You are working with a UAP to care for a client who has had a right breast lumpectomy and axillary lymph node dissection. Which nursing action can you delegate to the UAP?

• A. Elevating the client's arm on two pillows to promote lymphatic drainage
• B. Teaching the client why blood pressure measurements are taken on the left arm
• C. Assessing the client's right arm for lymphedema
• D. Reinforcing the dressing if it becomes saturated

Answer: (A)

After axillary lymph node dissection, the area is at risk for lymphedema, so simple measures that promote lymphatic drainage and comfort are appropriate to delegate. Elevating the affected arm on two pillows is a safe, noninvasive positioning task that a UAP can perform. It helps reduce swelling by facilitating venous and lymphatic return without requiring clinical judgment, assessment, or wound care. The nurse can observe for changes in swelling or pain and intervene as needed.

Teaching about why blood pressure is taken on the left arm is an educational activity that requires nursing instruction, not delegation to a UAP. Assessing the right arm for lymphedema involves assessment and clinical judgment, which are nursing responsibilities. Reinforcing the dressing if it becomes saturated involves wound care and potential sterile technique, which should be performed by the nurse rather than the UAP.