Exam 2 Focused Review
NUR2502 Exam 2 Focused Review
• Neck cancer-
o S/S
▪ Pain
▪ Lump in mouth, throat or neck
▪ Difficulty swallowing
▪ Color changes in mouth
▪ Numbness of mouth, lips, or face
▪ Persistent, unilateral ear pain
▪ SOB
▪ Anorexia and weight loss
o Nursing interventions
▪ Improve preoperational preparation
▪ Optimal in-hospice care
▪ Discharge planning and teaching
▪ Monitor gas exchange
▪ Assess RR and breath sounds Teach patient to use fowlers for best
gas exchange
o Treatment
▪ Surgery
▪ Radiation
▪ Chemotherapy
▪ Biotherapy
o Teaching regarding treatment
▪ Weight gain is not a sign of neck cancer
▪ Radiation
• Most patients have hoarseness, dysphagia, skin problems, and dry
mouth for a few weeks after therapy
• Hoarseness may become worse during therapy and
difficulty swallowing
• Gargle with saline or sucking ice may help
• Avoid exposing the site to the sun
• Use fluoride to prevent tooth decay
▪ Chemotherapy
• Can be used with radiation and intensifies all the side effects
of radiation
• Breaks can occur due to the comfortability of the side effects, but
it affects the outcome of the cancer so they do not recommend
▪ Biotherapy
• Severe skin reactions are common and difficult for the patient
• Nasal fractures-
o S/S
, Exam 2 Focused Review
▪ Unaligned nasal bridge, change in breathing, crackling of skin
(crepitus), bruising, pain
▪ Blood or clear fluid (cerebrospinal fluid) leaking from nose indicates a serious
skull fracture
• Cerebrospinal fluid will contain glucose when tested with a dipstick
o Treatment
▪ Closed reduction- realigning the bones by moving them from exterior
within first 24 hours of injury
▪ Rhinoplasty- surgical reconstruction
▪ Nasoseptoplasty- submucous resection to fix blocked septum
o Nursing interventions (including post op care and teachings)
▪ Cold compresses and pain relief for simple closed fractures to decrease swelling
▪ Manage the packing in both nostrils after rhinoplasty to prevent bleeding
and support procedure
▪ Change the drip pad in place after rhinoplasty as necessary or teach patient
how to
▪ Observe for edema and bleeding after surgery, vital signs q4h until discharge
▪ Educate to stay in semi fowlers and move slowly
▪ Educate to eat soft foods after anesthesia and drink 2500 mL/day
▪ Educate to decrease bleeding by limiting sniffing, coughing, or straining
• Rhinosinusitis-
o S/S
▪Purulent drainage from both nares
▪Fever
▪Lack of response to decongestant therapy
▪Pain over cheek
▪Tenderness over sinuses
▪Erythema
▪Swelling
▪Fatigue
o Treatment or medical interventions
▪ Use of broad-spectrum antibiotics, analgesics for pain, decongestants
▪ Nasal saline irrigations
▪ Hot and wet packs
▪ Mast cell stabilizers
▪ Antipyretics
o Diagnosis
▪ Made on basis of patients history and manifestations
▪ Sinus x-rays
▪ Endoscopic examination
▪ Computed tomography
• Differentiating CSF from nasal drainage
o Blood or clear fluid (cerebrospinal fluid) leaking from nose indicates a serious skull
fracture
o Cerebrospinal fluid will contain glucose when tested with a dipstick
NUR2502 Exam 2 Focused Review
• Neck cancer-
o S/S
▪ Pain
▪ Lump in mouth, throat or neck
▪ Difficulty swallowing
▪ Color changes in mouth
▪ Numbness of mouth, lips, or face
▪ Persistent, unilateral ear pain
▪ SOB
▪ Anorexia and weight loss
o Nursing interventions
▪ Improve preoperational preparation
▪ Optimal in-hospice care
▪ Discharge planning and teaching
▪ Monitor gas exchange
▪ Assess RR and breath sounds Teach patient to use fowlers for best
gas exchange
o Treatment
▪ Surgery
▪ Radiation
▪ Chemotherapy
▪ Biotherapy
o Teaching regarding treatment
▪ Weight gain is not a sign of neck cancer
▪ Radiation
• Most patients have hoarseness, dysphagia, skin problems, and dry
mouth for a few weeks after therapy
• Hoarseness may become worse during therapy and
difficulty swallowing
• Gargle with saline or sucking ice may help
• Avoid exposing the site to the sun
• Use fluoride to prevent tooth decay
▪ Chemotherapy
• Can be used with radiation and intensifies all the side effects
of radiation
• Breaks can occur due to the comfortability of the side effects, but
it affects the outcome of the cancer so they do not recommend
▪ Biotherapy
• Severe skin reactions are common and difficult for the patient
• Nasal fractures-
o S/S
, Exam 2 Focused Review
▪ Unaligned nasal bridge, change in breathing, crackling of skin
(crepitus), bruising, pain
▪ Blood or clear fluid (cerebrospinal fluid) leaking from nose indicates a serious
skull fracture
• Cerebrospinal fluid will contain glucose when tested with a dipstick
o Treatment
▪ Closed reduction- realigning the bones by moving them from exterior
within first 24 hours of injury
▪ Rhinoplasty- surgical reconstruction
▪ Nasoseptoplasty- submucous resection to fix blocked septum
o Nursing interventions (including post op care and teachings)
▪ Cold compresses and pain relief for simple closed fractures to decrease swelling
▪ Manage the packing in both nostrils after rhinoplasty to prevent bleeding
and support procedure
▪ Change the drip pad in place after rhinoplasty as necessary or teach patient
how to
▪ Observe for edema and bleeding after surgery, vital signs q4h until discharge
▪ Educate to stay in semi fowlers and move slowly
▪ Educate to eat soft foods after anesthesia and drink 2500 mL/day
▪ Educate to decrease bleeding by limiting sniffing, coughing, or straining
• Rhinosinusitis-
o S/S
▪Purulent drainage from both nares
▪Fever
▪Lack of response to decongestant therapy
▪Pain over cheek
▪Tenderness over sinuses
▪Erythema
▪Swelling
▪Fatigue
o Treatment or medical interventions
▪ Use of broad-spectrum antibiotics, analgesics for pain, decongestants
▪ Nasal saline irrigations
▪ Hot and wet packs
▪ Mast cell stabilizers
▪ Antipyretics
o Diagnosis
▪ Made on basis of patients history and manifestations
▪ Sinus x-rays
▪ Endoscopic examination
▪ Computed tomography
• Differentiating CSF from nasal drainage
o Blood or clear fluid (cerebrospinal fluid) leaking from nose indicates a serious skull
fracture
o Cerebrospinal fluid will contain glucose when tested with a dipstick
