About
Carcinoma of the esophagus. Major risk factors include smoking and alcohol consumption, GERD, and irritation of the esophagus.
Assess
Dysphagia, impaired swallowing, pain upon swallowing, feeling of something lodged in throat, regurgitation, foul odor to breath, weight loss.
Complications
Metastasis, infection, malnutrition, aspiration, treatment related complications including infection, nausea, emesis, and surgical interventions.
Diagnosis
- Knowledge deficit related to treatments and management.
- Ineffective airway clearance related to surgical procedure and esophageal obstruction.
- Impaired swallowing related to esophageal obstruction.
- Acute pain related to esophageal obstruction.
- Nutrition less than body requirements related to impaired oral intake.
Goals
- The client will state a decrease in pain using a 0-10 visual analogue scale.
- The client will identify appropriate nutritional supplements and therapies to ensure adequate intake.
- The client will be able to express concerns, fears, and feelings related to diagnosis and interventions.
- The client will be able to state understanding of treatment and follow-up.
- The client will maintain a patent airway.
Interventions
- Assess and monitor understanding of treatment, pain levels, daily alcohol consumption, smoking history, oral mucosa.
- Monitor caloric intake, food diary, daily weight, fluid volume status.
- Monitor for stomatitis/ thrush.
- Encourage opportunities for client to express feelings and concerns regarding diagnosis and treatment.
- Administer pain medications as ordered by a physician, including swish and swallow anesthetics.
- Teach client about prescribed treatments, nutrition needs, and disease process.
- Prepare for surgery as indicated.
- Teach client the importance of abstaining from smoking and alcohol.
- Monitor for complications of treatment ( surgical, chemotherapy, radiation therapy).
- Assess respiratory status including lung sounds and pulse-ox.
- Monitor for stridor, which could indicate severe respiratory compromise or obstruction.
- Maintain suction equipment at the bedside and perform suctioning frequently to remove excess secretions.
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