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CANCER OF THE ORAL CAVITY Data Base A. Etiology and pathophysiology 1. Primarily in clients who smoke and drink alcohol in large quantities 2. Cancer of the lip easily diagnosed; prognosis is good; incidence highest in pipe smokers 3. Cancer of the tongue usually occurs with cancer of the floor of the mouth; metastasis to the neck is common 4. Cancer of the submaxillary glands; highly malignant and grows rapidly B. Clinical findings 1. Subjective: pain (not an early symptom); alterations of taste 2. Objective: leukoplakia (white patches on mucosa), which is considered precancerous; ulcerated, bleeding areas in the involved structure C. Therapeutic interventions 1. Reconstructive surgery if indicated 2. Radiation or implantation of radioactive material may arrest growth of tumor 3. Total parenteral nutrition, enteral tube feedings Nursing Care of Clients with Cancer of the Oral Cavity A. Assessment 1. History of hemoptysis and pain 2. Baseline nutritional data including weight, dietary intake, and ability to chew 3. Characteristics of lesions in oral cavity B. Analysis/Nursing Diagnoses 1. Ineffective airway clearance related to tissue trauma from iatrogenic stresses 2. Impaired oral mucous membranes related to oral lesions 3. Imbalanced nutrition: less than body requirements related to decreased taste, dysphagia, and pain C. Planning/Implementation 1. Maintain a patent airway; keep a tracheostomy set at the bedside 2. Maintain fluid, electrolyte, and nutritional balance; administer TPN, enteral tube feedings as ordered 3. Relieve dryness of the mouth by frequent saline mouthwashes and ample fluids if client is receiving radiation therapy 4. Consider time and distance in relation to the radioactive implants when giving nursing care D. Evaluation/Outcomes 1. Maintains airway patency 2. Maintains nutritional status |
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