Normal narrative bank — stable / at-baseline
Seven upgraded normal narratives. Each shows what was assessed, the objective finding, the baseline comparison, and the skilled reason the visit required a nurse — edit to the actual visit.
N1 Post-mastectomy limb, compression worn, no progression | Skilled lymphatic assessment of an at-risk arm after mastectomy and axillary node dissection. Limb girth is unchanged from baseline at the measured landmarks with no new increase; there is no red streaking, warmth, or skin break; the compression sleeve is fitted and worn as ordered. The stable girth and protected limb, assessed because the limb is at lifelong risk for lymphedema and infection, confirm effective management; limb precautions, compression use, and infection recognition were reinforced, with the patient return-demonstrating correct sleeve application. |
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N2 No new lymphadenopathy | Skilled assessment of the lymph-node regions in a patient with a cancer history. The cervical, axillary, supraclavicular, and inguinal regions are without new adenopathy; any chronic node is unchanged, soft, and mobile. The absence of new or concerning nodes, compared to baseline, confirms no new finding requiring escalation; the node changes that would warrant evaluation (new hard, fixed, or growing nodes) were taught, with the patient verbalizing them correctly (cross-reference Hematologic). |
N3 Lymphedema stable with compression | Skilled assessment of a patient with established lower-extremity lymphedema. Limb girth is unchanged from baseline under the current compression; the skin shows stable chronic changes without new breakdown; there is no infection. The stable girth and intact skin under compression, compared to baseline, confirm the plan is holding; compression, elevation, skin care, and infection recognition were reinforced, with the patient return-demonstrating correct compression application. |
N4 Post-node-dissection precautions effective | Skilled assessment of a leg after inguinal node dissection. There is no new girth increase, streaking, or skin break; the patient consistently observes limb precautions and skin care. The protected limb without infection or progression, compared to baseline, confirms effective precautions; injury prevention, skin care, and infection signs were reinforced, with the patient verbalizing the precautions correctly. |
N5 Compression garment fit and use correct | Skilled assessment of compression technique in a patient with lymphedema. The garment fits correctly without constriction; the patient, after coaching, applied and removed it correctly and inspected the skin beneath; girth is stable. The correct fit and technique on return demonstration and the stable girth confirm effective compression; application, skin care, and the signs of an ill-fitting garment were reinforced, with the patient return-demonstrating correctly. |
N6 Lymphangitis resolved on monitoring | Skilled assessment following treatment for lymphangitis of an at-risk arm. The streaking, warmth, and tenderness have resolved and the patient is afebrile; girth has returned toward baseline. The resolution of the infection and return of girth, compared to the infected presentation, confirm the infection has cleared; limb precautions, skin care, and early reporting of recurrence were reinforced, with the patient verbalizing the warning signs correctly (cross-reference Integumentary). |
N7 Node monitoring stable | Skilled assessment of a patient with a previously evaluated benign node under monitoring. The node is unchanged in size, soft, mobile, and non-tender, without new overlying change. The stable, benign-appearing node, compared to baseline, confirms no concerning evolution requiring escalation; the changes that would warrant re-evaluation were taught, with the patient verbalizing them correctly. |