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Upper Respiratory ProblemsMedical Surgical Nursing

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What are the late signs of head and neck cancers?
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Pain, dysphagia, decreased mobility of the tongue, airway obstruction, and CN neuropathies
A white patch in the mouth is called...
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Leukoplakia
A red patch in the mouth is called...
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Erythroplakia
T/F Leukoplakia and/or erythroplakia can precede carcinomas by many years, therefore biopsy can identify a need for treatment in the early stages.
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True
What characteristics of neoplastic tissue of head and neck cancers make it easily identifiable?
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The tissue is of greater density, it distorts, displaces, or destroys normal anatomic structures
TNM staging of cancer refers to...
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T=tumor size N=number of lymph nodes involved M=extent of metastasis
Radiation is effective in treating early vocal cord lesions, but may lead to the development of ________.
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Hypothyroidism
A __________ is a surgical, partial removal of one vocal cord. It is usally performed when there is a superficial tumor that wasn't resolved with radiation.
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Cordectomy
A ________ is surgical removal of one vocal cord or part of a cord and requires a tracheostomy.
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Hemilaryngectomy
__________ is surgical removal of structures above the true vocal cords, including the false vocal cords and epiglottis.
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Supraglottic laryngectomy
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Advanced head and neck cancer lesions are treated with a total laryngectomy which involves removal of...
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The entire larynx and preepiglottic region, requiring a permanent tracheostomy
A radical neck dissection is often performed in conjunction with a total laryngectomy to decrease the risk of lymphatic spread of cancer. What structures may be removed or transected during this procedure?
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-Sternocleidomastoid muscle and closely associated muscles -internal jugular vein -mandible -submaxillary gland -part of the thyroid and/or parathyroid glands -spinal accessory nerve
What structures are usually involved in a modified neck dissection?
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-the major cervical lympathic vessels -lateral cervical space with preservation of the nerves and vessels
What always happens if a patient requires a bilateral neck dissection to treat vocal cord cancer?
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One side of the dissection is modified (as opposed to radical) to minimize structural and functional deficits
___________ is a concentrated and localized method to deliver radition by placing a radioactive source in or near a head and/or neck cancer tumor.
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Brachytherapy
In brachytherapy, radioactive _______ seeds are inserted into a thin, hollow, plastic needle. The needle is then placed near or into a tumor to deliver continuous radiation.
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Iridium
What medication is used to treat unresectable head and neck cancers or to treat those cancers that have metastasized after standard chemotherapy?
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Cetuximab (Erbitux)
T/F When teaching a patient how to perform a supraglottic swallow, you should avoid carbonated beverages because they are acidic and irritating to the surgical/resection sites.
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False, you should use carbonated beverages for a patient to get an idea of the location of the fluid
T/F A patient who has undergone a supraglottic laryngectomy (removal of the upper portion of the larynx, including the epiglottis and false cords) will still be able to speak.
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True, the true vocal cords are still in place
What are the 6 steps for performing the supraglottic swallow?
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Take a deep breath Perform the Valsalva manuever to close the vocal cords Place food in mouth and swallow Cough to remove food from top of vocal cords Swallow again Breathe
T/F If a patient has been diagnosed with oral cancer, cessation of smoking is a moot point.
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False, the risk of a secondary cancer is reduced if a patient stops smoking
  
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