The following would be considered contraindications to MLD

• A. Cardiac edema, CHF, renal insufficiency
• B. Hypertension, Diabetes, Asthma
• C. Cardiac arrhythmia, Hypertension, Kidney stones
• D. Pregnancy, Abdominal pain, Fever

Answer: (A)

This question is testing when it’s unsafe to use manual lymph drainage because moving fluid through the lymph system can put extra stress on the body’s already struggling systems. In cardiac edema and congestive heart failure, the heart is already overloaded with fluid. Encouraging more lymph flow toward the central circulation can increase preload and potentially worsen edema or even trigger pulmonary edema. In renal insufficiency, the kidneys can’t effectively handle fluid and waste after shifts in fluid balance; mobilizing additional fluid via the lymphatic system can destabilize fluid and electrolyte balance and overload the system. Because of these risks, those conditions are considered contraindications to MLD.

Other conditions listed aren’t automatic contraindications. Hypertension, diabetes, or asthma aren’t absolute prohibitions, and pregnancy or fever may be managed with caution or omitted depending on the situation, rather than being universally disallowed like the cardiac and renal issues above.