REPLY POSTS:Reply separately to two of your classmates article critique's posts (See attached classmates posts, post#1 and post#2). - Use at least two scholarly references per peer post. The expectati

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Chapter 11: Lymphedema

The purpose of this paper is to discuss lymphedema and critique an article on the topic. Lymphedema is when there is an obstruction in the lymphatic vessels that cause the tissues in the extremities to swell (Hubert & Vanmeter, 2018). This also allows for accumulation of lymph in the tissues as well. Commonly, this disorder is congenital and may involve the lymph nodes along with the vessels (Hubert & Vanmeter, 2018). It can also be caused by blockage of the lymph vessels due to parasitic worms (Hubert & Vanmeter, 2018). When the lymph states to build up in the body, the more the extremity swells (Huber & Vanmeter, 2018). As lymphedema continues to progress over time, the extremity becomes enlarged, firm and painful (Hubert & Vanmeter, 2018). Lymphedema can be chronic as well, which leads to frequent infection (Hubert & Vanmeter, 2018). According to Johns Hopkins Medicine (2020), lymphedema can occur after cancer surgery when lymph nodes are removed.

Authors Rebecca J. Tsai, Leslie K. Dennis, Charles F. Lynch, Linda G. Snetselaar, Gideon K. D. Zamba, Carol Scott-Conner published an article on lymphedema after breast cancer entitled “Lymphedema following breast cancer: The importance of surgical methods and obesity” Published to Front Women’s Health in 2018. The purpose of the article is to discuss the research that the authors have conducted on the association between developing lymphedema after cancer surgery and personal risk factors (Tsai et al., 2018). This research will allow for them to better understand if there are certain factors that make a person more at risk for developing lymphedema after cancer surgery. The literature was drawn from a systemic approach. This is because it focuses on a specific question and critically appraises all relevant research. The review focuses on cause and effect meaning how does one issue effect the other. In this case, the authors are correlating developing lymphedema after surgery and certain risk factors that can affect this. Tsai et al. (2018) identify concern that the measures of the study are from subject self-reporting. The authors feel that there can be issues with self-reporting because the patients do not always participate until the end of the study.

The aim of the study is to understand if there is a correlation between arm lymphedema and certain personal risk factors (Tasi et al., 2018). To achieve an accurate study, the authors used a population-based cohort design. This allows for better understanding of the research for this specific population of women. The sample was obtained in Iowa from 2004 to 2010. Tsai et al. (2018) states that the women who met the criteria, completed a short telephone interview about their lymphedema status, arm activities, demographics and chronic conditions that they currently have. The patients were confirmed to have lymphedema from physician reports and the presence of at least four major arm symptoms that can occur with the disease (Tsai et al., 2018). There were 522 participants in the study, which seems to be an adequate size for a population-based cohort design.

The study showed that lymphedema was identified in 102 of the 522 patients (Tsai et al., 2018). The results showed that people who had radiation and some dissection if the axilla were more at risk for lymphedema after breast cancer surgery (Tsai et al., 2018). Tsai et al. (2018) states that the women who were the most likely to have lymphedema had a body mass index above 40. This shows that obesity, the characteristics of the cancer and the methods used in surgery were all major factors in the patient developing lymphedema (Tsai et al., 2018). The authors found that obesity promotes the inflammation of the body which leads to issues with lymphedema. The authors also found that women who were younger had a higher chance of developing lymphedema as well. The authors are satisfied with the results and do not mention a need for further testing (Tsai et al., 2018).

The article is greatly recommended as a nurse and a future advanced practice nurse. This article is easy to comprehend and has pertinent information that can be used in practice. The information can be useful when assessing patients who have had breast cancer surgery. Knowing and understanding the risk factors for developing lymphedema after breast cancer surgery can allow for preventative care for the patients who are most at risk. It may not be completely curable, but there are certain steps that can be taken to reduce the symptoms or even keep it from starting in the first placed (Johns Hopkins Medicine, 2020). It is apparent that advanced practice nurses should understand the signs and symptoms of developing lymphedema so that it can be treated adequately.

References

Hubert, R. & VanMeter, K. C. (2018). Gould's pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders.

Johns Hopkins Medicine. (2020). Breast cancer: lymphedema after treatment. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/breast-cancer-lymphedema-after-treatment

Tsai R. J., Dennis, L. K., Lynch, C. F., Snetselaar, L. G., Zamba, G. K. D., Scott-Conner, C. (2018). Lymphedema following breast cancer: the importance of surgical methods and obesity. Front Women’s Health, 3(2), 1-17.

References

Lastname, C. (2008). Title of the source without caps except Proper Nouns or: First word after colon. The Journal or Publication Italicized and Capped, Vol#(Issue#), Page numbers.

Lastname, O. (2010). Online journal using DOI or digital object identifier. Main Online Journal Name, Vol#(Issue#), 159-192. doi: 10.1000/182

Lastname, W. (2009). If there is no DOI use the URL of the main website referenced. Article Without DOI Reference, Vol#(Issue#), 166-212. Retrieved from http://www.mainwebsite.org