HEAD AND NECK CANCER Flashcards
Cancer of the Larynx
- Accounts for approximately half of all head and neck cancers
- Most common in men/people over age 65
Cancer of the Larynx Signs and Symptoms
EARLY
- Hoarseness
- Persistent cough
- Sore throat or pain burning in throat
- Raspy voice, lower pitch
- Lump in neck
Cancer of the Larynx Signs and Symptoms
LATE
- Dysphagia
- dyspnea
- Nasal obstruction
- Persistent hoarseness
- Persistent ulceration
- Foul breath
- General debilitation
Cancer of the Larynx Medical Diagnostics
- History and physical
- Laryngoscopy
- FNA biopsy (fine needle aspiration)
- Barium swallow study
- Endoscopy, CT, MRI, PET scan
Medical Management of Laryngeal Cancer
Stages I and II
(May not have cancer of entire larynx)
- Radiation therapy
- Cordectomy (take out vocal cord that has cancer)
- Endoscopic laser excision (shoot it with laser)
- Partial laryngectomy (take out part of larynx)
Medical Management of Laryngeal Cancer
Stages III and IV
- Radiation therapy
- Chemotherapy
- Chemo-radiation
- Total laryngectomy
— tumor extends beyond vocal cords
— cant breathe/ talk on own
— cant swallow
— - pts have tracheostomy after
Changes in Airflow With Total Laryngectomy
Nursing Process: Assessment
- Health history
- Physical, psychosocial, and spiritual assessment
- Nutrition, BMI, albumin, glucose, electrolytes
- Literacy, hearing, and vision; may impact communication after surgery
- Coping skills and available support systems for patient and family after surgery
Nursing Process: Diagnoses
- Knowledge deficit about surgical procedure
- Anxiety relating to diagnosis
- Ineffective airway clearance
- Impaired verbal communication
- Imbalanced nutrition
- Disturbed body image
- Self-care deficit
Postoperative Nursing Care
- Reduce anxiety
- Maintain patent airway, control secretions
- Support alternative communication
- Promote adequate nutrition and hydration
- Promote positive body image, self-esteem
- Self-care management
Collaborative Problems/Potential Complications
- Respiratory distress
- Hemorrhage
- Infection
— no spirometry
— clean with sterile saline - Wound breakdown
- Aspiration
- Tracheostomal stenosis
EDUCATING PATIENTS ABOUT SELF-CARE
- Tracheostomy and stoma care
- Hygiene and safety measures Chart 27-7, page 580
- Continuing and Transitional Care
Head and neck cancer can be devastating even with successful treatment how so?
- disrupting breathing
- eating
- facial appearance
- self-image
- speech
- communication.
Care needs for patients with these problems are _________
complex
- requiring a coordinated and comprehensive team approach.
Allow the patient and family members the opportunity to express fear or anxiety and grieve for the change in body image, a cancer diagnosis, or a change in breathing status.
Teach family members ___________
ways to communicate with a patient who is unable to speak after surgery for head and neck cancer.
Allow time to communicate with the patient who has voice loss.
Teach patients how to care for the skin in the radiation path.
Encourage the patient who has had head and neck surgery for cancer to __________.
look at the wound and touch the affected area.
Teach patients who have had radiation therapy to the neck or oral cavity to _________.
have dental examinations at least every 6 months.
At one time, patients were told to avoid using lotions or other skin care products within 4 hours of the radiation therapy; however, this practice is not evidence-based and is now controversial.
Instead teach patients ___________.
to follow the radiation-oncology department’s policy regarding the use and timing of skin care products.
Encourage patients with permanent tracheostomies or laryngectomies to ___________.
become involved in self-care.
Refer patients and families to__________ after surgery for head and neck cancer.
the American Cancer Society (ACS)
- Encourage people who smoke to quit smoking or using tobacco in any way.
- Encourage people who use alcohol to reduce their intake of alcoholic beverages.
Total laryngectomy produces ___________.
a change in airflow for breathing and speaking
