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Upper Respiratory ProblemsMedical Surgical Nursing

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Question Answer
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
What is the most frequent/annoying problem related to radiation therapy?
Show Answer
Xerostomia (dry mouth)
What medication can help a patient with xerostomia from radiation treatment?
Show Answer
Pilocarpine hydrochloride (Salagen). Should be started before radiation and given for 90 days
What non-pharmacological measures can patients on radiation take to ease the discomfort from dry mouth?
Show Answer
Increase fluid intake, chew sugarless gum or candy, use nonalcoholic mouth rinses (like baking soda or glycerine solutions), use artificial saliva, always carry a water bottle
T/F A patient that experiences fatigue from radiation should rest often and avoid exercise.
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False, they should attempt light, regular exercise to get more energy (they should rest often)
What can help a patient cope with stomatitis from radiation?
Show Answer
Eat soft, bland foods Frequently rinse mouth with water or suck on ice chips Avoid commercial mouthwashes Avoid spicy or hot foods
A mixture of equal parts of antacid, lidocaine and diphenhydramine is a concotion that is useful in treating ________ from radiation therapy.
Show Answer
Severe Stomatitis, the patient should rinse with the mixture and spit it out
T/F Dry mouth from radiation is a common, temporary problem that resolves within weeks of the last treatment.
Show Answer
False, it is a common problem, but it can be temporary or permanent
T/F Patients on radiation treatment should only used prescribed lotions and skin products. Store bought lotions can be too irritating.
Show Answer
True
Patients receiving radiation treatments should not apply any lotion, whether prescription or store bought, within _______ prior to treatment.
Show Answer
2 hours
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What skin condition should be reported to a physician if the patient is getting radiation treatments?
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Moist skin reaction (desquamation of skin cells leaves the area feeling burned, tender or painful)
What teaching is important to perform prior to a laryngectomy?
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Expected changes in speech, and communication methods for immediately after surgery
What are post-surgical nursing actions for a patient immediately following a head or neck surgery?
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-Maintaining a patent airway (edema may compress the trachea) -Place the patient in semi-Fowlers to limit edema and suture stress -monitor vital signs closely because of risks of hemorrhage or respiratory distress -monitor drainage systems, packing, dr
What type of drainage is expected after a radical neck dissection?
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Serosanguineous drainage that decreases in volume over 24 hours
How often should tube patency of a Hemovac drain be assessed after a radical neck dissection surgery?
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Every 4 hours, poor draining or kinked tubing can predispose the patient to infection and impaired wound healing
T/F A patient who has undergone a laryngectomy requires frequent suctioning after the surgery.
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True
You have a patient on your floor who has just undergone a laryngectomy. You are suctioning the patient frequently and notice that initially the drainage was copius and blood tinged, but now there is less and it is a lot thicker. Is this a normal finding?
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Yes
You have a patient on your floor who has undergone a laryngectomy. His secretions have become thick and tenacious. An older nurse on your floor suggests that you administer a bolus dose of saline via the trach tube to assist with the removal of the thickened secretions and clear the airway. Is this sound advice?
Show Answer
No, this can lead to hypoxia and damage to the epithelial cells, using a humidifier may help
T/F Following a neck resection involving the removal of the sternocleidomastoid muscle and and the spinal accessory nerve, it is important the patient exercise to maintain strength and movement on the affected side.
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True, otherwise the patient may be left with a frozen shoulder and limited neck ROM
What options are available to restore speech in a person who has had a laryngectomy?
Show Answer
Voice prosthesis, esophageal speech, or an electrolarynx
What is the most common type of voice prosthesis used after a laryngectomy?
Show Answer
The Blom-Singer prosthesis
  
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