Why no sticks after mastectomy

[wannadowell]

Please can someone explain to me why needle sticks are dangerous to affected side after breast removal. I understand that we lose lymph nodes which interrupts the flow of lymph so no BP cuffs should go there. Why can't we draw blood from the veins? Is there simply a greater risk of infection because of irregular lymph drainage? I can't seem to work this out in my brain.

[Esme12, ASN, BSN, RN]

The removal of lymph nodes may affect the drainage of lymphatic fluid from the arm on the surgical side. Problems with lymphatic drainage may result in arm swelling and an increased risk for infection from trauma to the arm. In addition, there is an increased risk for blood clots in the veins of the armpit because of surgical trauma in the area.

[nurseprnRN, BSN, RN]

Please can someone explain to me why needle sticks are dangerous to affected side after breast removal. I understand that we lose lymph nodes which interrupts the flow of lymph so no BP cuffs should go there. Why can't we draw blood from the veins? Is there simply a greater risk of infection because of irregular lymph drainage? I can't seem to work this out in my brain.

Gold star for thinking about it and letting us know how you did that, rather than just asking for the answer. Thinking is good. :flwrhrts:

[prmenrs, RN]

My mother had a bilateral mastectomy when she was 51; one side was a "simple" the other was a radical w/node dissection, etc. She lived to be 86 and died of problems unrelated to her breast cancer.

But she did have problems w/lymphadema on the "radical" side, the typical swelling, and several incidents of cellulitis and @ least one episode of sepsis.

I think she was a good example of why clients need to be careful of any injury, including venipunctures on the affected side.

[Philly_LPN_Girl, LPN]

Please can someone explain to me why needle sticks are dangerous to affected side after breast removal. I understand that we lose lymph nodes which interrupts the flow of lymph so no BP cuffs should go there. Why can't we draw blood from the veins? Is there simply a greater risk of infection because of irregular lymph drainage? I can't seem to work this out in my brain.

I justt did an nclex practice question today similar to what you are asking. The question was "a women had a mastectomy on her right breast and is not aloud to get venipuncture or blood pressures in taken in that arm. What is the rationale"? The answer was it could cause Lymphedema.

[nurseprnRN, BSN, RN]

Venipuncture and BP checks don't cause lymphedema. Disruption of the lymphatic chain in an area does. This may happen c mastectomy depending on the individual surgery done.

Lymphedema makes them risky due to the presence of lymphatic stasis, though. What does your lymphatic system do when it encounters infectious agents? If it can't do that, what happens? What other conditions predispose to/cause large areas of edema? What happens to those areas? How do we try to prevent this complication?

[classicdame, MSN, EdD]

If a patient had a radial mastectomy on one side and not on the other, you can draw from the non-radical side. Many nurses fail to ask about that. My friend had a double mastectomy because one breast had been treated before and another lesion appeared. The contra-lateral breast was removed simply so she would not have to worry about it in the future. But she still has lymph glands there. She also has a T-shirt that says "Yes, they are fake. But my real ones tried to kill me". Nurses have sick humor!! :)

Nurses have sick humor!! :)

I disagree... nurses have realistic and pragmatic humor :-)

OP: Realize that mastectomy is a relative contraindication, not an absolute contraindication. Just like placing IVs in the feet of diabetics... it's not a great choice but it's sometimes better than the alternatives...

That's the reality of most of medicine and most of its diagnostics and therapies.

[wannadowell]

Thank you so much for your help and time, ESME.

[wannadowell]

Thanks for your comment :)

[wannadowell]

Ha ha. Thanks so much classicdame...

[comm]

I disagree... nurses have realistic and pragmatic humor :-)

OP: Realize that mastectomy is a relative contraindication, not an absolute contraindication. Just like placing IVs in the feet of diabetics... it's not a great choice but it's sometimes better than the alternatives...

That's the reality of most of medicine and most of its diagnostics and therapies.

Yes, this should be higher up on the reply chain. People take suggestions as absolutes far to often and tend to not even do their own thinking. Everything is a weighted risk as you said. Great post.