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Integumentary 1 - Final > Treatment - Lymphedema > Flashcards

Treatment - Lymphedema Flashcards

1
Q

Complete decongestive therapy

A

phase 1

phase 2

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2
Q

phase 1 —> CDT

A

5 components of daily tx

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3
Q

5 components of daily tx –> phase 1

A

manual lymphatic drainage (MLD)

compression bandaging

skin care

remedial exercises

pt education of self care management

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4
Q

phase 2 –> CDT

A

maintenance phase

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5
Q

maintenance phase

A

compression garments during the day

self-bandaging at night or use night time garment

meticulous skin care

daily remedial exercises

self MLD daily

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6
Q

types of compression garments

A

standard v. custom

class 1,2,3

stypes

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7
Q

standard compression garment

A

circular knit

risk of tourniquet

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8
Q

class 1,2,3

A

40-50 mmHg

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9
Q

tx goals

A

volume reduction

infection

improve
-skin integrity
-cosmesis
-psychosocial morbidity
-fxnal mobility and QOL

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10
Q

what is MLD

A

gentle manual therapy which improves activity of lymph vascular systems

increases re-absorption of protein rich fluid

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11
Q

what does MLD do

A

re-routes lymph flow around the blocked areas into more centrally located healthy lymph vessels

which drain into the venous system

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12
Q

what does MLD improve

A

lymph production

lymph circulation increasing the volume of lymph fluid transported

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13
Q

what does MLD help do

A

breakdown fibrotic areas

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14
Q

what does MLD promote

A

relaxation

analgesic effect

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15
Q

MLD has a

A

diuretic effect

increases urine output

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16
Q

what type of bandages do we use w/ compressive bandaging

A

short stretch bandages only

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17
Q

what does compression bandaging improve

A

efficiency of the muscle and joint pumps

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18
Q

what does compression bandaging increase

A

tissue pressure in the swollen limb

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19
Q

compression bandaging prevents

A

re-accumulation of evacuated lymph fluids

20
Q

compression bandaging helps

A

break up deposits of accumulated scar tissue and connective tissue

21
Q

how long do bandages stay in place

A

remain in place until next MLD session begins during phase 1 of tx

22
Q

contraindication to compression bandaging

A

ABI < 0.7

23
Q

how should exercise be performed

A

lower exertion

slow

rhythmic

24
Q

what should exercise be performed w/

A

compression bandaging/garments on

25
Q

purpose of exercise

A

increase muscle and joint pump efficiency

increase venous and lymphatic return

26
Q

skin care

A

decreases risk of infection

keeps skin clean

always use lotions and soaps with low pH levels

27
Q

general contraindications

A

acute infection of any kind

cardiac edema

malignant dz (relative)

renal dysfxn

acute DVT

arterial disorders/dz

acute CHF

HTN (relative)

28
Q

why does tx fail

A

malignant lymphedema

morbid obesity

poor or absent homecare support

co-morbidities

lack of compliance

faulty dz

insufficient tx

29
Q

insufficient tx

A

improper bandaging techniques or MLD techniques

deviation from proper CDT protocol

30
Q

risk reduction practices

A

skin care

exercise

no deep tissue massage to affected quadrant

no heat to affected limb

never wear tight fitting clothes or jewelry

avoid extreme temps

avoid prolonged positioning

air flight

31
Q

skin care

A

moisturize daily w/ non fragrance lotion

use soap w/ low alc base (Dove)

proper nail care

32
Q

proper nail care

A

no pedicaure/manicures

33
Q

there should be no

A

blood draws

injections

blood pressure to the affected limb

34
Q

avoid… –> skin care

A

bug bites or sunburns

scratches or cuts

35
Q

exercise –> RR practice

A

minimal restrictions w/ activity

36
Q

minimal restrictions w/ activity

A

upper extremity pt

aquatic therapy

do not overstress affected limb

37
Q

UE pt –> RR practices

A

should not lift more than 15 lbs

38
Q

aquatic therapy –> RR practices

A

very beneficial for lymphedema pts

39
Q

no heat to the affected limb

A

hot packs

moist heat

hot tobs

whirlpool

hot showers

40
Q

avoid prolonged positioning –> RR practices

A

that would cause compression to affected lymph node groups

41
Q

air flight –> RR practices

A

always wear compression sleeve/stocking

even if pt has no sxs, they are at risk then compression should be worn

42
Q

wrapping

A

base layer

artiflex

wrap individual fingers

foam layer

bandage

43
Q

artiflex

A

used to shape and padding

1-2 layers

44
Q

foam layer

A

helps with conical shape

45
Q

bandage

A

multiple layers

Integumentary 1 - Final (20 decks)

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