Nokea
A nurse is caring for a patient who has had surgery for oral cancer. When addressing the patients long-term needs, the nurse should prioritize interventions and referrals with what goal?
- A. Enhancement of verbal communication
- B. Enhancement of immune function
- C. Maintenance of adequate social support
- D. Maintenance of fluid balance
Correct Answer: A
Rationale: Verbal communication may be impaired by radical surgery for oral cancer. Addressing this impairment often requires a long-term commitment. Immune function, social support, and fluid balance are all necessary, but communication is a priority issue for patients recovering from this type of surgery.
You may also like to solve these questions
A patient who had a hemiglossectomy earlier in the day is assessed postoperatively, revealing a patent airway, stable vital signs, and no bleeding or drainage from the operative site. The nurse notes the patient is alert. What is the patients priority need at this time?
- A. Emotional support from visitors and staff
- B. An effective means of communicating with the nurse
- C. Referral to a speech therapist
- D. Dietary teaching focused on consistency of food and frequency of feedings
Correct Answer: B
Rationale: Verbal communication may be impaired by radical surgery for oral cancer. It is therefore vital to assess the patients ability to communicate in writing before surgery. Emotional support and dietary teaching are critical aspects of the plan of care; however, the patients ability to communicate would be essential for both. Referral to a speech therapist will be required as part of the patients rehabilitation; however, it is not a priority at this particular time. Communication with the nurse is crucial for the delivery of safe and effective care.
A nurse is caring for a patient who has undergone neck resection with a radial forearm free flap. The nurses most recent assessment of the graft reveals that it has a bluish color and that mottling is visible. What is the nurses most appropriate action?
- A. Document the findings as being consistent with a viable graft.
- B. Promptly report these indications of venous congestion.
- C. Closely monitor the patient and reassess in 30 minutes.
- D. Reposition the patient to promote peripheral circulation.
Correct Answer: B
Rationale: A graft that is blue with mottling may indicate venous congestion. This finding constitutes a risk for tissue ischemia and necrosis; prompt referral is necessary.
A nurse is caring for a patient in the late stages of esophageal cancer. The nurse should plan to prevent or address what characteristics of this stage of the disease?
- A. Perforation into the mediastinum
- B. Development of an esophageal lesion
- C. Erosion into the great vessels
- D. Painful swallowing
- E. Obstruction of the esophagus
Correct Answer: A,C,E
Rationale: In the later stages of esophageal cancer, obstruction of the esophagus is noted, with possible perforation into the mediastinum and erosion into the great vessels. Painful swallowing and the emergence of a lesion are early signs of esophageal cancer.
A radial graft is planned in the treatment of a patients oropharyngeal cancer. In order to ensure that the surgery will be successful, the care team must perform what assessment prior to surgery?
- A. Assessing function of cranial nerves V, VI, and IX
- B. Assessing for a history of GERD
- C. Assessing for signs or symptoms of atherosclerosis
- D. Assessing the patency of the ulnar artery
Correct Answer: D
Rationale: If a radial graft is to be performed, an Allen test on the donor arm must be performed to ensure that the ulnar artery is patent and can provide blood flow to the hand after removal of the radial artery. The success of this surgery is not primarily dependent on CN function or the absence of GERD and atherosclerosis.
A nurse is caring for a patient who has just had a rigid fixation of a mandibular fracture. When planning the discharge teaching for this patient, what would the nurse be sure to include?
- A. Increasing calcium intake to promote bone healing
- B. Avoiding chewing food for the specified number of weeks after surgery
- C. Techniques for managing parenteral nutrition in the home setting
- D. Techniques for managing a gastrostomy
Correct Answer: B
Rationale: The patient who has had rigid fixation should be instructed not to chew food in the first 1 to 4 weeks after surgery. A liquid diet is recommended, and dietary counseling should be obtained to ensure optimal caloric and protein intake. Increased calcium intake will not have an appreciable effect on healing. Enteral and parenteral nutrition are rarely necessary.