Chapter 18 Management of pts with upper respiratory tract disorders

You are a nurse caring for a client who has just had a tracheostomy. What should you monitor frequently? A. Airway patency B. Psychological status C. Pain level D. Level of consciousness

A. Airway patency

Late symptoms of laryngeal cancer include which of the following. Select all that apply. A. Dysphagia B. Dyspnea C. Persistent hoarseness D. Sore throat E. Burning in throat

A. Dysphagia B. Dyspnea C. Persistent hoarseness

The nurse is caring for a client who underwent a laryngectomy. Which intervention will the nurse initially complete in an effort to meet the client's nutritional needs? A. Initiate enteral feedings. B. Offer plenty of thin liquids. C. Liberally season foods. D. Encourage sweet foods.

A. Initiate enteral feedings.

Which nursing diagnosis is most likely for a client who has just undergone a total laryngectomy? A. impaired verbal communication B. deficient knowledge C. risk for chronic low self-esteem D. risk for infection

A. impaired verbal communication

As part of a primary cancer prevention program, an oncology nurse answers questions from the public at a health fair. When someone asks about laryngeal cancer, the nurse should explain that: A. laryngeal cancer is one of the most preventable types of cancer. B. laryngeal cancer occurs primarily in women. C. adenocarcinoma accounts for most cases of laryngeal cancer. D. inhaling polluted air isn't a risk factor for laryngeal cancer.

A. laryngeal cancer is one of the most preventable types of cancer.

The nurse is assessing a patient who smokes 2 packs of cigarettes per day and has a strong family history of cancer. What early sign of cancer of the larynx does the nurse look for in this patient? A. Burning of the throat when hot liquids are ingested B. Affected voice sounds C. Enlarged cervical nodes D. Dysphagia

Affected voice sounds

The nurse makes the observations shown in the accompanying notes about a client who will be discharged following a laryngectomy. The nurse makes a referral to the home health nurse for client reteaching based on which observation? A. Use of non-sterile tissues to wipe secretions from the airway. B. Initial washing of hands after cleaning inner cannula. C. Client use of tweezers to remove encrustations. D. Wearing a loose-fitting cloth over the stoma.

B. Initial washing of hands after cleaning inner cannula.

A patient has had a laryngectomy and was able to retain his airway, with no difficulty swallowing. There is no split of thyroid cartilage. The nurse would record this type of laryngectomy as which of the following? A. Supraglottic laryngectomy B. Partial laryngectomy C. Total laryngectomy D. Hemilaryngectomy

B. Partial laryngectomy

Once the patient has been cleared for oral feedings, post laryngectomy, the nurse knows to prepare: A. Solid foods, so chewing can be reestablished to stimulate salivation. B. Thick liquids that are easy to swallow. C. Clear, warm liquids to slowly stimulate peristalsis. D. Soft, pureed foods, similar in consistency to baby food.

B. Thick liquids that are easy to swallow.

When a client has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the client very carefully because of the high risk for A. pulmonary embolism. B. carotid artery hemorrhage. C. pneumonia. D. dehydration.

B. carotid artery hemorrhage.

client with thrombocytopenia, secondary to leukemia, develops epistaxis. The nurse should instruct the client to: A. blow his nose and then put lateral pressure on his nose. B. sit upright, leaning slightly forward. C. lie supine with his neck extended. D. hold his nose while bending forward at the waist.

B. sit upright, leaning slightly forward. Sitting upright and leaning slightly forward avoids increasing vascular pressure in the nose and helps the client avoid aspirating blood. Lying supine won't prevent aspiration of the blood. Nose blowing can dislodge any clotting that has occurred. Bending at the waist increases vascular pressure in the nose and promotes bleeding rather than halting it.

The nurse is discussing immediate postoperative communication strategies with a client scheduled for a total laryngectomy. What information will the nurse include? A. "After surgery you will have a sore throat, but you will be able to speak." B. "After surgery you will have to use an electric larynx to communicate." C. "You can use writing or a communication board to communicate." D. "A speech therapist will evaluate you and recommend a system of communication after surgery."

C. "You can use writing or a communication board to communicate."

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? A. When the patient states that there is discomfort and requests removal B. In 1 week when the patient no longer has serous drainage C. When the patient has less than 30 mL for 2 consecutive days D. When the drainage tube comes out

C. When the patient has less than 30 mL for 2 consecutive days

A client finished a course of antibiotics for laryngitis but continues to experience persistent hoarseness. Which symptom would cause the nurse to suspect laryngeal cancer? A. discomfort when drinking cold liquids B. weight loss C. a feeling of swelling at the back of the throat D. headaches in the morning

C. a feeling of swelling at the back of the throat

The nurse at an employee wellness clinic is meeting with a client who reports voice hoarseness for more than 2 weeks. To determine if the client may have symptoms of early laryngeal cancer, the next question the nurse should ask is, "Do you have A. a foul odor to your breath" B. difficulty swallowing foods" C. a persistent cough or sore throat" D. trouble with your breathing"

C. a persistent cough or sore throat"

A client comes into the clinic complaining of hoarseness that has lasted for about a month. What would you suspect? A. Chronic tonsillitis B. Chronic pharyngitis C. Laryngeal polyps D. Laryngeal cancer

D. Laryngeal cancer

nurse is performing preoperative teaching with a client who has cancer of the larynx. After explaining the most important information, what is the nurse's best action? A. Refer the client to a social worker or psychologist. B. Give the client his or her cell phone number. C. Reassure the client and family that outcomes are nearly always positive. D. Provide the client with audiovisual materials about the surgery.

D. Provide the client with audiovisual materials about the surgery

When the nurse gives a client and family instructions after laryngeal surgery, which does the nurse indicate should be avoided? A. Hand-held showers B. Coughing C. Wearing a scarf over the stoma D. Swimming

D. Swimming

The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice? A. Laser surgery B. Radiation therapy C. Partial laryngectomy D. Total laryngectomy

D. Total laryngectomy

A late complication of radiation therapy is A. pain. B. dysphasia. C. xerostomia. D. laryngeal necrosis.

D. laryngeal necrosis.