A complete lymphatic assessment addresses each of the following as indicated by the patient’s condition and orders, and compares each finding to baseline.
Lymph nodes — the cervical, axillary, and inguinal regions for size, tenderness, mobility, and consistency.
Lymphedema — limb girth and swelling, comparing the affected to the unaffected limb and to baseline.
Skin changes of lymphedema — peau d’orange, fibrosis, thickening, and any breakdown.
Lymphangitis — red streaking, warmth, tenderness, and systemic signs suggesting spreading infection.
At-risk limbs — the arm after mastectomy or axillary node dissection, or the leg after inguinal dissection, for early swelling and infection.
Compression therapy — garment or bandage fit, wear, and effect, and the skin beneath it.
The oncologic context — active or prior cancer, radiation, and the current treatment plan (coordinate with Hematologic and Psychosocial).
The venous context to distinguish venous from lymphatic edema (cross-reference Peripheral Vascular).
Function and mobility as affected by limb swelling.
The patient’s adherence to limb precautions and self-care.
