Cancer of the Larynx

You are explaining to a nursing student what a Total Laryngectomy is. What would you include in your explanation?

• A complete removal of the larynx

• This procedure is performed for advanced laryngeal cancer

• Results in permanent loss of the voice

• Need to breathe through a stoma created in the lower neck

After a total laryngectomy what nursing interventions would you implement when caring for this client?

• Maintain HOB in Semi or High Fowlers position

• Provide adequate Humidification

• Cautious use of analgesic medications

• Use pulse oximeter to monitor 02 status

• Encourage coughing and deep breathing

When caring for a postoperative laryngectomy patient what are some nursing interventions that Promote Adequate Nutrition & Hydration especially if client is NPO.

• Provide IV fluids

• Provide thick liquids, closely monitor and have suction readily available

• Monitor weight & Vital signs

• Monitor electrolytes

• Administer enteral feedings through a nasogastric or gastrostomy tube, and parenteral nutrition.

In preparing the client to go home, the nurse assesses the patient’s level of knowledge about self-care management. What are some nursing interventions you would utilize to ensure the client is ready to go home?

• Explain tubes, dressings, and drains, monitor drainage

• Verbalize avoidance of strenuous exercise

• Educate client on proper nutrition and fluid intake to prevent malnutrition and dehydration

• Ensure client and family recognize s/s of infection

• Educate on the importance of wearing or carrying medical identification—such as a bracelet or card

What would the RN include when Monitoring for Respiratory Distress/Hypoxia?

• Restlessness

• Confusion

• Tachypnea

• Use of accessory muscles

• Pulse oximetry

Bleeding is a postoperative complication. What are signs and symptoms of bleeding would the RN assess and monitor for?

• Active bleeding from the surgical site, drains, and trachea.

• Increased heart rate, decreased blood pressure

• Cold, clammy, pale skin

• Tachypnea

What are some nursing interventions that an RN would implement to Monitoring for or Prevent Aspiration?

• Administer antiemetic medications

• Have functioning suction set-up

• Confirm placement of feeding tube and check residuals per protocol

• Keep the HOB at 30-45 degrees

Is a Supraglottic laryngectomy a voice-sparing operation?

• Yes

• No

• I don't know

With a hemilaryngectomy.......

• No change may occur in voice quality occurs

• Airway and swallowing remain intact

• Airway and swallowing do not remain intact

A Total laryngectomy results in?

• Permanent loss of the voice and a change in the airway.

• Retains some voice

• Client is able to eat post operatively