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After undergoing a radical mastectomy, your client/family membermay experience swelling in her affected arm -- even after healing is complete. Why? Because, as shown here, this type of surgery includes lymph node removal. It may also damage blood vessels in the surgical area, permanently impairing blood circulation in the affected arm. Lymph nodes and blood vessels, of course, normally drain body fluids before they accumulate and cause swelling. Damage to these two drainage systems makes your client/family member prone to arm edema. Depending on the degree of circulatory impairment and her own tendency to retain fluids, she may suffer from arm edema periodically or continually.
To help manage arm edema, the health care provider may order an arm sleeve with flap and a gauntlet, like those made by Jobst. After being specially measured, the client/family member will receive her own garment from the manufacturer. Instruct her to wear it as the health care provider directs and to carefully review and follow the manufacturer's recommendations.
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1. To reduce edema as much as possible before applying the garment, ask your client/family member to elevate her arm for about 30 minutes.
Then, begin applying the sleeve, as shown here. Ask her to insert her arm into the sleeve, so her hand protrudes from the sleeve's tapered end.![]()
2. Carefully apply the sleeve so it's smooth and wrinkle-free. Check the seam that's visible along the underside of her arm. Make sure it's straight and unpuckered.
When you smooth the sleeve over her elbow, look for a black dot on the sleeve. Make sure this dot rests precisely over the elbow's point.
When you've finished, again check for wrinkles. Because of the sleeve's custom fit, it should be comfortably snug.![]()
3. Now, smooth the shoulder flap in place. As you see here, half of its elastic band crosses the client's/family member's chest; the other half crosses her back. Both ends are attached to an elastic waist belt.![]()
4. Fasten the waist belt to secure the flap; as shown. Adjust the waist belt for a comfortable fit, if necessary.![]()
5. Adjust the flap's straps, so the flap is comfortable but secure.![]()
6. Finally, help her apply the gauntlet. Make sure its cuff overlaps the sleeve's cuff; as shown here, and that all material is flat and unwrinkled.
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