NCLEX Review & Nursing School

Laryngeal Cancer

Causes and Factors

• EXCESSIVE ALCOHOL INTAKE
• SMOKING AND CHEWING TOBACCO

Assessment

• EARLY SIGN INCLUDES HOARSNESS IN VOICE
• LATE SIGN ARE DYSPHAGIA, DYSPNEA, MUFFLED SOUND, COUGHING, HEMOPTSIS

Treatment:

• CHEMOTHERAPY, RADIATION AND SURGERY.
• TOTAL LARYGECTOMY IS OFTEN PERFORMED

Post Op Interventions:

• THE USE OF ALTERNATIVE COMMUNICATION
• ASSIST WITH ESOPHAGEAL SPEECH
• STOMA CARE IS PERFORMED AS REQUIRED
• PATIENT AIRWAY IS NUMBER 1 PRIORITY

Note that Tracheaostomy tubes are used for long term airway management.

• THEY ARE INSERTED THROUGH SURGICAL OPENING (STOMA) INTO THE TRACHEA.

LUNG PROCEDURES
Respiratory Procedures:

LaryngectomyPartial Laryngectomy

– surgical, excision of a lesion on one vocal cord.

Total Laryngectomy- surgical removal of the larynx, hyoid bone and tracheal rings and formation of a permanent tracheotomy-
Post Op- establish methods of communication: writing, magic slate, picture board.- assess gag reflex and ability to swallow

Radical Neck Dissection- incision of the sternocleidomastoid, omohyoid muscles, sub maxillary gland, internal jugular vein, external carotid artery and cervical chain of lymph nodes, in addition to the laryngectomy.

Suctioning
Maximum time for suction is 10 seconds, prolonged suctioning can cause hypoxemia.