The home health nurse teaches the client with chronic lymphedema of the left arm secondary to treatment for breast cancer the importance of removing the intermittent pressure device used for the affected arm at least every 8 hours

Question

The best rationale for this teaching measure is because this device: 1. Causes pain in the affected extremity, and when removed periodically, the client comfort is promoted.
2. Compresses small vessels, and without periodic removal, tissues nourished by these vessels can break down.
3. Exerts continuous pressure and can cause a rebound effect and lead to more lymphatic fluid if not interrupted.
4. Moves edema from the distal to proximal area of the arm, and periodic removal will increase effectiveness of treatment.

Answer 1

2. Compresses small vessels, and without periodic removal, tissues nourished by these vessels can break down.

Rationale:
This device will compromise small vessel circulation, and unless periodically removed, tissues will receive less oxygen and therefore are prone to breakdown. The compression device itself will promote comfort due to movement of edematous fluids from tissues into vessels. There is not a rebound effect from tissue compression itself. Although the movement of edema does flow from distal to proximal, the periodic removal is for the purpose of nourishing tissues fed by small vessels that are compressed when the device is left on continuously.