The node groups that are considered major and should be primarily reviewed can be found at the base of the jaw and along the front and the back sides of the neck. In case if the nodes are rather large, the nurse would be able to see the bumps under the patient’s skin. The enlargement would be more obvious if it is lopsided and one of the sides is significantly larger than the other (Quasmi et al., 2012). The palpation process should be performed with the use of four fingertips due to the fact that these body parts are ones of the most sensible in the human body.
The nurse should examine the head from both sides (at the same time). Firm but moderate pressure should be applied to the examined areas by means of the fingertips (Robenshtok et al., 2012). The major groups of lymph nodes that might be examined include Waldeyer ring, pre-auricular, supraclavicular, and occipital nodes. It is important to take into consideration that lymph nodes are known to be a part of the natural defenses of the body and its immune system. Consequently, when dealing with infections, lymph nodes should be palpated in order to identify the origin and the nature of the infection.
The latter may appear near the drained organs, or they may as well originate in the interior of the lymph node mentioned above. This is called lymphadenitis (Robenshtok et al., 2012). The patient’s infected lymph nodes are susceptible to being stable, squashy, inflamed, and warm. Reddening may be visible on the patient’s skin in the areas of inflammation. The core of the node will become necrotic if the nurse does not provide any relevant treatment. As a result, an abscess would appear that would feel like a fluctuance when touched. The knowledge of which areas are drained by specific lymph nodes would help the nurse identify the issues more effectively (Quasmi et al., 2012).
If the infection is not treated, the nodes will stay permanently enlarged and feel like elastic. For instance, it is normal to find palpable nodes in the submandibular region of comparably healthy patients. Most probably, this is a consequence of prior dental infections or pharyngitis (Quasmi et al., 2012). The node should be considered insignificant if its dimensions range from 1 cm to 3 cm in diameter. If the node is soft, it is an insignificant aspect, but the nurse should pay close attention if it is rubbery or hard. For pediatric patients (2-12 years old) insignificant lymph nodes are the second most prevalent infection origin (Robenshtok et al., 2012). Nonetheless, the recommendations for pediatric patients would not differ significantly from the diagnoses in adult patients. The only difference is that geriatric patients should be screened for bad habits (for instance, smoking) because these factors may impact the treatment process greatly.
There is a number of tests that may be performed in the case of abnormal findings. First, the nurse might perform specific blood tests. These tests might be done in order to identify certain issues connected to the swollen lymph nodes. In this case, complete blood count (CBC) is essential (Quasmi et al., 2012). Throughout the process, the nurse might detect leukemia or other significant infections. Second, the nurse might perform imaging studies. Potential sources of infection could be identified by means of X-ray or computerized tomography (Khanna, Sharma, Khanna, Kumar, & Shukla, 2011). The third option is lymph node surgery. The lymph node or a sample of it would be removed in order to perform an examination.
References
Khanna, R., Sharma, A., Khanna, S., Kumar, M., & Shukla, R. C. (2011). Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy. World Journal of Surgical Oncology, 9(1), 29-36. Web.
Quasmi, S., Kiani, F., Malik, A., Salamatullah, J., Farooq, M., & Abassi, M. (2012). Cervical lymphadenopathy: A common diagnostic dilemma. Journal of Surgery Pakistan, 17(2), 76-80.
Robenshtok, E., Fish, S., Bach, A., Domínguez, J. M., Shaha, A., & Tuttle, R. M. (2012). Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients. The Journal of Clinical Endocrinology & Metabolism, 97(8), 2706-2713. Web.