· DEFINITION: Accumulated
progressive lymph in the interstitial spaces of the subcutaneous tissue, accompanied by retention water.
is a high protein accumulation, which contributes to increased fibrosis and edema own establishment.
· OBJECTIVE: Reduce
now that the introduction of malignancy can cause lymphedema, seeking a reduction of the edema.
· CAUSE:
neoplastic Lymphedema is caused by a blockage of circulation in the lymph collectors.
· DEMONSTRATION:
is common in cancers of the female genital tract of slow evolution. The edema in these cases are occurring very slowly, is located at the root of the limb and is often hard consistency and without fovea.
When lymphedema is due to the axillary or inguinal venous obstruction by thrombi produced by the same tumor progression is mixed edema, lymphatic and venous.
· NURSING CARE:
Skincare:
skin should be kept clean to avoid cuts, scratches, etc.. If this happens, wash the area, apply a local antiseptic such as povidone-iodine and monitor the possible onset of local infection.
meticulous care in cutting nails and toes, it is best to use clippers that the use of scissors.
body wash with water not too hot. Thorough drying of the skin, with emphasis on the folds and interdigital spaces.
Applying lotions or moisturizers, should be non-perfumed or alcohol based, as they tend to irritate.
do not recommend prolonged sun exposure of the affected limb, and solar dermatitis avoid only aggravate the skin condition. Place
compresses on the affected limb if we observe that there is excessive exudation of lymph, changing them whenever they are wet.
Avoid wearing clothes too tight, the clip in the case of women it will not tighten or chest, or shoulder.
nursing staff should avoid performing invasive procedures on the affected limb:
· Extraction of blood.
· Determination of capillary blood glucose levels by pricking the heel of your fingers.
· Manage drugs or vaccines administered intradermally, subcutaneously or intramuscularly.
• Take your blood pressure.
Exercise:
The movement is essential to have a good lymphatic flow, and muscle contraction stimulating massage makes this flow.
should be viewed as a moderate and preferably continuous but led by a physiotherapist.
manual lymphatic drainage and massage:
are movements on the skin in order to stimulate lymphatic circulation, so that excess lymph enter the lymphatic system.
should be soft but firm, 20 to 30 minutes. It should start from the healthy to the edematous area, and from the distal to proximal draining lymph previous nodes also massaged. This provides an increased flow of surface and during the massage the distal drain more easily.
measures are recommended after compression. Measures compressive
:
are important when there is no scarring and assists circulation of interstitial fluid into the lymphatic system.
These measures are aimed at reducing edema, lymph is formed by limiting the pressure on the skin and subcutaneous tissue. Dressing
or compressive elastic bandage 10 cm wide from fingertip to the root of the limb. Effective if the swelling does not exceed the root of the limb.
or compression stockings and gloves, since the lifting of the patient. During the rest will raise the affected limb.
or intermittent pneumatic compression, useful in the cases had severe lymphedema fingers and constant pain.
contraindicated if infection, venous thrombosis, or metastasis, to prevent its extension. And if you are undergoing radiation therapy.
These measures, together with the exercise carried out consistently allowed:
§ Limit the accumulation of lymph in the limb. §
promote venous return and lymph to the origin of the limb. §
stimulate muscle action.
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