Why is placing an IV in the arm on the operative side after mastectomy contraindicated?

• A. It increases the risk of infection
• B. It can cause lymphedema due to impaired lymphatic drainage
• C. It can interfere with range of motion
• D. It compromises graft integrity

Answer: (B)

The key idea is the effect of breast/axillary surgery on the lymphatic system. After mastectomy with axillary node removal or radiation, the arm on the operative side has impaired lymph drainage. Placing an IV there can disrupt or inflame the already fragile lymphatic vessels, increasing the risk of lymphedema—the swelling due to lymph fluid buildup. Lymphedema can be hard to manage and raises the risk of infections, so the IV is placed on the nonoperative side to protect lymphatic function.

Infection and range of motion issues can be concerns in general, but they don’t address the specific risk created by compromised lymphatic drainage. Graft integrity isn’t relevant to this scenario. So the best reason to avoid IV on the operative side is to prevent lymphedema from impaired lymphatic drainage.