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EARLY SYMPTOMS:

  • hoarseness of voice
LATER SYMPTOMS:
  • pain
  • obstructed respiration
  • difficulty of swallowing
  • bleeding and swelling from tumor growth

CAUSES:
  • excessive smoking
  • too much drinking of alcohol
  • vocal straining
  • chronic laryngitis


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NURSING MEASURES FOR PREOPERATIVE CARE:
  • psychological preparation (try to alleviate worries; explain that he will lose natural voice completely but assure that there are ways in which he can carry on a normal conversation; tell that there are speech rehabilitation centers for speech therapy)
  • get the operation consent from the patient or direct relatives
  • oral care plus whole bath should be done
  • shave the beard or excess hair near the neck down to the nipple lines
  • carry out pre-operative medications
POST OPERATIVE CARE

TRACHEOSTOMY TUBE
  • close attention for first 24 hours
  • alleviate apprehension of the patient
  • provide humidification (heavily saturated mist from a tent or ultrasonic fog or inhalation of nebulized water solution or mucolytic agents)
  • secretion should be wiped away carefully and quickly before aspirated by the patient
  • watch out for any hemorrhage from the tracheostomy site
  • proper aspiration of secretion by sterile rubber

NASO-ESOPHAGEAL CATHETER
  • intravenous fluids regulated correctly
  • oral feeding start as ordered
  • speaking deferred until doctor ordered
  • observe for any excessive coughing and hemoptysis
  • communication can be translated through writing
  • naso-esophangeal can be removed by nurse if the doctor ordered
  • teach patient how to feed himself with feeding tube
  • oral care must be observed after feeding
  • oral feeding starts after the wound is healed

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