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?

Postoperative care after a modified radical mastectomy with placement of a tissue expander focuses on wound healing, prevention of complications such as infection or lymphedema, and proper management of surgical drains. Clients are taught to monitor drainage output, maintain appropriate arm positioning, and avoid activities that increase strain on the surgical site. Understanding expected outcomes of drainage and activity restrictions is essential for safe recovery and complication prevention. A. Waiting 2 months before additional saline is added to the breast expander is not accurate because tissue expanders are typically gradually inflated in the outpatient setting starting a few weeks after surgery, depending on wound healing and provider protocol. The timing is individualized and not fixed at 2 months for all clients. B. Keeping the left arm flexed at the elbow is incorrect because prolonged flexion increases the risk of shoulder stiffness and reduced range of motion. Clients are encouraged to gently elevate and gradually extend the arm to prevent contractures and promote lymphatic drainage. Early controlled movement is essential for recovery. C. Expecting less than 25 mL of drainage per day is correct because surgical drains are typically removed when output decreases to minimal levels, often around 20–30 mL or less per day. This indicates that excess fluid accumulation is resolving and that the surgical site is healing appropriately. Monitoring drainage helps determine readiness for drain removal. D. Performing strength-building exercises with a 15-pound weight is inappropriate in the early postoperative period. Heavy lifting and resistance exercises are restricted initially to prevent strain on the surgical site and reduce the risk of lymphedema. Arm exercises should begin with gentle range-of-motion activities and progress gradually as healing allows.