Gina is filling in for the triage nurse at her facility’s outpatient solid tumor department. She receives a call from a patient who reports severe swelling in her left arm after returning from a trip on the opposite side of the United States. She says the skin in her arm and hand is quite tight, and that her hand was throbbing when she woke up this morning. Gina reviews the patient’s chart and notes she had a modified radical mastectomy three months ago on the same side as the new swelling.

What Would You Do?

Lymphedema is a common side effect of surgery involving lymph node removal and can occur at any time after surgery. The onset can be insidious or sudden and may be precipitated by airplane travel. Although the patient did not indicate these to Gina, signs and symptoms of infection may also be present, particularly if trauma has occurred to the area.

Upon further investigation, Gina learns that the patient had been fitted for a compression sleeve but was no longer using it because she hadn’t had any problems. Gina calls the patient back after making arrangements for her to see the hospital’s lymphedema nurse for a complete evaluation.