A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?

Discharge teaching after a modified radical mastectomy with tissue expander focuses on wound care, drain management, prevention of lymphedema, and gradual restoration of arm function. A Modified radical mastectomy is often followed by placement of surgical drains to prevent fluid accumulation and support healing. Clients are also taught safe upper extremity movement and restrictions to avoid complications such as lymphedema or wound disruption. Understanding expected drain output and safe activity levels is essential for recovery. Rationale: A. Keeping the left arm flexed at the elbow as much as possible is incorrect because prolonged flexion can promote stiffness, reduce circulation, and increase the risk of lymphedema. Instead, the client should perform gentle range-of-motion exercises and avoid immobilization to maintain joint flexibility and lymphatic flow. Proper positioning helps prevent shoulder contractures and swelling. B. Expecting less than 25 mL of drainage per day indicates proper understanding because decreasing serosanguineous output is a sign of healing and reduced fluid accumulation. Surgical drains are typically removed when output decreases to a low level, often around this range depending on provider protocol. Monitoring drainage volume helps assess recovery progress and readiness for drain removal. C. Waiting 2 months before additional saline can be added to a breast expander is incorrect because tissue expanders are typically gradually filled over weeks, not months, depending on healing and tolerance. Expansion usually begins shortly after surgery and continues at regular intervals until the desired breast size is achieved. Delaying expansion for such a long period does not reflect standard postoperative care. D. Performing strength-building arm exercises using a 15-pound weight is unsafe after mastectomy because heavy lifting can increase the risk of lymphedema and surgical site complications. Early rehabilitation focuses on gentle range-of-motion exercises rather than resistance training. Heavy weights are avoided until full healing and clearance from the healthcare provider are achieved.