Stage of Chronic Kidney Disease Description

Stage 0 Cancer only affects the top layer of cells

inside the nasopharynx.
Stage 1 The tumor has grown into nearby
structures, such as the back of the throat
or the nasal cavity.
Stage 2 At this stage, cancer has spread to one or
more lymph nodes on one side of the
neck.
Stage 3 Cancer has spread to lymph nodes on
both sides of the neck.
Stage 4 The tumor has spread to the skull, eye,
cranial nerves, salivary glands or lower
part of the throat. At stage 4,
nasopharyngeal cancer may also spread
to distant parts of the body.

SIGNS AND SYMPTOMS

 Tinnitus, or ringing in your ears.
 Hearing loss.
 A feeling of fullness in the ear.
 Headaches.
 Nasal stuffiness.
 Nosebleeds.
 Difficulty opening your mouth.
 Facial pain.
 Facial numbness.
 Difficulty breathing or speaking.
 Ear infections that won’t go away.

CAUSES
Experts aren’t exactly sure what causes nasopharyngeal cancer. However, certain risk
factors can increase your chance of developing the disease, including:
 Epstein-Barr virus (EBV).
 Salt-cured foods.
  Alcohol and tobacco use.
 Age
 Race
 Sex
 Family history

Clinical History

History of Present Health Concern

A 46-year-old male was admitted to Batangas medical center last March 28,
2023 due to symptoms like headache. Prior to the admission, the patient already
experienced having sinusitis

Past Medical History and Drug Therapy

Patient started having symptoms in the year 2021 for 3 months, in 2022, patient
was feeling no symptoms until November 2022 which he was having symptoms like
cold.

Family History

Both parents were healthy, and they live in a normal healthful lifestyle.

Lifestyle & Social History

Patient has a lifestyle of smoking and alcohol intake and for his social history the
patient works as a security guard.

PHYSICAL ASSESSMENT
General Survey

Patient T. R, 46-years-old, was awake. Patient’s BP: 150/110, HR is 65bpm, RR of 20cpm,

Temp of 36.8 C and O2 saturation of 99%.
 PHYSICAL ASSESSMENT
Date April 03, 2023
Vital Signs BP – 150/110
T – 36.8o C
CR – 65 bpm
RR - 20 cpm
O2 saturation – 99%

Body Parts Methods Findings Analysis

Head & Neck

Mouth Inspection Dry and inflamed

Nose Inspection Lump on the left nostril

ANATOMY AND PHYSIOLOGY

Nasopharynx:
 The main function of your nasopharynx is to connect your nasal passages to the
rest of your respiratory system. This allows air to get from your nose to your lungs. Your
nasopharynx is located toward the bottom and back of your skull. It’s in the back of your
nose and the roof of your mouth.

Eustachian tubes: These tubes run from the middle of your ears to your nasopharynx.
They equalize ear pressure and drain fluid from your ear.

Adenoids (nasopharyngeal tonsils): These glands are part of your immune system
and help protect your body from viruses and bacteria.

Eustachian tubes: The Eustachian tubes, sometimes called the auditory tubes, lie on
either side of the nasopharynx and connect to the middle ear. The Eustachian tubes
help equalize pressure inside the ears and drain mucus from the middle ear. If a
nasopharyngeal tumor were to block one of the Eustachian tubes, it would cause a
buildup of mucus in the middle ear, which could cause hearing impairment or an ear
infection.

Base of skull: The nasopharynx is located right below and in front of the base of the
skull. On the other side of the base of the skull is the brain. Advanced nasopharyngeal
cancers can destroy the bone at the base of the skull, enter the cranial cavity, and affect
the brain.
 PATHOPHYSIOLOGY

Nasopharyngeal Cancer

Modifiable Risk Factors Non-Modifiable Risk Factors

 Poor diet and lifestyle  Age

 Excessive sodium and alcohol intake  Race
 Smoking  Sex
 Epstein-Barr virus (EBV).  Family history

Nasopharyngeal Cancer Verbalized by the

patient with a pain
scale of 10/10

Sinusitis Elevated Blood Pressure Facial Pain Headache

LABORATORY EXAMINATION
Date
HEMATOLOGY

Laboratory Exam Normal Values Result Significance

Complete Blood Count

ERYTHROCYTES 4.6 - 6.2 4.15 Within normal range

10^12/L
Hemoglobin 140 - 180 126 g/L Below normal range

Hematocrit 0.40 - 0.54 0.367 Below normal range

LEUKOCYTE 4.5 - 11.0 19.04 Above normal range

10^9/L
Differential Count

Neutrophils 0.37 - 0.72 0.840 Above normal range

Lymphocytes 0.20 - 0.50 0.084 Below normal range

Monocytes 0.0 - 0.14 0.074 Below normal range

Eosinophils 0.0 - 0.06 0.001 Within normal range

Basophils 0.0 - 0.01 0.001 Within normal range

THROMBOCYTE 150.0 - 400.0 348 Within normal range

MCH 27.0 - 31.0 30.4 Within normal range

MCV 80.0 - 96.0 88.4 Within normal range

MCHC 0.32 - 0.36 0.34 Within normal range

RDW 11.5 – 14.5 12.0 Within normal range

MPV RNF 11.4 Within normal range

LABORATORY EXAMS
Date
HEMATOLOGY
Laboratory Exam Normal Values Result Significance
Blood Chemistry

BUN

Creatinine Male: 58 - 110 51 Below normal range

Female: 46 – 92

SGPT/SGOT Male: Less than 50 138.82 Above normal range

Female: Less than 35

Others:
Date
Laboratory Exam Normal Values Result Significance
Serum Electrolytes
Sodium 135 - 148 133.7 Within normal range
Potassium
Calcium
Others:
 DIAGNOSTIC EXAMS
Normal
Examination Date Results Analysis
Findings
X-ray

Ultrasound

CT-Scan

ECG

Others:
 DRUG STUDY

NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Pain scale Acute pain related  Patient will  Build a rapport.  Exercise can be
10/10 Hypertension as report relief of a difficult subject After a series of
manifested by to broach with nursing intervention
elevated blood pain/discomfort. patients. Those
Objective: goals have been met:
pressure  Patient will with a sedentary
verbalize lifestyle may balk Patient reported relief
Facial Grimace at changing their
connotes pain methods that of pain/comfort
behavior. It’s
provide relief.
important for the Patient verbalizes relief
Lump on the left nostril  Patient will nurse to first form
noted follow a therapeutic
Patient follows
prescribed relationship with
prescribed medication
On IVF of PNSS intact pharmacological the patient in
well order to
regimen. understand and Patient demonstrates
 Patient will overcome use of relaxation skills
Tracheostomy tube demonstrate resistance. and diversional
intact activities, as indicated,
use of for individual situation.
relaxation skills  Instead of simply
V/s as follows: telling the patient
and diversional  Assess their history to move more,
BP: 150/110
activities, as and interests. get to know what
indicated, for types of exercise
individual or activities
Temp: 36.8 they’ve done in
situation. the past. Patients
HR: 65 are more likely to
create a habit
02: 99% when they enjoy
what they’re
doing.
RR: 20

 Minimizes
stimulation and
promotes
relaxation.
 Encourage and
maintain bed rest
during the acute
phase.
 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective: Risk for Infection  The client will  Encourage
Surgical incision of remain free of proper  Hand washing is After a series of nursing
Objective: tracheostomy infection, as handwashing or one of the intervention goals have
evidenced by alcohol-based simplest but been met:
normal hand rubs. most important
On IVF of PNSS intact temperature, keys to the Patient is free of
well normal sputum prevention of infection
culture, normal hospital-
Tracheostomy tube white blood cell acquired Patient indicates
intact (WBC) count, infection. understanding of
absence of  Utilize individual risk factors
V/s as follows: purulent drainage appropriate  Healthcare
around the stoma, personal professionals
and clear breath Patient identifies
protective should wear
BP: 150/110 sounds. interventions to prevent
equipment (PPE) PPE when or reduce the risk of
when handling a handling a client infection.
Temp: 36.8  The client will client with a with a
indicate an tracheostomy tracheostomy.
understanding of tube. Patient demonstrates
HR: 65 techniques to promote
individual risk
factors.  Maintain and a safe environment.
02: 99% screen visitors.  The client is
 The client will Limit them as already
RR: 20 identify much as compromised
interventions to possible. and is at
prevent or reduce increased risk of
the risk of exposure to
infection. infections.
 The client will
demonstrate Limiting visitors
techniques to and avoiding
promote a safe
contact with
environment.
persons with
respiratory
infections help
decrease the
client’s
exposure to
harmful
 Keep emergency pathogens.
supplies such as
a spare  Being prepared
tracheostomy for an
tube of the same emergency
size and brand at helps prevent
the bedside. future
complications.
 If signs of
infection are
present,
administer an
 hese agents are
antifungal or
either toxic to
antibacterial
the pathogen or
medication, as
retard its
prescribed.
growth. One
study showed
that it is difficult
to differentiate
between
bacterial and
nonbacterial
pneumonia
episodes and,
therefore,
antibiotics
overuse is
difficult to avoid.
 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective: Anxiety related to lack Clients will describe Give an explanation to
of client knowledge the level of anxiety clients about the illness Increase client After a series of nursing
Objective: about diseases and and coping patterns. slowly, quietly and use of understanding about intervention goals have
medical procedures clear sentences, short the disease and been met:
The client knows and easy to understand therapies for the
Lump on the left nostril understands about his disease so that the Patient describes the
noted illness and its client more cooperative level of anxiety and
treatment. Get rid of excessive coping patterns.
On IVF of PNSS intact stimulation By removing the
well stimulus that will Patient explains his
enhance the peace of illness and its treatment.
V/s as follows: the client concerned.
Monitor v/s
BP: 150/110 To know patients’
development
Temp: 36.8 throughout admission

HR: 65

02: 99%

RR: 20
PROGNOSIS
Nasopharyngeal carcinoma has a five-year survival rate of 61%. That indicates that
after five years, 61% of all patients newly diagnosed with the illness are still living. Bear
in mind that when cancer is treated in its early stages, the chances of survival increase.

Name of Patient: Patient T.V

Here are some Nursing Interventions towards the following:

Fluid status - Assess fluid status and identify potential sources of imbalance.

Nutritional intake - Implement a dietary program to ensure proper nutritional intake

within the limits of the treatment regimen.

Independence - Promote positive feelings by encouraging increased self-care and

greater independence.

Medications - Alter schedule of medications so that they are not given immediately
before meals.

Rest - Encourage alternating activity with rest.

REFERENCES
Introduction:
Cleveland Clinic. (2022). Nasopharyngeal Cancer.
Retrieved from https://my.clevelandclinic.org/health/diseases/21661-
nasopharyngeal-cancer

Ravanzo, R. (2021). A warrior's fight: A story of inspiration & hope. Retrieved from
https://www.siemens-healthineers.com/en-ph/news/ddvmh-patient-
testimonial#:~:text=Nasopharyngeal%20cancer%20%E2%80%93%20also
%20commonly%20known,before%20the%20age%20of%2075.

Anatomy and Physiology:

https://thancguide.org/cancer-types/throat/pharyngeal/nasopharyngeal/anatomy/
#:~:text=Advanced%20nasopharyngeal%20cancers%20can%20destroy,lymph
%20nodes%20in%20this%20space.

https://my.clevelandclinic.org/health/body/22376-nasopharynx

Drug Study:
https://medlineplus.gov/druginfo/meds/a684035.html#:~:text=Metoclopramide%20is%20in%20a
%20class,through%20the%20stomach%20and%20intestines.

https://www.pediatriconcall.com/drugs/metoclopramide/9#:~:text=Mechanism%20%3A,trigger
%20zone%20of%20the%20CNS.

https://go.drugbank.com/drugs/DB01233

https://www.rxlist.com/reglan-drug.htm#medguide

https://medlineplus.gov/druginfo/meds/a601209.html

Treatment and Interventions:

https://my.clevelandclinic.org/health/diseases/21661-nasopharyngeal-cancer