Quote from shopgirl1
alright, another question, not to do with picc's but arms and bp's, and lab draws. patient has a bilateral masectomy...where do i do all of the above? and she has extreme 3+ ble edema!! :uhoh21:
the reason for not doing blood draws in a mastectomy arm is because their protection to invading bacteria has been compromised due to the removal of the lymph nodes during their mastectomy. a bp can be done as long as you don't keep the cuff inflated for a prolonged period of time.
for bilateral mastectomy patients without a central line, we got an order from the doctor to draw or place ivs in the arms and then followed a very strict skin cleansing protocol before any sticking.
edema can be overcome by placing an ace wrap on the arm, elevating it and wrapping it with a warm k-pad to help the circulation along. within 15-30 minutes enough swelling is displaced to find a vein.
if you are still in doubt about any of this (as you should be), ask several surgeons who do mastectomies or oncologists what the pathophysiology is behind why
a blood pressure, needlestick or iv can't be done on a mastectomy arm and when there can be exceptions to it.