Page 1282 - Saunders Comprehensive Review For NCLEX-RN

return from surgery usually with a surgical brassiere
and a prosthesis in place.
8. Provide the use of a pressure sleeve as prescribed if
edema is severe.
9. Maintain fluid and electrolyte balance; administer
diuretics and provide a low-salt diet as prescribed for
severe lymphedema.
10. Consult with the PHCP and physical therapist
regarding the appropriate exercise program, and
assist the client with prescribed exercise.
11. Instruct the client about home care measures (Box 44-
13).

No IVs, no injections, no blood pressure measurements, and

no venipunctures should be done in the arm on the side of the
mastectomy. The arm on the side of the mastectomy is protected, and
any intervention that could traumatize the affected arm is avoided
because of the risk for lymphedema on this side.
XVII. Esophageal Cancer
A. Description
1. Esophageal cancer is a malignancy found in the
esophageal mucosa, formed by squamous cell
carcinoma (SCC) or adenocarcinoma.
2. The cause is unknown but major risk factors include
cigarette smoking, alcohol consumption, chronic
reflux, Barrett’s esophagus, and vitamin deficiencies.
3. Complications include dysphagia, painful swallowing,
loss of appetite, and malaise.
4. The goal of treatment is to inhibit tumor growth and
maintain nutrition.
B. Assessment
1. Dysphagia
2. Odynophagia
3. Epigastric pain or sternal pain
C. Interventions

1. Monitor nutritional status, including daily

weight, intake and output, and calories consumed.
2. Instruct the client about diet changes that make eating
easier and less painful.
3. Prepare the client for chemotherapy and radiation as
prescribed.
4. Prepare the client for surgical resection of the tumor as
prescribed.
XVIII. Gastric Cancer
A. Description
1. Gastric cancer is a malignant growth of the mucosal

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