Upper Resp 2 Flashcards
After the first tube change of trach care how often should it be changed
once a month
Can the pt change their tube their self
Yes
How do you decide if the pt should have a cuff or no cuff trach
if they are at risk for aspirations then they should get a cuff
When can decannulation happen
when the patient has adequate air echange and can epectorate
What is a consideration for patients undergoing decannulation
instruct them to splint the stoma with theiri fingers when they cough, swallow or speak
What is the stoma usu covered with
tape and occlusive dressing
What type of risk is increased with heck and neck cancer
speaking disability
Who is at highest risk for head and neck cancer
smokers GERD men double than women over 50 yo alcohol use
What are the manifestatioins of head and neck cancer in the oral cavity
early signs are painless growths, non-healing ulcers, change in denture fits and citric acid irritation
Late signs- pain dysphagia deceased tongue mobility airway obst, thickened oral mucosa, leukplakia and erythroplakia
What are the early signs of laryngeal cancer
hoarsness, change invoice quality, lumps
What is the process of diagnosing cancer
we suspect it like dysphagia, denture malf, and citric irritation
We look at it (CT etc)
We cut it then analyse it
What is the process of diagnosing cancer
we suspect it like dysphagia, denture malf, and citric irritation
We look at it (CT etc)
We cut it then analyse it
How is cancer staged
by the sise of the tumor (T)
degree of regional lymph node involvement (N)
absence or presence of distant metastases (M)
Once the TNM of the tumor are determined what is assigned
the stages I, II, III, IV
What is stage I
small
localized
usu curable
What is stage II and III
usu locally advanced and/or have spread to local lymph nodes
What is stage IV
usu metastatic and incurable (if travels to the liver, bone or brain
What is a complication of radiation therapy
cerostomia
What is cerostomia
dry mouth
What are some considerations for treating cerostomia
give lots of fluids
dont use alc mouth rinses
use glycerin swabs
What surgeries require a perminant hole in the throat
total laryngectomy
radical neck dissection
modified neck dissectioin
What will likely be part of a nursing care plan for head and neck surgery patients
elevate HOB for first 24 hours
suctioning
nutritional therapy
What are some nursing diagnoses for head and neck surgeries
Anxiety Ineffective airway clearance Ineffective tissue perfusion Imbalanced nutrition: less than body requirements Impaired verbal communication Disturbed body image Acute pain
Even when patients cant speak like after a neck/head surgery, what is something you can incorporate to be more caring
continue to talk outloud to them even though they cant respond
What are some discharge teaching points for total neck surgeries
you can resume normal activities but
avoid smoking and carbon monoxide
never occlude the decanulation cap
get a medic alert sys
