10.5 Objective Assessment
The objective assessment of the lymphatic system is usually completed after the subjective assessment. Position the client depending on the related area being assessed.
Be aware of the environmental temperature in the room and the temperature of your hands. Room temperatures are not easily modified, so try to limit exposing the client and keep them covered, and try to warm your hands before placing them on the client’s body.
Objective assessment of the lymphatic system involves the techniques of inspection and palpation. Compare your assessment bilaterally and ask the client if they feel any pain. If you notice leaking fluid or blisters, wear gloves to help prevent and control infection.
Contextualizing Inclusivity
You will be exposing various areas of the body, so it is important to be attentive to the client’s needs during the assessment. Always use a trauma-informed approach: ask permission to touch and explain what you are doing before you proceed.
A cultural humility approach to assessment is also important because you cannot know and fully understand all cultures. This kind of approach requires a lifelong process of reflection and self-critique to address power imbalances within systems and develop mutually beneficial partnerships and relationships (Tervalon & Murray-Garcia, 1998). Health care professionals should engage in continuous, critical reflection on power and privilege, and find ways to interact with clients of different race, sex, gender, age, and ability.
For example, some of your clients may wear head coverings or coverings over their face or body. Some Muslim women wear hijabs that cover their heads or niqabs that cover their faces, some Sikh individuals wear turbans, and some married Jewish women cover their hair with scarves or wear wigs. These are just some examples. For some clients, touch (i.e., physical assessment) from a person of the opposite gender may not be permissible or encouraged. Some Muslim women may prefer or require a health care provider of the same gender, but others may feel that receiving health care from a male practitioner can be medically necessary and is therefore permitted.
Another consideration is that many clients are uncomfortable with assessments of the lymph nodes in the groin area. This kind of assessment may be particularly uncomfortable for clients who have experienced trauma and/or clients who experience gender incongruence.
Overall, you should first determine whether the assessment is necessary, if the client feels comfortable with you doing the assessment, and if accommodations can be made for the client. You can find some tips for providing sensitive care to 2SLGBTQ+ clients at https://soginursing.ca/.
References
Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi.org/10.1353/hpu.2010.0233
