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NRSG 200: Med Surg 3 > [Exam 3] Chapter 22 - Cancer of the Larynx > Flashcards

[Exam 3] Chapter 22 - Cancer of the Larynx Flashcards

1
Q

Cancer of the Larynx: How common is this?

A

Accounts for half of head and neck cancers

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2
Q

Cancer of the Larynx - RFs: What can cause this?

A

Tobacco, Alcohol, Smoking, Abstesos, Second-Hand Smoking, >65, Genetic Predisposition

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3
Q

Cancer of the Larynx - RFs: What gender is this more common with?

A

Men

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4
Q

Cancer of the Larynx - RFs: What race is this most common with?

A

African Americans and Caucasians

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5
Q

Cancer of the Larynx - CMs: Larynx is composed of what?

A

Epiglottis,, Supraglottis, Vocal Cord, GLottis and Subglottis

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6
Q

Cancer of the Larynx - CMs: What are some early signs?

A

Hoarseness (#1 sign. Hoarse, Rashy, Lower Pitch Voice)

Persistent Cough or Sore Throat

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7
Q

Cancer of the Larynx - CMs: What are some later signs of this?

A

Dysphasia (Difficulty Swallowing), Dyspnea (Difficulty breathing), Foul Breath bc tumor smells,

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8
Q

Cancer of the Larynx - Surgical Mx: What may this include?

A 
Vocal Cord Stripping
Cordectomy
Laser Surgery
Partial Laryngectomy
Total Laryngectomy
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9
Q

Cancer of the Larynx - Surgical Mx: Why is Speech Therapy usually involved?

A

Because the vocal cords are most likely ot be impacted.

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10
Q

Cancer of the Larynx - Surgical Mx: What is a vocal cord stripping?

A

Mucus is removed off the edges of the vocal cord. Strips away the cancer cells

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11
Q

Cancer of the Larynx - Surgical Mx: What is Cordectomy?

A

This removes vocal cords . Voice quality will change depending on the amount of vocal cords removed.

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12
Q

Cancer of the Larynx - Surgical Mx: What is laser surgery?

A

Used if larynx cancer is identified early on. Is an earlier treatment.. Microsurgery done at the glottis to help laser off that tumor

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13
Q

Cancer of the Larynx - Surgical Mx: When is a Partial Laryngectomy done?

A

More toward the beginning of treatment when only one vocal cord is involved

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14
Q

Cancer of the Larynx - Surgical Mx: What is a Partial LAryngectomy?

A

They go in and remove part of larynx.

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15
Q

Cancer of the Larynx - Surgical Mx: What is a Total Laryngectomy?

A

They remove the entire larynx

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16
Q

Cancer of the Larynx - Surgical Mx: What will they use to monitor progress of tumor?

A

TNM Model, which tracks tumor nodes metastasis to determine stage of cancer. Dictates what tx plan is.

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17
Q

Cancer of the Larynx - Radiation Therapy: Why is this done?

A

Helps eradicate cancer but helps preserve the function of the larynx because no vocal cords are removed.

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18
Q

Cancer of the Larynx - Speech Therapy: What is important to do before surgery?

A

Determine how they are going to communicate when they come out. Don’t want them to come out and not be able to communicate.

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19
Q

Cancer of the Larynx - Speech Therapy: What are the different types of therapies that will be used?

A

Esophageal Speech
Artificial Larynx
Tracheoesophageal Puncture

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20
Q

Cancer of the Larynx - Speech Therapy: How does Esophgaeal Speech work?

A

Patient has to compress air from esophagus to help make speech.

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21
Q

Cancer of the Larynx - Speech Therapy: How does artifical larynx work?

A

Mechanical device that helps create voice for them.

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22
Q

Cancer of the Larynx - Speech Therapy: What is a voice prosthesis ?

A

It is inserted and forces air into the esophagus and they can speak that way. .

23
Q

Cancer of the Larynx - PreOp Txing: What instruction will you give patient?

A

The type of procedure and resultant changes such as changes in speech or permanent loss of speech/airway.

24
Q

Cancer of the Larynx - PreOp Txing: What teaching will you include for their future?

A

How to take care of tubes like drainage and feeding tubes, and provide teaching to prevent postop complications

25
Q

Cancer of the Larynx - PreOp Txing: A plan must be set in place before surgery for what?

A

Postoperative communication and long-term speech rehabilitation

26
Q

Cancer of the Larynx - PreOp Txing: What team members will be present with this?

A

ST, Dietary, Social Work, Clinical Nurse Specialist, and others.

27
Q

Cancer of the Larynx - PreOp Txing: What is the stoma here?

A

Is the area that is currently open from the surgery

28
Q

Cancer of the Larynx - PreOp Txing: Why do you want to protect the stoma from water?

A

Because this is your airway and water can get into your lungs

29
Q

Changes in Airfrow with Total Laryngectomy: What must you always do here?

A

You must always protect the stoma (the out pouch where trach is) so water doesn’t go into lungs.

30
Q

Changes in Airfrow with Total Laryngectomy: What does the normal flow of air usually do in the body?

A

It is filtered with the ciliary and is warmed/humidified. That is now gone with this.

31
Q

Changes in Airfrow with Total Laryngectomy: Where will air enter and exit?

A

Through the trachestomy.

32
Q

Nursing Process - Care of Pt With Laryngectomy - Assessment: What assessments will be done?

A

Health Hx, S&S, Nutrition, Do they drink? What causues larynx cancer.

33
Q

Nursing Process - Care of Pt With Laryngectomy - Assessment: What should you check with patient before proceeding with surgery?

A

If they are psychologically ready to get a trach or laryngectomy

34
Q

Nursing Process - Care of Pt With Laryngectomy - Diagnosis: What problems may they experience?

A 
Deficient Knowledge
Anxiety - Listen to concerns
Ineffective Airway Clearance
Disturbed Body Image
Imbalanced Nutrition - May not eat for 7 days.
35
Q

Nursing Process - Care of Pt With Laryngectomy - Diagnosis: Why may ineffective airway clearance happen?

A

Bronchial tree may try to compensate for lack of humidity and will create excessive mucus and are going to have secretions building up. May not have strong cough yet either.

36
Q

Nursing Process - Care of Pt With Laryngectomy - Diagnosis: What position will patients be placed in?

A

At least 45 degrees when suctioning

37
Q

Nursing Process - Care of Pt With Laryngectomy - Diagnosis: What must you make sure to check with trach?

A

That it is secure and so they don’t pop out.

38
Q

Nursing Process - Care of Pt With Laryngectomy - Diagnosis: How will body handle extra mucus?

A

Body will eventually adapt to the extra mucus and new airway.

39
Q

Laryngectomy - Potential Collaborative Problems: What potential problems may occur?

A 
Respiratory Distress
Hemorrhage
Infections
Wound Breakdown
Aspiration
40
Q

Laryngectomy - Potential Collaborative Problems: What may cause respiratory distress?

A

May come from a mucus plug from the ineffective airway clearance

41
Q

Laryngectomy - Potential Collaborative Problems: Why is hemorrhage a concern?

A

It is always a concern whenever surgery occurs

42
Q

Laryngectomy - Potential Collaborative Problems: Why are infections a concern?

A

Because they have open wound.

43
Q

Laryngectomy - Potential Collaborative Problems: What should patient be taught for infections?

A

How to take care of themselves and prevent it. And how to monitor for signs and symptoms if they are having purulent drainage, site warm, or temperature going up.

44
Q

Laryngectomy - Potential Collaborative Problems: What must you monitor with wound breakdown?

A

How the site is healing

45
Q

Laryngectomy - Potential Collaborative Problems: Why may aspiration occur?

A

From any food that they are eating.

46
Q

Laryngectomy - Communication: What must be done preoperatively?

A

Plan communication

47
Q

Laryngectomy - Communication: What can be used immediately after surgery to communicate?

A

Magic Slate or Communication Board (Dry erase board or pictures)

48
Q

Laryngectomy - Self Care: What will they need to learn?

A

How to take care of tracheostomy and stoma.

Also hygiene and safety measures

49
Q

Laryngectomy - Self Care: What can they do to air since they cannot humify air?

A

They can purchase stuff to help humidify the home. Humidification

50
Q

Laryngectomy - Self Care: What special precautions should they taken?

A

In the shower, they must cover the site to ensure to air goes in.

51
Q

Laryngectomy - Self Care: What must be done if patient needs CPR?

A

The site must be plugged because the breaths that we give them would otherwise just disappear and go through the opening

52
Q

Laryngectomy - Self Care: What is the biggest safety measure they can do?

A

Making sure no water is entering the stoma.

53
Q

Laryngectomy - Self Care: What is the stoma?

A

The actual opening in the skin

54
Q

Laryngectomy - Self Care: what is the trach ?

A

The actual airway holding the site open, so thatll stay in until scar tissue is able to keep the site open.

NRSG 200: Med Surg 3 (46 decks)

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