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CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,

INFECTIOUS, INFLAMMATORY AND IMMUNOLOGIC RESPONSE, CELLULAR ABERRATIONS,
ACUTE & CHRONIC
WORKSHEET 3
NAME: Binwag, Angelica D.
COURSE / YEAR LEVEL: BSN-3
DATE:9/20/20
SCORE:

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CASE STUDY
INSTRUCTIONS:
 CONSIDER THE SCENARIO AND ANSWER THE QUESTION
 CAREFULLY READ AND UNDERSTAND THE QUESTION
 ANSWER CONCISELY AND COMPREHENSIVELY. (Note: It doesn’t have to be that
long as long as you have stated your point)
 PLEASE ATTACH ANY REFERENCES IF ANY

A. LARYNGECTOMY
Pt. Jerome, a 52-year old widower, is admitted for a laryngectomy owing to a malignant
tumor.

1. Before developing a care plan, the nurse needs to know whether Jerome’s voice
will be preserved. What surgical procedure does the nurse understand will not
cause damage to the voice box?
 Partial laryngectomy or Supraglottic laryngectomy
2. Jerome is scheduled for a total laryngectomy. What education should the nurse
provide to the patient in the preoperative phase of surgery?
 Informing him that there are ways he will be able to carry on a conversation
without his voice.
 Making sure that he knows he will require a permanent tracheal stoma.
 Reminding him that he will not be able to sing, whistle, or laugh.
3. The nurse is educating Jerome about the presence of a nasogastric catheter after
surgery. The nurse should inform him that he will begin receiving oral feedings
about how long after the surgery?
 1 WEEK
4. Jerome asks the nurse when the laryngectomy tube will be removed. What should
the nurse tell him?
 The nurse should inform him that the laryngectomy tube will be removed when the
stoma is well healed.

B. EPISTAXIS
Gilberta, a 14-year-old high school student, is being sent with her parents to the
emergency department of a local hospital for uncontrolled epistaxis.
1. What should the school nurse instruct Gilberta and her parents to do
control the bleeding during transport to the hospital?
 Gilberta should sit upright with her head tilted forward to prevent swallowing and
aspiration of blood. She should also pinch the soft outer portion of the nose
against the midline spectrum for 5-10 continuous minutes.
2. What emergency medical treatment will be used when Gilberta arrives?
 Application of nasal decongestants (phenylephrine) to act as vasoconstrictors
may be necessary.
3. The nurse can advise the parents that nasal packing used to control
bleeding can be left in place for how long?
 The packing may remain in place for 3-4 days of necessary to control bleeding.