Question

Al Conditions I. Laryngectomy A. Removal of larynx B. Indications: Pre-operative nursing care: Post-operative nursing care 1. C. D. No connection between nose and mouth and lungs 2. is only source of air for lungs 3. Establish means of communication a. Written b. Picture board C. Signals, gestures b. Artificial larynx c. Esophageal speech 4. Teach re: a. to filter out dust and warm air b. No sports c. Tub bath safer than d. Loss of sense of Chronic Obstructive Pulmonary Disease (COPD) A. Pulmonary Emphysema II. 1. Definition: Chronic disease with excessive inflation of air spaces distal to the terminal bronchioles, alveolar ducts, and alveoli. There is increased 4

Answer 1

1.Laryngectomy

B.Indication

• Laryngeal cancer
• Failure in chemotherapy treatment for laryngeal cancer
• Radiation tgerapy failure

C.Pre-operative nursing care

This part is the most crucial period, the following nursing care preoperatively are necessary

• Preparation of the patient as per order (pre op medication, neck draping)
• Keeping all investigations ready
• Providing psychological support

D.Post operative nursing care

After the surgery depending upon the type of surgery (total laryngectomy no connection of trachea with mouth and nose) partial laryngectomy (connection still exists with the mouth and nose during respiration )

Whether it is partial or complete the stoma (artificial opening created in the neck ,trachea ) forms the major part in exchange of air between the lungs.

4.a.Breathing takes place via the stoma so a stoma cover will help in filtering the dust and warm air during inspiration and preventing infection and complications

b.The patientafter laryngectomy are strictly adviced for no water sports (boating, fishing,swimming ) to avoid dampening of the site and preventing entering of water through the stoma and inducing cough and unnecessary complications.

c. The patient are adviced not to dampen or wet the surgical site during shower, a safer method to shower is taking a tub bath or if in a shower make sure the water lies on the back .

d. Post surgery the connection between the nose and mouth are affect.Though a patient can get started with oral diet after a period of time ,th chance for sense of taste can be got back accordingly but as there is a permanent disconnection between the nose and trachea the sense of smell is completely lostl