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Rationale
Tachypnea, shallow respirations, and
frequently.
Nursing Interventions
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secretions.
Deep breathing exercises facilitates
Teach and assist patient with proper deepbreathing exercises. Demonstrate proper
splinting of chest and effective coughing
while in upright position. Encourage him
to do so often.
fluids.
Nebulizers and other respiratory therapy
Assist and monitor effects of nebulizer
when appropriate.
oximetry readings.
Nursing Interventions
Rationale
facilitate necessary alterations in therapy.
Dyspnea, cyanosis
Tachycardia
Restlessness/changes in mentation
Hypoxia
Desired Outcomes
Demonstrate improved ventilation and oxygenation of tissues by ABGs within patients acceptable
range and absence of symptoms of respiratory distress.
Rationale
Manifestations of respiratory distress are
Nursing Interventions
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mucous membranes, and skin around the
bath.
Maintain bedrest. Encourage use of
activities.
infection.
effective coughing.
ventilation.
Anxiety is a manifestation of psychological
concerns and physiological responses to
Nursing Interventions
Rationale
The purpose of oxygen therapy is to
maintain PaO2 above 60 mmHg. Oxygen is
mask.
Demonstrate fluid balance evidenced by individually appropriate parameters, e.g., moist mucous
membranes, good skin turgor, prompt capillary refill, stable vital signs.
Nursing Interventions
Rationale
Elevated temperature and prolonged fever
hypotension, tachycardia.
membranes.
vomiting.
intake.
Weigh as indicated.
Nursing Interventions
Rationale
Meets basic fluid needs, reducing risk of
dehydration and to mobilize secretions and
promote expectoration.
4. Imbalanced Nutrition
Nursing Diagnosis
Rationale
encourage oral hygiene after emesis, after from the patient environment and can
aerosol and postural drainage treatments,
reduce nausea.
these treatments.
Nursing Interventions
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feedings.
abdominal distension.
5. Acute Pain
Nursing Diagnosis
Acute Pain
May be related to
Rationale
Chest pain, usually present to some degree
with pneumonia, may also herald the onset
of complications of pneumonia, such as
pericarditis and endocarditis.
Changes in heart rate or BP may indicate
breathing exercises.
6. Activity Intolerance
Nursing Diagnosis
Activity intolerance
May be related to
Rationale
promoting rest
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During this period of time, potentially fatal
complications (hypotension, shock) may
develop.
Although patient may find expectoration
handwashing technique.
acquisition of infection.
infection.
Nursing Interventions
Encourage adequate rest balanced with
moderate activity. Promote adequate
nutritional intake.
Rationale
therapy.
as indicated.
8. Deficient Knowledge
Nursing Diagnosis
Lack of exposure
Misinterpretation of information
Altered recall
Possibly evidenced by
Rationale
condition.
Nursing Interventions
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treatment regimen.
Information can enhance coping and help
reduce anxiety and excessive concern.
homemaker needs.
exercises.
pneumonia.
Early discontinuation of antibiotics may
URIs.
Stress importance of continuing medical
follow-up and obtaining vaccinations as
appropriate.
Nursing Interventions
Rationale
Impaired oral mucous membranemay be related to malnutrition or vitamin deficiency, poor oral
hygiene, chronic vomiting, possibly evidenced by sore, inflamed buccal mucosa, swollen salivary
glands, ulcerations, and reports of sore mouth and/or throat.
Poor Diet is a modifiable factor in which this is crucial in the strengthening of the immune system of the
client. Without the sufficient intake of vitamins and minerals that are present in the diet, the defense
mechanism of the body is weakened; making it susceptible to infection and invasion of possible
microorganisms that are present in the environment. This can be attributed to the possibility that these
microorganisms are dwelling in the environment itself.
Place of residence is underdeveloped is another modifiable factor since crowdedness of the people living in
a particular geographical area would facilitate direct contact mode of transmission of possible
microorganisms or through droplet infection, as well. This will make the client susceptible for acquiring a
disease from someone proximal to him; therefore, a disease may or may not develop depending on the
distance of the client from an infected person and the virulence of the disease.
Age is a non-modifiable factor in which the clients immunity against possible diseases is not that developed
in comparison to adults.
Sex is a non-modifiable factor in which the occurrence of the said disease in prevalent in males more it is in
females.
great vessels. Cyanosis is a finding based on observation, not a laboratory test. Cyanosis is usually caused
by either serious lung or heart disease, or circulation problems.
Loss of Appetite is a result of decrease in the brain impulses that stimulates the function of the taste buds.
It is because of the vascular changes in the cephalic area. Since the alveoli where filled with fluids and
exudates, gas exchange was not accomplished well; so what happened was, there was diminished Oxygen in
the body, as it was manifested by the presence of cyanosis. Hypoxemia had erupted resulting to low oxygen
in the brain and muscles which eventually lead to the vascular changes.
Abdominal pain: the patient experiences pain on his/hers stomach
Decreased activity: decrease in activity patter
Loss of appetite (in older children) or poor feeding (in infants)
In extreme cases, bluish or gray color of the lips and fingernails
Headache is the outcome when there is low oxygen in the brain. There are vascular changes in the cephalic
area.
Body Malaise had resulted out of low oxygen content in the muscles. Since the cells in the body require
sufficient amount in oxygen, it cannot work properly if its level is decrease resulting to malaise.
Preventive Measures
Get vaccinated. A vaccine known as pneumococcal conjugate vaccine can help protect young children
against pneumonia. Its recommended for all children younger than age 2 and for children 2 years and older
who are at particular risk of pneumococcal disease, such as those with an immune system deficiency, cancer,
cardiovascular disease or sickle cell anemia. Side effects of the pneumococcal vaccine are generally minor
and include mild soreness or swelling at the injection site.
Wash hands. Hands are in almost constant contact with germs that can cause pneumonia. These germs
enter your body when you touch your eyes or rub the inside of your nose. Washing your hands thoroughly
and often can help reduce your risk. When washing isnt possible, use an alcohol-based hand sanitizer, which
can be more effective than soap and water in destroying the bacteria and viruses that cause disease. Whats
more, most hand sanitizers contain ingredients that keep your skin moist. Carry one in your purse or in your
pocket.
Dont smoke. Smoking damages your lungs natural defenses against respiratory infections.
Proper rest and a diet. Foods rich in fruits, vegetables and whole grains along with moderate exercise can
help keep the immune system strong.
Protect others from infection. Try to stay away from anyone with a compromised immune system. When that
isnt possible, help protect others by wearing a face mask and always coughing into a tissue.
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus
(purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of
organisms, including bacteria, viruses and fungi, can cause pneumonia.
Pneumonia can range in seriousness from mild to life-threatening It is most serious for infants and young
children, people older than age 65, and people with health problems or weakened immune systems.
Causes
Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your
body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your
immune system, even if your health is generally good.
Pneumonia is classified according to the types of germs that cause it and where you got the infection.
Community-acquired pneumonia
Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other
health care facilities. It may be caused by:
Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae.
This type of pneumonia can occur on its own or after you've had a cold or the flu. It may affect one part
(lobe) of the lung, a condition called lobar pneumonia.
Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces
milder symptoms than do other types of pneumonia. Walking pneumonia, a term used to describe
pneumonia that isn't severe enough to require bed rest, may be caused by M. pneumoniae.
Viruses. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most
common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some
cases it can become very serious.
Fungi. This type of pneumonia is most common in people with chronic health problems or weakened
immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can
be found in soil or bird droppings.
Hospital-acquired pneumonia
Some people catch pneumonia during a hospital stay for another illness. This type of pneumonia can be
serious because the bacteria causing it may be more resistant to antibiotics. People who are on breathing
machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia.
Aspiration pneumonia
Aspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more
likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive
use of alcohol or drugs.
Symptoms
The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of
germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those
of a cold or flu, but they last longer.
Signs and symptoms of pneumonia may include:
Shortness of breath
Fatigue
Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough,
appear restless or tired and without energy, or have difficulty breathing and eating.
People older than age 65 and people in poor health or with a weakened immune system may have a lower than
normal body temperature. Older people who have pneumonia sometimes have sudden changes in mental
awareness.
People receiving chemotherapy or taking medication that suppresses the immune system
For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a
life-threatening condition.
Risk factors
Pneumonia can affect anyone. But the two age groups at highest risk are:
Chronic disease. You're more likely to get pneumonia if you have asthma, chronic obstructive
pulmonary disease or heart disease.
Weakened or suppressed immune system. People who have HIV/AIDS, who've had an organ
transplant, or who receive chemotherapy or long-term steroids are at risk.
Smoking. Smoking damages your body's natural defenses against the bacteria and viruses that cause
pneumonia.
Being hospitalized. You're at greater risk of pneumonia if you're in a hospital intensive care unit,
especially if you're on a machine that helps you breathe (a ventilator).
Complications
Pneumonia can be treated successfully with medication.However, some people, especially those in high-risk
groups, may experience complications, including:
Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can
spread the infection to other organs, potentially causing organ failure.
Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated
with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is
needed to remove the pus.
Fluid accumulation around your lungs (pleural effusion).Pneumonia may cause fluid to build up in
the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes
infected, you may need to have it drained through a chest tube or removed with surgery.
Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you
may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing
machine (ventilator) while your lung heals.
Your doctor will start by asking about your medical history and doing a physical exam, including listening to your
lungs with a stethoscope to check for abnormal bubbling or crackling sounds that indicate the presence of
secretions.
If pneumonia is suspected, your doctor may recommend the following tests:
Chest X-ray. This helps your doctor diagnose pneumonia and determine the extent and location of the
infection. However, it can't tell your doctor what kind of germ is causing the pneumonia.
Blood tests. Blood tests are used to confirm infection and to try to identify the type of organism
causing the infection. However, precise identification isn't always possible.
Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent your lungs
from moving enough oxygen into your bloodstream.
Sputum test. A sample of fluid from yourlungs (sputum) is taken after a deep cough and analyzed to
help pinpoint the cause of the infection.
Your doctor might order additional tests if you're older than age 65, are in the hospital, or have serious
symptoms or health conditions. These may include:
Pleural fluid culture. A fluid sample is taken by putting a needle between your ribs from the pleural
area and analyzed to help determine the type of infection.
CT scan. If your pneumonia isn't clearing as quickly as expected, your doctor may recommend a chest
CT scan to obtain a more detailed image of your lungs.
Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the
type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't
improve, your doctor may recommend a different antibiotic.
Fever reducers. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and
acetaminophen (Tylenol, others).
Cough medicine. This medicine may be used to calm your cough so that you can rest. Because
coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough
completely.
Hospitalization
You may need to be hospitalized if:
Your nausea and vomiting prevent you from keeping down oral antibiotics
You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if
your symptoms are severe.
Children may be hospitalized if they:
Appear dehydrated
Get plenty of rest. Don't go back to school or work until after your temperature returns to normal and
you stop coughing up mucus. Even when you start to feel better, be careful not to overdo it. Because
pneumonia can recur, it's better not to jump back into your routine until you are fully recovered. Ask your
doctor if you're not sure.
Stay hydrated. Drink plenty of fluids, especially water, to help loosen mucus in your lungs.
Take your medicine as prescribed. Take the entire course of any medications your doctor prescribed
for you. If you stop medication too soon, your lungs may continue to harbor bacteria that can multiply and
cause your pneumonia to recur.
Prevention
To help prevent pneumonia:
Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with
your doctor about getting these shots.
Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children
younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease.
Children who attend a group child care center should also get the vaccine. Doctors also recommend flu
shots for children older than 6 months.
Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to
pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.
Don't smoke. Smoking damages your lungs' natural defenses against respiratory infections.
Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.
Symptoms
Signs and symptoms of throat cancer may include:
A cough
Changes in your voice, such as hoarseness
Difficulty swallowing
Ear pain
A sore throat
Weight loss
Causes
By Mayo Clinic Staff
Throat cancer occurs when cells in your throat develop genetic mutations. These mutations cause cells to grow
uncontrollably and continue living after healthy cells would normally die. The accumulating cells can form a
tumor in your throat.
It's not clear what causes the mutation that causes throat cancer. But doctors have identified factors that may
increase your risk.
Nasopharyngeal cancer begins in the nasopharynx the part of your throat just behind your nose.
Oropharyngeal cancer begins in the oropharynx the part of your throat right behind your mouth
that includes your tonsils.
Risk factors
By Mayo Clinic Staff
Using a scope to get a closer look at your throat.Your doctor may use a special lighted scope
(endoscope) to get a close look at your throat during a procedure called endoscopy. A tiny camera at the
end of the endoscope transmits images to a video screen that your doctor watches for signs of
abnormalities in your throat. Another type of scope (laryngoscope) can be inserted in your voice box. It uses
a magnifying lens to help your doctor examine your vocal cords. This procedure is called laryngoscopy.
Removing a tissue sample for testing. If abnormalities are found during endoscopy or laryngoscopy,
your doctor can pass surgical instruments through the scope to collect a tissue sample (biopsy). The
sample is sent to a laboratory for testing.
Imaging tests. Imaging tests, including X-ray, computerized tomography (CT), magnetic resonance
imaging (MRI) and positron emission tomography (PET), may help your doctor determine the extent of your
cancer beyond the surface of your throat or voice box.
Staging
Once throat cancer is diagnosed, the next step is to determine the extent, or stage, of the cancer. Knowing the
stage helps determine your treatment options.
The stage of throat cancer is characterized with the Roman numerals I through IV. Each subtype of throat
cancer has its own criteria for each stage. In general, stage I throat cancer indicates a smaller tumor confined
to one area of the throat. Later stages indicate more advanced cancer, with stage IV being the most advanced.
Your treatment options are based on many factors, such as the location and stage of your throat cancer, the
type of cells involved, your overall health, and your personal preferences. Discuss the benefits and risks of each
of your options with your doctor. Together you can determine what treatments will be most appropriate for you.
Radiation therapy
Radiation therapy uses high-energy beams, such as X-rays, to deliver radiation to the cancer cells, causing
them to die. Radiation therapy can come from a large machine outside your body (external beam radiation). Or
radiation therapy can come from small radioactive seeds and wires that can be placed inside your body, near
your cancer (brachytherapy).
For early-stage throat cancers, radiation therapy may be the only treatment necessary. For more advanced
throat cancers, radiation therapy may be combined with chemotherapy or surgery. In very advanced throat
cancers, radiation therapy may be used to reduce signs and symptoms and make you more comfortable.
Surgery
The types of surgical procedures you may consider to treat your throat cancer depend on the location and
stage of your cancer. Options may include:
Surgery for early-stage throat cancer. Throat cancer that is confined to the surface of the throat or
the vocal cords may be treated surgically using endoscopy. Your doctor may insert a hollow endoscope into
your throat or voice box and then pass special surgical tools or a laser through the scope. Using these tools,
your doctor can scrape off, cut out or, in the case of the laser, vaporize very superficial cancers.
Surgery to remove all or part of the voice box (laryngectomy). For smaller tumors, your doctor
may remove the part of your voice box that is affected by cancer, leaving as much of the voice box as
possible. Your doctor may be able to preserve your ability to speak and breathe normally. For larger, moreextensive tumors, it may be necessary to remove your entire voice box. Your windpipe is then attached to a
hole (stoma) in your throat to allow you to breathe (tracheotomy). If your entire larynx is removed, you have
several options for restoring your speech. You can work with a speech pathologist to learn to speak without
your voice box.
Surgery to remove all or part of the throat (pharyngectomy). Smaller throat cancers may require
removing only part of your throat during surgery. Parts that are removed may be reconstructed in order to
allow you to swallow food normally. Surgery to remove your entire throat usually includes removal of your
voice box as well. Your doctor may be able to reconstruct your throat to allow you to swallow food.
Surgery to remove cancerous lymph nodes (neck dissection). If throat cancer has spread deep
within your neck, your doctor may recommend surgery to remove some or all of the lymph nodes to see if
they contain cancer cells.
Surgery carries a risk of bleeding and infection. Other possible complications, such as difficulty speaking or
swallowing, will depend on the specific procedure you undergo.
Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Chemotherapy is often used along with radiation therapy in
treating throat cancers. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But
combining chemotherapy and radiation therapy increases the side effects of both treatments. Discuss with your
doctor the side effects you're likely to experience and whether combined treatments will offer benefits that
outweigh those effects.
Other targeted drugs are being studied in clinical trials. Targeted drugs can be used in combination with
chemotherapy or radiation therapy.
The care of a surgical opening in your throat (stoma) if you had a tracheotomy
Eating difficulties
Swallowing difficulties
Speech problems
Your doctor can discuss the potential side effects and complications of your treatments with you.
Stopping smoking can be very difficult. And it's that much harder when you're trying to cope with a stressful
situation, such as a cancer diagnosis. Your doctor can discuss all of your options, including medications,
nicotine replacement products and counseling.
Alternative medicine
By Mayo Clinic Staff
No alternative treatments have proved helpful in treating throat cancer. However, some complementary and
alternative treatments may help you cope with your diagnosis and with the side effects of throat cancer
treatment. Talk to your doctor about your options.
Acupuncture
Massage therapy
Meditation
Relaxation techniques
Being diagnosed with cancer can be devastating. Throat cancer affects a part of your body that is vital to
everyday activities, such as breathing, eating and talking. In addition to worrying about how these basic
activities may be affected, you may also be concerned about your treatments and chances for survival.
Though you may feel like your life your survival is out of your hands, you can take steps to feel more in
control and to cope with your throat cancer diagnosis. To cope, try to:
Learn enough about throat cancer to make treatment decisions. Write down a list of questions to
ask your doctor at your next appointment. Ask your doctor about further sources of information about your
cancer. Knowing more about your specific condition may help you feel more comfortable when making
treatment decisions.
Find someone to talk with. Seek out sources of support that can help you deal with the emotions
you're feeling. You may have a close friend or family member who is a good listener. Clergy members and
counselors are other options. Consider joining a support group for people with cancer. Contact your local
chapter of the American Cancer Society (ACS) or Support for People with Oral and Head and Neck Cancer.
The ACS's Cancer Survivors Network offers online message boards and chat rooms that you can use to
connect with others with throat cancer.
Take care of yourself during cancer treatment. Make keeping your body healthy during treatment a
priority. Avoid extra stress. Get enough sleep each night so that you wake feeling rested. Take a walk or find
time to exercise when you feel up to it. Make time for relaxing, such as listening to music or reading a book.
Go to all of your follow-up appointments. Your doctor will schedule follow-up exams every few
months during the first two years after treatment, and then less frequently after that. These exams allow
your doctor to monitor your recovery and check for a cancer recurrence. Follow-up exams can make you
nervous, since they may remind you of your initial diagnosis and treatment. You may fear that your cancer
has come back. Expect some anxiety around the time of each follow-up appointment. Plan ahead by finding
relaxing activities that can help redirect your mind away from your fears.
Prevention
There's no proven way to prevent throat cancer from occurring. But in order to reduce your risk of throat cancer,
you can:
Stop smoking or don't start smoking. If you smoke, quit. If you don't smoke, don't start. Stopping
smoking can be very difficult, so get some help. Your doctor can discuss the benefits and risks of the many
stop-smoking strategies, such as medication, nicotine replacement products and counseling.
Drink alcohol only in moderation, if at all. For women, this means one drink a day. For men,
moderate drinking means no more than two drinks a day.
Choose a healthy diet full of fruits and vegetables. The vitamins and antioxidants in fruits and
vegetables may reduce your risk of throat cancer. Eat a variety of colorful fruits and vegetables.
Protect yourself from HPV. Some throat cancers are thought to be caused by the sexually
transmitted infection human papillomavirus HPV. You can reduce your risk of HPV by limiting your number
of sexual partners and using a condom every time you have sex. Also consider the HPV vaccine, which is
available to boys, girls, and young women and men.
What are the risk factors for laryngeal and hypopharyngeal cancers?
A risk factor is anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors. Some
risk factors, like smoking, can be changed. Others, like a persons age or family history, cant be changed.
But risk factors dont tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease.
And many people who get the disease may have few or no known risk factors.
Laryngeal and hypopharyngeal cancers are often grouped with other cancers of the mouth and throat (known as head and neck
cancers). These cancers often have many of the same risk factors, some of which are included below.
Poor nutrition
Poor nutrition may increase the risk of getting head and neck cancer. The exact reason for this is not known. Heavy drinkers often
have vitamin deficiencies, which may help explain the role of alcohol in increasing risk of these cancers.
Infection with certain types of HPV can also cause some forms of cancer, including cancers of the penis, cervix, vulva, vagina, anus,
and throat. Other types of HPV cause warts in different parts of the body.
HPV can be passed from one person to another during skin-to-skin contact. One way HPV is spread is through sex, including
vaginal and anal intercourse and even oral sex.
HPV types are given numbers. The type linked to throat cancer (including cancer of the hypopharynx) is HPV16.
Most people with HPV infections of the mouth and throat have no symptoms, and only a very small percentage develop throat
cancer. HPV infection of the mouth and throat is more common in men than in women. The risk of this infection is linked to certain
sexual behaviors, such as open mouth kissing and (in some studies) oral-genital contact (oral sex). The risk also increases with the
number of sexual partners a person has and with. Smoking also increases the risk of oral HPV infection. At this time, there is no test
for HPV infection of the mouth and throat that is approved by the US Food and Drug Administration.
HPV infection of the throat seems to be a factor in some throat cancers, such as some cancers of the tonsils and some cancers of
the hypopharynx. HPV infection is very rarely a factor in laryngeal cancer.
Get more information in our document HPV and HPV Testing.
Genetic syndromes
People with syndromes caused by inherited defects (mutations) in certain genes have a very high risk of throat cancer, including
cancer of the hypopharynx.
Fanconi anemia: This condition can be caused by inherited defects in several genes. People with this syndrome often have blood
problems at an early age, which may lead to leukemia or aplastic anemia. They also have a very high risk of cancer of the mouth
and throat.
Dyskeratosis congenita: This genetic syndrome can cause aplastic anemia, skin rashes, and abnormal fingernails and toenails.
People with this syndrome have a very high risk of developing cancer of the mouth and throat when they are young.
Workplace exposures
Long and intense exposures to wood dust, paint fumes, and certain chemicals used in the metalworking, petroleum, plastics, and
textile industries can also increase the risk of laryngeal and hypopharyngeal cancers.
Asbestos is a mineral fiber that was often used as an insulating material in many products in the past. Exposure to asbestos is an
important risk factor for lung cancer and mesothelioma (cancer that starts in the lining of the chest or abdomen). Some studies have
also found a possible link between asbestos exposure and laryngeal cancer.
Gender
Cancers of the larynx and hypopharynx are about 4 times more common in men than women. This is likely because the main risk
factors smoking and heavy alcohol use are more common in men. But in recent years, as these habits have become more
common among women, their risks for these cancers have increased as well.
Age
Cancers of the larynx and hypopharynx usually develop over many years, so they are not common in young people. Over half of
patients with these cancers are 65 or older when the cancers are first found.
Race
Cancers of the larynx and hypopharynx are more common among African Americans and whites than among Asians and Latinos.
Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions
such as speech and language therapy, physical therapy and occupational therapy.
Nursing Diagnosis for Stroke / CVA : Impaired Verbal Communication related to the decrease in cerebral blood circulation.
Goal: communication can function optimally.
Outcomes:
Interventions:
1.
2.
Assess the type / degree of dysfunction, such as patients do not seem to understand the word or have difficulty
speaking or understanding their own making.
Distinguish between aphasia by dysarthria.
3.
4.
Ask the patient to follow simple commands (like "open eyes," "point to the door") repeat the word / phrase that
simple.
5.
Show the object and ask the patient to name the object.
6.
7.
Ask the patient to write the name and / or short sentences. If you can not write, ask the patient to read short
sentences.
8.
Place a notice in the nurses' station and patient room on the speech disorder. Give special bell when necessary.
9.
Provide alternative methods of communication, such as writing on the blackboard, drawing. Provide visual cues
(hand gestures, drawings, list of requirements, demonstrations).
Rationale :
1.
2.
Help define the area and the degree of cerebral damage that occurred and the patient's difficulties in some or all
stages of the communication process. Patients may have difficulty understanding spoken words (aphasia sensory /
damage to the area Wernick); pronounce words correctly (expressive aphasia / damage to Broca's speech area) or
suffered damage to both regions.
Interventions are chosen depending on the type of degradation. Aphasia is a disorder in use and interpret
language and symbols may involve components of sensory and / or motor skills, such as the inability to understand
the writing / speech or written word, making signs, talking. Someone with disantria can understand, read, and write
the language but have difficulty forming / pronounce words with respect to weakness and paralysis of the muscles
of the oral region.
3.
Patients may lose the ability to monitor speech out and do not realize that real communication is not spoken.
Feedback helps patients realize why caregivers do not understand / respond accordingly and provide an
opportunity to clarify the content / meaning contained in the words.
4.
5.
Assessing the damage to motor (motor aphasia, such patients may recognize it but can not mention).
6.
Identify the presence of dysarthria appropriate motor component of speech (such as the tongue, lips, breath
control) that may affect articulation and may also not accompanied by motor aphasia.
7.
Assess the ability to write (agrafia) and correct deficiencies in reading (aleksia) are also part of aphasia sensory
and motor aphasia.
8.
Eliminate the anxiety of patients in connection with the inability to communicate and the fear that the patient's
needs will not be met immediately. The use of the bell is activated with minimal pressure will be beneficial when the
patient cannot use regular bell system.
9.
10. Helpful in reducing frustration when dependent on others and cannot communicate meaning.
11. Lowering the confusion / anxiety during the communication process and respond to information more at any given
time. As the process of re-training to further develop communication more and more complex to stimulate memory
and can improve the association of ideas / words.
12. Patients do not need to damage hearing, and raised his voice can lead to angry patients / cause pain. Focusing
responses can result in frustration and may cause patients to come talk to "automatic," such as twisting the words,
talking rough / dirty.
13. Reduce the social isolation of patients and enhance the creation of effective communication.
14. Increasing meaningful conversation and provide opportunities for practical skills.
15. The ability of the patient to feel self-esteem, because patients often remain intellectual abilities well.
16. Assessment of individual speech and sensory, motor and cognitive functions to identify gaps / needs therapy.
Nursing Diagnosis : Disturbed Body Image related to loss of voice, face and neck anatomy changes.
characterized by: negative feelings about body image, a change in social engagement, anxiety, depression, lack of eye
contact.
Goal: Identify feelings and coping methods for negative perceptions of themselves.
Outcomes:
Shows the initial adaptation to changes in the body as evidence of the participation of self-care activities and positive
interactions with others.
Communicating with people nearby on the roles change has occurred.
Begin to develop a plan for lifestyle change.
Participate in an effort to carry out the rehabilitation team.
Interventions and Rationale:
1 Discuss the meaning of loss or change in the patient, identification of perception or expectation that the situation will come.
Rational: Tool in identifying or interpreting issues to focus attention and intervention constructively.
2 Note the non-verbal body language, behavior or the negative self talk. Assess self destruction or suicide behavior.
Rational: may indicate depression or despair, the need for further assessment or more intensive intervention.
3 Record the emotional reaction, sample loss, depression, anger.
Rationale: The patient may experience depression after surgery or shock reaction and deny. Acceptance of change can not
be imposed and the process takes time to improve loss.
4. Arrange the limits on maladaptive behavior; help the patient to identify positive behaviors that will improve.
Rational: refusal may result in a decrease in self-esteem and affect the acceptance of a new self-image.
5. Collaborative: to refer patients or those closest to the source of support, examples of the psychological therapist, social
worker, family counseling.
Rationale: a comprehensive approach is needed to help patients face the rehabilitation and health. Families need help in
understanding the process through which patients and assist them in their emotions. The goal is to enable them to resist the
tendency to reject or isolation of patients from social contact.