Chapter 46 Management of Patients With Oral and Esophageal Disorders

A nurse is caring for a patient who has had surgery for oral cancer. When addressing the patient's long-term needs, the nurse should prioritize interventions and referrals with what goal?

A) Enhancement of verbal communication

A patient has received treatment for oral cancer. The combination of medications and radiotherapy has resulted in leukopenia. Which of the following is an appropriate response to this change in health status?

A) Ensure that none of the patient's visitors has an infection.

A medical nurse who is caring for a patient being discharged home after a radical neck dissection has collaborated with the home health nurse to develop a plan of care for this patient. What is a priority psychosocial outcome for a patient who has had a radical neck dissection?

A) Indicates acceptance of altered appearance and demonstrates positive self-image

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? Select all that apply.

A) Perforation into the mediastinum C.) Erosion into the great vessels E.) Obstruction of the esophagus

The nurse notes that a patient who has undergone skin, tissue, and muscle grafting following a modified radical neck dissection requires suctioning. What is the most important consideration for the nurse when suctioning this patient?

A. Avoid applying suction on or near the suture line.

The school nurse is planning a health fair for a group of fifth graders and dental health is one topic that the nurse plans to address. What would be most likely to increase the risk of tooth decay?

A. Organic fruit juice

An elderly patient comes into the emergency department complaining of an earache. The patient and has an oral temperature of 100.2ºF and otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next?

A. Palpate the patient's parotid glands to detect swelling and tenderness.

A patient with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett's esophagus with minor cell changes. Which of the following principles should be integrated into the patient's subsequent care?

A. The patient will require an upper endoscopy every 6 months to detect malignant changes.

A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What patient most likely faces the highest immediate risk of oral cancer?

A.) A 65-year-old man with alcoholism who smokes

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 patient's priority need at this time?

B. An effective means of communicating with the nurse

The nurse's comprehensive assessment of a patient includes inspection for signs of oral cancer. What assessment finding is most characteristic of oral cancer in its early stages?

B. Presence of a painless sore with raised edges

A nurse is assessing a patient who has just been admitted to the postsurgical unit following surgical resection for the treatment of oropharyngeal cancer. What assessment should the nurse prioritize?

C) Assess for a patent airway.

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action has the greatest potential to prevent esophageal cancer?

C) Early diagnosis and treatment of gastroesophageal reflux disease

A patient has undergone surgery for oral cancer and has just been extubated in postanesthetic recovery. What nursing action best promotes comfort and facilitates spontaneous breathing for this patient?

C.) Placing the patient in Fowler's position

A patient has been diagnosed with a malignancy of the oral cavity and is undergoing oncologic treatment. The oncologic nurse is aware that the prognosis for recovery from head and neck cancers is often poor because of what characteristic of these malignancies?

D) Metastases are common and respond poorly to treatment.

A nurse is providing oral care to a patient who is comatose. What action best addresses the patient's risk of tooth decay and plaque accumulation?

D. Brushing the patient's teeth with a toothbrush and small amount of toothpaste

A radial graft is planned in the treatment of a patient's oropharyngeal cancer. In order to ensure that the surgery will be successful, the care team must perform what assessment prior to surgery?

D.) Assessing the patency of the ulnar artery