A 45 year old male, with a history of smoking ½ packs of cigarettes a day for the past 30 years has been diagnosed with laryngeal cancer. The patient comes into the hospital for a follow up visit to his health care provider. Where he has been getting radiation and chemotherapy treatments for the cancer. He has complaints of pain, dyspnea at times and dysphasia. While discussing the progress of his condition the doctor states that the chemo and radiation therapy has not been successful and the cancer has started to progress. The doctor then states the next steps to prevent the spread of the cancer, and that’s to have total laryngectomy surgery. The patient understands the severity of his condition but is now experiencing anxiety because of …show more content…
The purpose of laryngectomy is to remove tumor or cancerous tissues. It is done when the larynx is badly damaged or when cancer has advanced. Often, if the cancer has spread, other surrounding structures in the neck, such as lymph nodes, are removed at the same time. Partial laryngectomies are done when cancer is limited in one area of which the tumor is located, will be removed. Also laryngectomy is performed because cancer treatment option, such as radiation or chemotherapy has failed. (Gale Encyclopedia of medicine. 2008). Nurses play a critical role in patient education throughout the entire spectrum of healthcare. Nursing care of people who have a total laryngectomy starts in the pre-operative period with patient education and continues after discharge with follow-up care. The nurse-patient relationship begins in the outpatient setting, where the nurse performs a complete head-and-neck assessment and comprehensive review of the patient’s past medical and social history. (Cheryl Bressler, MSN, RN). First, to start the process of preop care, making sure the patient had a restriction of foods and liquids at least six to nine hours before the surgery. The nurse would make sure the patient signed a consent form after thoroughly explaining the procedure. A
Selection of the best techniques varies from person to person depending on their age and personal preferences. Esophageal speech is popular among laryngectomies because it costs less and can provide a more normal sounding voice than some of the other options.
Cancer has one of the biggest effects on the patients mental health but also the patients loved ones and friends. It is one of the hardest things to get a grip on when the doctor tells someone that they have cancer and a fifty-fifty chance of making it. "The disease can bring many changes-in what people do and how they look, in how they feel and what they value" (Dakota 4). It makes people look at the world and their lives in a different way, valuing now what they took for granted and seeing the bigger picture in every scenario. It is something that no one can actually brace, even after the doctor tells them. Through it all though, the person must remain strong and optimistic because the cancer can affect the person's moods and in return affect the outcome of the person and the chances of their making it
"You have stage IV lung cancer that has metastasized to your lymph nodes and bones. Your prognosis is poor; you may have another 18 months left [to live]." The oncologist’s words marked the beginning of my ex-husband’s physical and emotional suffering until his untimely death in January 2017. Witnessing his unrelenting pain and watching him suffer from lung cancer and the horrible side effects of chemotherapy, I wondered why the doctors did not offer him any other alternatives other than living in progressive pain. Why would they let him suffer for the next 18 months with ineffective pain management treatment when his prognosis was so poor? This option should have been available to him, but due to state laws and
Jane was diagnosed with lung cancer 6 months ago and underwent chemo and radiation. The treatment was not entirely effective, and her oncologist is recommending another course of chemo, along with a possibility of surgery. The oncologist and surgeon feel that this course of treatment would not necessarily be a cure, but would potentially extend life, and that the chance of living beyond a year is about 30-40% with this treatment. Without treatment, they estimate that she will likely live approximately 6-9 months. Jane is concerned that she will have little quality of life, as the first course of chemo and radiation caused extreme fatigue and nausea, as well as hair loss and skin peeling.
The values such as communication, innovation, quality, and collaboration is key to the growing field of perioperative nursing (AORN, 2015). During surgery communication is important between surgeons, anesthesia and nursing. Surgeons are focused on surgery, anesthesia takes care of breathing and vital signs, nurses are at the bedside or circulating and can assess the OR and what is happening during the procedure. The ARON believes that every patient has the right to receive the highest quality of perioperative nursing care of every surgical or invasive setting; all health care providers must collaborate and strive to create an environment of patient safety; and every patient experiencing a surgical or invasive
t is not always possible to recover fully from cancer. When the treatment does not succeed, the disease is called terminal or advanced cancer. Diagnosis is very stressful for many patients to discuss. It is however crucial to have an honest and open discussion with the healthcare team or doctor to express concerns, preferences, and feelings. Patients with advanced cancer and expected to live for less than six months should consider palliative care known as hospice. Hospice care is intended to provide the possible best quality life for people near the end of life. Personally, I chose this topic because I have many friends that smoke or have smoked in their lives and I wanted to prove to them all of the vast impairments and damages that a single
Over the last decade, medicine has acknowledged the psychosocial impact of cancer treatments on patients, to the point that it has become a subject of psycho-medical research. Chemotherapy-induced alopecia (CIA) is a physical condition that can have profound psychosocial consequences, leading to a negative body image, lowered self-esteem, and a reduced sense of well-being. Patients, women who fear alopecia in particular, may sometimes refuse or select another treatment that lower the risk of baldness. In her testimony, Lori, a breast cancer patient, expresses a common feeling for women with cancer: “The worst part of this entire experience [cancer], is losing my hair [….] The chemotherapy would be so much easier if I had my own hair. I appreciate
The pre-operative nursing considerations begin with patient education. This should begin at the time the decision is made to have the surgical procedure performed. It is important that the patient understand the preoperative requirements, the surgical procedure, postoperative care and the necessary home/activity modification. The patient should be instructed in self-preparation, including mental and emotion readiness and having a
Our current patient is Mr. William Blake. Mr. Blake is 68 years old, married for 40 years. Father and Grandfather too many children. He is a retired school teacher and Sunday school teacher. Mr. Blake has terminal lung cancer, and does not wish to die at the end of a long and drawn out battle with his disease. Mr. Blake has been healthy most of his life, except for his habit of smoking which has caused him
To begin with, the client whose name is Mr. Sam Pilsudski has an obstructed airway secondary to cancer of the larynx. He is a 67-year-old widower, and a father of one son and two daughters, who is unconscious and terminally ill, if not for a much-needed operation to remove both his cancer and larynx to save his life. However, one of Mr. Pilsudski’s daughters has adamantly refused to consent to the surgical procedure despite the physician explaining that although the operation would unfortunately render his patient disabled without a voice consequentially, but ultimately surviving the procedure to live and recover. Moreover, the physician attempted with rational and clear communication to express the gravity of the rather poor prognosis of his illness to his daughter that in the event of foregoing the surgery, his patient would surely die (Ralph Dolgoff, Donna Harrington, and Frank M. Loewenberg (2012), Ethical Decisions for Social Work Practice. 9th Ed; p. 279).
Preoperative examination of the airway is essential. Identification of patients with a potentially difficult airway before anesthesia allows time to plan an appropriate anesthetic technique. Previous anesthetic records should always be consulted. However, a past record of normal tracheal intubation is no guarantee against difficulty on subsequent occasions as airway anatomy can be altered as in trauma affecting the airway. The presence of stridor or hoarse voice is warning sign for the anesthetist. As it is impossible to identify all patients with a difficult airway during preoperative assessment, the anesthetist must be prepared to manage the unexpected difficult laryngoscopy (Alan et al,. 2001).
To date MSK has twenty-four facilities throughout New York and New Jersey providing a multitude of inpatient and outpatient services associated with the study, diagnosis and treatment of various forms of cancer. The Memorial hospital accommodates 471 beds, a 72,000-square-foot surgical center and state-of-the-art outpatient treatment center (Memorial Sloan Kettering Cancer Center, 2015c). MSK houses more than 35 core facilities with research being conducted in over 120 laboratories. Core facilities are dedicated to the development of scientific technology that aids in the study and treatment of cancer. Additionally Gerstner Sloan Kettering Graduate School of Biomedical Sciences and Weill Cornell Graduate School of
A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional
In our body we have normal cells that send signals to every cell all the time and our normal cells obey what the signals are saying. Normal cells know when they have reached their limit and when it is time to die or to do something to themselves or to others. On the other hand, we have cancer cells, they override the normal signaling system. For example, cancer cells do not stop dividing and growing when they have reached their limit. Due to this, the cells keep replicating, forming like a tumor that is growing. My point is that cancer cells grow and divide in a manner that you are not able to control, they would invade normal tissues, organs and eventually spreading throughout the body. Cancer cells lost their control of growth and it is
Common head and neck surgery includes the removal of the voice box: largyngectomy and tracheostomy: making an incision on the anterior aspect of the neck and opening an airway through an incision in the trachea. The removal of the larynx occurs in cases of laryngeal cancer and in this case the airway is separated from the mouth, nose and oesophagus meaning that the patient will breathe through a stoma in the neck. In tracheostomy cases the resulting stoma can act as an airway and a tracheotomy tube is inserted, enabling the individual to breathe without the use of their nose and mouth.