What should lymph nodes be assessed for when they are palpable? (Select all that apply)

Lymphadenopathy involves the enlargement of lymphoid tissue in response to infection, inflammation, or neoplasia. Palpable nodes require detailed evaluation to differentiate between benign reactive processes and malignant infiltration. Physical characteristics such as tissue consistency and fixation to underlying structures provide critical diagnostic clues. Normal nodes are generally non-palpable in adults. A. Bruit: A bruit is an audible vascular sound associated with turbulent blood flow, typically auscultated over arteries or vascular shunts. It is not an assessment finding associated with lymph nodes. Auscultation is not part of a standard lymphatic examination as nodes do not produce vascular sounds. B. Tenderness: The presence or absence of pain during palpation helps distinguish etiology. Tender, warm, and enlarged nodes usually suggest an acute inflammatory or infectious process. Conversely, nodes that are non-tender, stony-hard, and fixed are highly suspicious for malignancy or chronic granulomatous disease. C. Size: The nurse must measure the diameter of the node, usually in centimeters. Significant enlargement, typically greater than 1 cm, is considered clinically relevant. Monitoring changes in size over time is essential for evaluating the patient's response to treatment or the progression of systemic disease. D. Mobility: Healthy or reactive lymph nodes are usually mobile and can be moved under the skin. Nodes that are "fixed" or matted together suggest that a primary tumor or infection has breached the node capsule. This finding often indicates a more invasive or advanced pathological process. E. Shape: The physical configuration of the node provides additional data for clinical reasoning. Normal or reactive nodes tend to be oval or bean-shaped. Changes in the contour or a loss of the normal hilum, resulting in a more spherical or irregular shape, can be indicators of pathological infiltration.