Summary NUR 2502 / NUR2502 Exam 2 Focused Review (Latest 2022 / 2023): Multidimensional Care III / MDC 3 - Rasmussen

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

, 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