A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander

Answer:

The correct answer is Option 4. "i should expect less than 25 ml of secretions per day in the drainage devices"

Explanation:

Modified left radical mastectomy involves the removal of left br_east and left axillary lymph nodes, vessels without removal of pectoralis major muscle. A reconstructive surgery is possible for modified left radical mastectomy.

The nurse should teach the following points while discharging:

• A drain will be placed at the site of surgery for up to 3 weeks and the secretions into the drainage shall be less than 25 mL per day.
• Exercise should be encouraged on the left arm regularly
• Left arm should be elevated using support or pillow to allow return of lymphatic fluid
• The client should be advised to sit at 30 degrees to allow for drainage.

Thus, when the patient says that the she expects less than 25 mL secretions into drainage devices, it indicates understanding of the teaching by the client.

Hence, the correct answer is Option 4.  

Why the other options are incorrect?

• Additional saline is injected weekly and shall not have to wait for up to 2 months. Thus, Option 1 is also incorrect.
• The weight for arm exercises should not exceed 5 to 10 pounds. Hence, option 2 is incorrect as the client mentions a weight of 15 pounds.
• When the arm is kept flexed it prevents return of lymphatic fluid, hence, option 3 is incorrect as it does not indicate patient understanding