Upper Resp 2

Question 1

After the first tube change of trach care how often should it be changed

Answer 1

once a month

Question 2

Can the pt change their tube their self

Answer 2

Yes

Question 3

How do you decide if the pt should have a cuff or no cuff trach

Answer 3

if they are at risk for aspirations then they should get a cuff

Question 4

When can decannulation happen

Answer 4

when the patient has adequate air echange and can epectorate

Question 5

What is a consideration for patients undergoing decannulation

Answer 5

instruct them to splint the stoma with theiri fingers when they cough, swallow or speak

Question 6

What is the stoma usu covered with

Answer 6

tape and occlusive dressing

Question 7

What type of risk is increased with heck and neck cancer

Answer 7

speaking disability

Question 8

Who is at highest risk for head and neck cancer

Answer 8

smokers 
GERD
men double than women
over 50 yo
alcohol use

Question 9

What are the manifestatioins of head and neck cancer in the oral cavity

Answer 9

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

Question 10

What are the early signs of laryngeal cancer

Answer 10

hoarsness, change invoice quality, lumps

Question 11

What is the process of diagnosing cancer

Answer 11

we suspect it like dysphagia, denture malf, and citric irritation
We look at it (CT etc)
We cut it then analyse it

Question 12

What is the process of diagnosing cancer

Answer 12

we suspect it like dysphagia, denture malf, and citric irritation
We look at it (CT etc)
We cut it then analyse it

Question 13

How is cancer staged

Answer 13

by the sise of the tumor (T)
degree of regional lymph node involvement (N)
absence or presence of distant metastases (M)

Question 14

Once the TNM of the tumor are determined what is assigned

Answer 14

the stages I, II, III, IV

Question 15

What is stage I

Answer 15

small
localized
usu curable

Question 16

What is stage II and III

Answer 16

usu locally advanced and/or have spread to local lymph nodes

Question 17

What is stage IV

Answer 17

usu metastatic and incurable (if travels to the liver, bone or brain

Question 18

What is a complication of radiation therapy

Answer 18

cerostomia

Question 19

What is cerostomia

Answer 19

dry mouth

Question 20

What are some considerations for treating cerostomia

Answer 20

give lots of fluids
dont use alc mouth rinses
use glycerin swabs

Question 21

What surgeries require a perminant hole in the throat

Answer 21

total laryngectomy
radical neck dissection
modified neck dissectioin

Question 22

What will likely be part of a nursing care plan for head and neck surgery patients

Answer 22

elevate HOB for first 24 hours
suctioning
nutritional therapy

Question 23

What are some nursing diagnoses for head and neck surgeries

Answer 23

Anxiety 
Ineffective airway clearance 
Ineffective tissue perfusion 
Imbalanced nutrition: less than body requirements
 Impaired verbal communication 
Disturbed body image 
Acute pain

Question 24

Even when patients cant speak like after a neck/head surgery, what is something you can incorporate to be more caring

Answer 24

continue to talk outloud to them even though they cant respond

Question 25

What are some discharge teaching points for total neck surgeries

Answer 25

you can resume normal activities but
avoid smoking and carbon monoxide
never occlude the decanulation cap
get a medic alert sys