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NURS 3512 - Class 1-6 > Week 6 - Esophageal Cancer > Flashcards

Week 6 - Esophageal Cancer Flashcards

1
Q

what is esophageal cancer

A
  • rare malignant neoplasm of the esophagua
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2
Q

what are 2 main risk factors for esophageal cancer

A
  • excessive alcohol intake

- smoking

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3
Q

what are other risk factors for esophageal cancer (7)

A
  • diet low in fruits & veggies
  • certain minerals & vitamins
  • lye (in strong cleaners)
  • hx of achalsia
  • hx of gerd
  • hx of hiatal hernia (can cause gerd)
  • hx of barrets esophagus (comp of gerd)
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4
Q

describe symptoms of esophageal cancer (2)

A
  • late onset

- relates to extent of tumour

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5
Q

list symptoms of esophageal cancer (4)

A
  • progressive dysphagia
  • globus sensation
  • pain
  • weight loss
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6
Q

where is pain located in esophageal cancer (3)? where may it radiate to (3)

A
  • substernal
  • epigastric
  • back areas

radiate to:

  • neck
  • jaw
  • ears
  • shoulders
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7
Q

if the tumour is located in the upper third of the esophagus, what symptoms might be present (3)

A
  • sore throat
  • choking
  • hoarseness
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8
Q

what are 4 complications of esophageal cancer

A
  • hemorrhage
  • esophageal perforation w fistula formation
  • esophageal obstruction (if get big enough)
  • metastasis
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9
Q

how can esophageal cancer cause hemorrhage

A
  • if cancer erodes thru esophagus into the aorta
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10
Q

where can esophageal perforation w fistual formation occur in esophageal cancer (2)

A
  • into the lung

- or trachea

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11
Q

what are common sites of metastasis w esophageal cancer (2)

A
  • liver

- lung

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12
Q

what diagnostic studies can be used for esophageal cancer (6)

A
  • barium swallow w fluoroscopy
  • endoscopy w biopsy (definitive**)
  • endoscopic US
  • bronchoscopic exam
  • CTI
  • MRI
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13
Q

treatment for esophageal cancer has best result w…

A

combo of:

  • surgery
  • radiation
  • chemo
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14
Q

what 3 types of surgeries can be done for esophageal cancer

A
  • esophagectomy
  • esophagogastrostomy
  • esophagoenterostomy
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15
Q

what is an esophagectomy

A
  • removal of part or all of esophagu
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16
Q

what is an esophagogastrostomy

A
  • resection of a portion of the esophagus and anastomosis of remaining portion to the stomach
17
Q

what is an esophagoenterostomy

A
  • resection of a portion of the esophagus and anastomosis of a segment of colon to the remaining portion
18
Q

surgical approaches for esophageal cancer

A
  • thoracic

- or both abdominal & thoracic

19
Q

a tumour in the ___ part of the esophagus usually indicates radiation

A
  • upper third (cervical section)
20
Q

a tumour in the lower third of the esophagus usually indicates ___

A

surgery

21
Q

palliative therapy for esophageal cancer usually consists of? (2)

A
  • restoration of the swallowing function

- maintenance of nutrition and hydration

22
Q

what can be used to relive obstruction in esophageal cancer (3)

A
  • dilation
  • stent placement
  • or both
23
Q

what can be used in combo w dilation for esophageal cancer (2)

A
  • endoscopic laser therapy

- or vaporization

24
Q

what nutritional therapy is indicated after esophageal surgery

A
  • NPO until ordered
  • parental fluids after surgery
  • fluids after BS returned –> 30-60 mL/hr with gradual progression to small, bland meals
25
Q

describe nursing interventiosn r/t nutrition after esophageal surgery (3)

A
  • position in upright position to prevent regurg
  • observe for signs of intolernance to food
  • observe for signs of leakage into mediastinum
26
Q

what symptoms could indicate leakage of food/liquids into the mediastinum post op (3)

A
  • pain
  • increased temp
  • abdominal distension
27
Q

what may be performed to help feed the pt post-op

A

gastrostomy

28
Q

describe preop care for a pt with esophageal cancer (7)

A
  • general preop teaching and prep
  • high cal, high protein diet (many malnourished d/t dysphagia, inability to ingest adequate amt of food & liquids before surgery) –> may be liquid form, IV, TPN
  • instruct on how to keep I&O record
  • assess S&S of fluid & electrolyte imbalance
  • meticulous oral care
  • teaching about chest tubes (if thoracic approach used), IVs, NG tubes, gastrostomy feeding, turning
  • teach abt DB&C
29
Q

describe postop care for esophageal cancer (8)

A
  • usually have NG tube
  • NPO until ordered
  • assess drainage
  • maintenance of tube
  • oral & nasal care
  • emphasis on preventing resp complications
  • semi-fowler/fowler pstn (prevent reflux & aspiration)
  • once eating & drinking, upright position for 2h after eating to assist GI tract
30
Q

describe drainage postopw

A
  • bloody for 8-12 h

- eventually becomes greenish yellow

31
Q

what postop care can be done to prevent resp complications postop (2)

A
  • turning and deep breathing q2h

- use incentive spirometer

32
Q

what is imp to note regarding the NG tube postop

A
  • do not reposition!
33
Q

what should you do if the NG tube is not draining

A
  • flush w 20-30 mL NS

- if still not, call Dr

34
Q

nursing care for esophageal cancer focuses on (7)

A
  • emotional support
  • diet
  • meds
  • decreasing complication for cancer treatments (radiation, chemo, sx)
  • assessment of supports
  • home care (wound care)
  • gastrostomy teaching

NURS 3512 - Class 1-6 (47 decks)

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