السبت، 25 أغسطس 2018

127-Oral- Pharyngeal Cancer

About
Malignancy of the oral cavity or pharynx, manifested by a sore in the mouth that does not heal, bleeds easily, and may cause tenderness and difficulty swallowing.
Assess
Oral-pharyngeal mucosa, especially the sides of the tongue, lips and underneath the tongue; swallowing, pain, tenderness, speech, sputum, cervical lymph nodes for swelling, alcohol and smoking consumption history, nutritional status
Complications
Metastasis, infection, malnutrition, treatment related complications including infection, nausea, emesis, and surgical interventions.
Diagnosis
  • Risk for infection related to changes in oral pharyngeal secretions and chemotherapy or radiation.
  • Body image disturbance related to surgical intervention.
  • Pain related to oral mucosa lesion.
  • Nutrition deficit less than body requirements related to decreased food consumption and pain.
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.
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).

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