Nursing Considerations-Nursing Interventions
Prepare the patient for scheduled treatments, such as radiation therapy or surgery.
Provide support. Encourage the patient to verbalize feelings, concerns, and fears. Help the patient develop positive coping strategies, and emphasize positive aspects of the patient’s body image.
Arrange for patient to meet with a laryngectomee for support prior to surgery if indicated.
Assist with establishing a method of communication.
Enlist the aid of a speech therapist to assist with meeting the patient’s communication needs.
Institute aspiration precautions as indicated. Auscultate lung sounds for changes; have suction readily available if patient begins to aspirate.
Administer analgesics as ordered to manage pain.
Institute measures to minimize the effects of chemotherapy as appropriate.
Administer nasogastric or gastrostomy feedings as ordered.
Prepare the patient and family physically and psychologically for surgery.
Prepare the patient for functional losses (inability to smell, blow his nose, whistle, gargle, sip, or suck on a straw).
Encourage patient participation in self-care and decision making to foster feelings of self-esteem and control.
Provide frequent mouth care preoperatively and postoperatively.
Maintain a patent airway; suction when needed.
After total laryngectomy, elevate the head of the bed 30 to 45 degrees and support the back of the neck to prevent tension on sutures and, possibly, wound dehiscence.
Provide tracheotomy care as appropriate.