck 26: Management of Lymphatic Disorders

Question 1

Which of the following correctly describes components of a comprehensive program and related procedures for management of lymphedema?

A)Compressive bandaging or garments are worn only during rest, not during exercise.
B)During manual lymphatic drainage (massage), the proximal areas, such as the groin or axilla, are cleared of fluid before the peripheral areas.
C)Active exercises but not resistive exercises are included in the exercise program.
D)A sequential pneumatic compression pump is used as an alternative, not an adjunct, to complex decongestive therapy.

Answer 1

B

Question 2

Intervention goals for lymphedema include all of the following except:

A)Educating the patient in techniques for self-management.
B)Reducing the risk of infection.
C)Softening of fibrotic tissue.
D)Resolving the lymphedema and returning the lymphatic system to a normal state.

Answer 2

D

Question 3

Which of the following factors associated with breast cancer surgery and adjuvant therapy is least likely to contribute to impaired shoulder mobility?

A)Incisional pain
B)Chemotherapy
C)Fibrosis of tissues in the axillary area as the result of radiation therapy
D)Increased thoracic kyphosis related to incisional pain or age

Answer 3

B

Question 4

Each of the following is true about a comprehensive exercise program for lymphatic drainage except:

A)Exercises are performed in a specific sequence, exercising proximal muscle groups before distal muscle groups.
B)If lymphedema is unilateral, exercises are performed with the noninvolved extremity before the involved extremity.
C)Many of the active exercises of the involved limb(s) are performed with the limb(s) elevated above the heart.
D)Each exercise for the involved limb(s) should be performed until the patient feels an aching in the exercising muscles to ensure a training effect.

Question 5

The treatment of lymphedema with compression therapy to the limb involves a combination of bandaging and use of compression garments.The type of compression to use depends on the phase of lymphedema treatment and the desired outcome.Which of the following is true regarding the proper utilization of compression treatment?

A)During phase II, a custom compression bandage or an Aceᵀᴹ wrap can be used by the patient for self-management.
B)During phase I, only high-stretch bandages are used to provide continuous high resting and working pressure until limb reduction is achieved.
C)Low-stretch bandaging is used to achieve limb reduction in phase I and to continue limb reduction intervention at night during phase II.
D)Ace wraps are used during phase I to achieve limb reduction and during phase II to control limb size during vigorous activity.

Question 6

Which of the following is the least advisable means of preventing limitations of the glenohumeral joint and improving shoulder range of motion (ROM) after mastectomy?

A)Self-assisted ROM of the involved upper extremity
B)Wand exercises
C)Pendulum exercises
D)Wall-climbing exercises with the involved upper extremity

Question 7

You have completed the examination and evaluation and determined that your patient presents with right upper extremity lymphedema.The edema is soft and pitting without evidence of tissue fibrosis, and the patient reports that elevation of the extremity reduces the swelling temporarily.What stage of lymphedema do you document?

A)Stage 0-latency stage
B)Stage I-reversible stage
C)Stage II-spontaneously irreversible
D)Stage III-lymphostatic elephantiasis

Question 8

Lymphatic dysfunction may result from all of the following except:

A)Trauma.
B)Congenital or hereditary factors.
C)Infection.
D)Diet.

Question 9

There are many interventions used to manage the signs and symptoms of lymphedema.Of the following, which is considered to be the least effective based on current evidence?

A)Liposuction
B)Manual lymphatic drainage
C)Pneumatic compression pump
D)Exercise

Question 10

Axillary web syndrome is a relatively common condition that develops after treatment for breast cancer.It is recognized by which of the following signs and symptoms?

A)A feeling of heaviness in the upper extremity during active flexion and adduction, indicating the initial sign of lymphedema
B)Muscle guarding and tenderness of the cervical muscles with fibrosis of the sternocleidomastoid muscle limiting ROM of the neck
C)Cording of the lymphatic vessels from the axilla to the antecubital space and/or forearm restricting shoulder mobility
D)Weakness of the serratus anterior after lymph node dissection resulting from surgical damage to the long thoracic nerve

Question 11

Which of the following describes the severity of lymphedema from least to most severe?

A)Pitting, brawny, weeping
B)Brawny, pitting, weeping
C)Weeping, brawny, pitting
D)Pitting, weeping, brawny

Question 12

The purpose of the lymphatic system is to collect and transport fluid from the:

A)Lungs to the venous system.
B)Interstitial spaces to the venous system.
C)Interstitial spaces to the kidneys.
D)Interstitial spaces to the blood capillaries.

Question 13

As part of the patient evaluation, you perform tests and measures to document your findings in a standard and objective way.You document a positive Stemmer sign when you find which of the following?

A)There is tenderness of the lymph nodes on palpation.
B)Skin on the dorsum of the fingers could not be pinched.
C)Skin is shiny and red.
D)Viscous fluid is weeping from the skin.

Question 14

Which of the following is a true statement about lymphedema?

A)It is a disease of the lymphatic system.
B)It occurs when the transport capacity exceeds the lymphatic load.
C)It consists primarily of water and protein found in the extracellular spaces.
D)It is a natural immune response to trauma and initially is beneficial during the early phases of healing.

Question 15

Signs and symptoms of chronic venous insufficiency can include any of the following except:

A)Venous distention in the affected limb.
B)Dependent peripheral edema.
C)Brownish pigmentation of the affected limb.
D)Severe pain with the limb in an elevated position.

Question 16

Each of the following is a recommendation advocated for the prevention or management of lymphedema except:

A)With unilateral upper extremity lymphedema, have blood pressure taken on the noninvolved arm.
B)Avoid carrying heavy objects or lifting heavy weights with the involved upper extremity.
C)Elevate the involved limb(s) on a regular basis.
D)Use a hot tub for relaxation or to perform repetitive exercises to promote circulation.

Question 17

Each of the following is true about lymphedema except:

A)Pitting edema is classified as more severe than brawny edema.
B)Lymphedema typically is seen with disorders of the venous or lymphatic systems but not with peripheral arterial vascular disease.
C)Lymphedema typically is most apparent peripherally (e.g., over the dorsum of the foot) but can also manifest centrally (e.g., in the groin area).
D)Secondary lymphedema as the result of trauma, surgery, or a tumor is far more common than primary lymphedema.