[xrachaelx]

****o! My name is Rachael, and I am a SN at the University of Nevada, Reno. For our theory class, we have an assignment to post a question on an online forum.

Because our 1st semester was basically all assessment, while doing my reading I realized I had what I thought was a unilateral (left) nontender, nonmobile, firm preauricular lymph node. The first thing that went through me mind was "Cancer, cancer, cancer!"

I didn't want to think much of it because, as everyone has probably experienced, when we're reading about all of these disorders you always think, "Holy moly, I think I have that!"

To make a long story short, I went to multiple doctor (primary, 2 ENT's) each doing a different diagnostic test (biopsy, CBC, MRI), each coming back with lymph cells or obvious lymph tissue.

Naturally, this struck an interest personally and as a future nurse. I've been doing plenty of medical research on the subject, so obviously I'm not looking for personal medical advice. The information I'm looking for are clinical/situational, or I'm looking for input from nurses knowledgeable in this area.

I'm just curious if any RN's have either experienced this personally, have seen this in practice whether it be at an ENT office, pre or post-op, etc.

Some possible questions (and any additional information would be greatly appreciated) I wanted to address would be in regards to discharge planning in a patient after the removal of a lymph node, or personal or individual patient situations seen as a nurse:

- What are some situations seen, requiring the removal of lymph nodes, if diagnostic tests thus far have ruled out cancer?

- Although we have many lymph nodes in the body, is anyone aware of whether or not there is a significant effect on the immune system after having 1 or more lymph node removed? Immune status?

- What are some of the adverse effects witnessed with the removal of alymph node?

- How often, or have you ever seen the diagnosis of an encapsulated infection in lymph tissue (making it unilateral, nontender, etc) ?

I've gotten little to no response on other forums, so I was hoping I found the spot to be to have a question answered! Again, this is for my future nursing knowledge and for a school assignment, so thank you all for your time. Your input and responses will be greatly appreciated!!

[sacbr1027]

****o,
I am also a nursing student who had to post 2 questions as an assignment. I will graduate in May and while I may not be a registered nurse yet I did have some information. This is in regards to your question involving adverse effects of lymph node removal. Well, there's the obvious: infection which I'm sure you've thought about but there were some others that I have seen people deal with. First is the location. The pt. can be at risk for body disfigurement and that can lead to body image disturbance for the pt. and family. There are other psychologically centered issues like the C word. People feel a lump and think cancer, just as you did. That is a very charged topic and brings about a grieving process of sorts. This is especially difficult for people who are still quite young and have not dealt with the death issue. Another issue is teaching. Blood pressures cannot be taken on that side because it can cause swelling and I've seen IV teams prefer not to use those sites because of the scarring. I hope that this has answered a little of that question. Good luck!!!
S