NUR 2502 / NUR2502 Exam 2 Focused Review Guide(Latest 2021 / 2022): Multidimensional Care III / MDC 3 - Rasmussen

1. Priority Questions 2. Neck Cancer - assessment, interventions, and education related to treatment a. Starts on page 548 in book b. Assessment i. Leukoplakia - patchy lesions in mouth ii. Erythroplakia - red velvety lesions in mouth iii. 2 most important risk factors include alcohol and tobacco use iv. History 1. Difficulty speaking, SOB, tumor bulk, tobacco/alcohol use, acute or chronic laryngitis/pharyngitis, oral sores, difficulty swallowing, lumps in neck, exposure to HPV v. Lab assessment 1. CBC, bleeding time, urinalysis, blood chemistries, HPV test vi. Scans 1. SPECT 2. CT PET 3. Panendoscopy - examination of the upper aerodigestive tract (pharynx, larynx, upper trachea and oesophagus) c. Interventions i. Priority is to remove or eradicate the cancer while preserving function ii. Monitor gas exchange by assessing resp rate, breath sounds, pulse ox, and arterial blood gas values 1. Airway obstruction can occur from tumor growth, edema, or both iii. Teach pt to use the fowler’s or semi fowler's position for best gas exchange iv. iv. d. Education related to treatment i. Radiation therapy 1. After radiation therapy, pt might experience hoarseness, dysphagia, skin problems, impaired taste, dry mouth, sore throat, difficulty swallowing 2. Voice hoarseness usually improves 4-6 weeks after completion of radiation therapy 3. For th.................................continued