Lymph Nodes

Hello! My name is Rachael, and I am a SN at the University of Nevada, Reno. For our theory class, we have an assignment to post a question on an online forum.

Due to personal cicumstances, I have become interested in the effects of lymph node removal associated with various disease processes such as breast cancer, lymphoma, melanoma, etc. I've been doing plenty of medical research on the subject, so obviously I'm not looking for medical advice. The information I'm looking for are clinical/situational, or I'm looking for input from nurses knowledgeable in this area.

I'm just curious if any RN's have either experienced this personally, have seen this in practice whether it be at an ENT office, pre or post-op, oncology unit, etc.

Some possible questions (and any additional information would be greatly appreciated) I wanted to address would be in regards to discharge planning in a patient after the removal of a lymph node, or personal or individual patient situations seen as a nurse:

- According to a journal titled, Nursing Management (November, 2002), "Prognostic factors (in Re: Breast CA) that influence survival and guide the patient's treatment plan include whether or not there's any spread to the axillary lymph nodes." I'm assuming this is an example of one of the reasons why lymph nodes are removed; basically, it's for further diagnostic testing. In addition to this situation, what are some other situations seen requiring the removal of lymph nodes?

- Lymph nodes act as filters for one's body's lymphatic drainage system, therefore, even though we have many lymph nodes in the body, is anyone aware of whether or not there is a significant effect on the immune system after having 1 or more lymph node removed?

- What are some of the adverse effects witnessed with the removal of a lymph node (such as lymphedema, etc)?

- According to the journal AORN (Association of Preioperative Registered Nurses), in a journal in August, 2001, they talked about a Sentinel lymph node biopsy, which is a diagnostic procedure used to determine the status of regional lymph nodes for staging purposes. What other diagnostic procedures have been seen in regards to lymph node? And what are possible nursing considerations?

Again, this is for my future nursing knowledge and for a school assignment, so thank you all for your time. Your input and responses will be greatly appreciated!