ONCOLOGY Laryngeal Cancer

Question 1

The main cause of laryngeal cancer is___.

other causes may be: alcohol, voice___ chronic___ industrial___

Answer 1

any form of tobacco.

use abuse

laryngitis

chemicals

Question 2

signs and symptoms of laryngeal cancer?

Answer 2

Difficulty swallowing.

hoarseness.

burning.

sore throat.

swelling in the neck.

loss of speech.

mouth sores.

lump in the neck.

color changes in mouth.

color changes in tongue.

dentures don’t fit anymore.

unilateral ear pain

Question 3

What are the early signs of laryngeal cancer?

Answer 3

There are none. by the time you start feeling symptoms, it has already progressed.

Question 4

Which 3 organs are removed when a TOTAL laryngectomy is performed?

which is most concerning?

Since all of these are removed, this person will have a permanent___

Answer 4

1- vocal cords

2- epiglottis (most concerning one because this covers your throat when swallowing.)

3- thyroid cartilage tracheostomy

*Permanent trache*… They can’t talk anymore. that’s why they have that device to talk like a robot

Question 5

Which position should a patient who has had a total laryngectomy be placed in post op?

Answer 5

mid/semi fowlers position (HOB elevated 35-40 degrees)

*WE WANT PRESSURE OFF THE SUTURE LINE*

Question 6

Your patient asks you why must they have an NG tube feeding after her laryngectomy. what do you tell her?

Answer 6

to protect the suture line because peristalsis could disrupt the suture line

*THEIR THROAT AND ALL THAT IS SUTURED, WE DON’T WANT THEM SWALLOWING FOOD OR ANYTHING*

Question 7

what would you do if went into your patient’s room that has had a brand new trache and you see it pulsating?

Answer 7

IT IS A MEDICAL EMERGENCY! It is caused by a ruptured of innominate artery

Question 8

Why is frequent mouth care necessary after a laryngectomy?

Answer 8

Decreased bacterial count in the mouth

NPO patients tend to get pneumonia

Question 9

why do 80% of NPO people in the hospital get pneumonia?

Answer 9

From improper mouth care (need tooth brush and tooth past)

Question 10

Why would you want to use a bib instead of a wash cloth to give mouth care for a patient who has a trache?

Answer 10

wash cloth has too many fibers that will irritate the trache

Question 11

WE NEVER WANT WHAT 3 THINGS AROUND A TRACHE?

Answer 11

• Plastic
• powder
• aerosols

Question 12

Why does a trache patient need a humidified environment?

what does the dry air do to the trache?

Answer 12

when we breathe through our noses, it gets humidified when it goes down to the lungs, but if you are breathing straight from your throat, it needs to be humidified first or else, the dried air can be very irritating.

makes the throat produce more and more secretions as a compensatory mechanism. thus, a humidified environment will help to decrease secretions.

Question 13

When doing trache care and you’re changing the strings, do you EVER take your finger off the stoma? why?

Answer 13

NO! if you take off your finger, the patient will cough and dislodge it

Question 14

What do you do if the trache becomes dislodged and there isn’t another one at the bedside?

Answer 14

you reinsert it (you don’t have to rinse it)

Question 15

with a total laryngectomy, ALL breathing is done through the___

Answer 15

stoma

Question 16

T OR F? A laryngectomy patient is able to use a straw.

can they smoke?

can they swim?

Answer 16

F! no air in mouth= no ability to suction.

not reccomended no.

they cannot plug it up.

Question 17

Trache suctioning: Sterile or not sterile?

when should you hyper-oxigenate?

when do you stop advancing the catheter?

apply suction when?

intermitten or continous suctioning?

suction no longer than___ seconds.

watch for arrythmias because which nerve can be stimulated?

when the vagus nerve is stimulated, the heart rate___

Answer 17

sterile.

before and after.

when you meet resistance or when the patient coughs.

on the way out.

intermitten .

10 seconds.

the vagus nerve.

heart rate decreases