Case Study on Cancer of the Larynx
Case Study on Cancer of the Larynx
Mr. Davids is a 65 year old accountant who is divorced and has adult children. He has smoked two packs of cigarettes daily for the last forty years and frequently has three to four cocktails each evening. After several months of complaining of a sore throat and hoarseness, he was diagnosed with cancer of the larynx. He is now on the surgical unit after spending two days in ICU following a total laryngectomy.
His assessment reveals vital signs which are: BP 150/90, pulse 94, temperature 99 orally. He has a laryngectomy tube in place and is receiving humidified oxygen at 28% per tracheostomy collar. His pulse reading is 92%. He is receiving continuous tube feedings via nasogastric tube. Two Hemovac drains are noted in the left neck area. There is a moderate amount of edema in the facial and submandibular area on the left side. Mr. Davids is ambulatory in the room and is up to the bathroom.
What are the six priority problems for this patient?
The six priority problems for this patient are
Ineffective airway clearance
Impaired verbal communication
Impaired skin/tissue integrity
Disturbed body image
Impaired swallowing/Risk for aspiration
Risk for infection
What is the number one priority problem?
Ineffective airway clearance
What should be included in the teaching plan for this patient?
*Tracheostomy care and looking for signs of infection.
*Stoma protection:
-Avoid swimming, and use care when showering or shaving.
-Lean slightly forward and cover the stoma when coughing or sneezing
-Wear a stoma guard or loose clothing to cover the stoma
-Clean the stoma with mild soap and water. Lubricate the stoma with a non-oil based ointment as needed.
-Increase humidity by using saline in the stoma as instructed, a bedside humidifier, pans of water, and houseplants.
-Obtain and wear a Medic-Alert bracelet and emergency care card for life threatening situations
Mr. Davids is a 65 year old accountant who is divorced and has adult children. He has smoked two packs of cigarettes daily for the last forty years and frequently has three to four cocktails each evening. After several months of complaining of a sore throat and hoarseness, he was diagnosed with cancer of the larynx. He is now on the surgical unit after spending two days in ICU following a total laryngectomy.
His assessment reveals vital signs which are: BP 150/90, pulse 94, temperature 99 orally. He has a laryngectomy tube in place and is receiving humidified oxygen at 28% per tracheostomy collar. His pulse reading is 92%. He is receiving continuous tube feedings via nasogastric tube. Two Hemovac drains are noted in the left neck area. There is a moderate amount of edema in the facial and submandibular area on the left side. Mr. Davids is ambulatory in the room and is up to the bathroom.
What are the six priority problems for this patient?
The six priority problems for this patient are
Ineffective airway clearance
Impaired verbal communication
Impaired skin/tissue integrity
Disturbed body image
Impaired swallowing/Risk for aspiration
Risk for infection
What is the number one priority problem?
Ineffective airway clearance
What should be included in the teaching plan for this patient?
*Tracheostomy care and looking for signs of infection.
*Stoma protection:
-Avoid swimming, and use care when showering or shaving.
-Lean slightly forward and cover the stoma when coughing or sneezing
-Wear a stoma guard or loose clothing to cover the stoma
-Clean the stoma with mild soap and water. Lubricate the stoma with a non-oil based ointment as needed.
-Increase humidity by using saline in the stoma as instructed, a bedside humidifier, pans of water, and houseplants.
-Obtain and wear a Medic-Alert bracelet and emergency care card for life threatening situations