Treatments for Throat cancer
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Hospital statistics for Throat cancer:
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- 0.002% (246) of hospital consultant episodes were for malignant neoplasm of trachea in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 86% of hospital consultant episodes for malignant neoplasm of trachea required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 56% of hospital consultant episodes for malignant neoplasm of trachea were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 34% of hospital consultant episodes for malignant neoplasm of trachea were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Hospitals & Medical Clinics: Throat cancer
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Dysphagia:
Treatment
(In a Page: Signs and Symptoms)
-
Acute mechanical obstructions require urgent endoscopy to relieve the obstruction and prevent potential perforation
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Dysphagia with gastroesophageal reflux disease can be minimized with promotility agents or proton pump inhibitors, weight loss, and avoiding offending foods
-
Chronic mechanical obstruction from webs, rings, and strictures require endoscopic treatment or thoracic surgery; balloon dilation may be considered
-
Lower esophageal spasm may improve with anticholinergic antispasmodics or the injection of botulinum toxin
-
Polymyositis: Glucocorticoids.
-
Myasthenia gravis: Muscarinic agents (pyridostigmine), glucocorticoids
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ALS, stroke: Speech therapy evaluation, anticholinergics to prevent saliva aspiration
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Sore Throat:
Treatment
(In a Page: Signs and Symptoms)
-
Viral pharyngitis: Treat symptomatically with hydration, decongestants, saline nasal spray, analgesics, and rest
-
Strep pharyngitis: Appropriate antibiotics (e.g., penicillin, erythromycin) and symptomatic treatment with analgesics
-
Mononucleosis: Symptomatic treatment with analgesics; limit contact sports if splenomegaly is present
–Hospitalization in patients with encephalitis, airway compromise, or dehydration due to nausea/vomiting secondary to hepatitis
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Allergic pharyngitis: Antihistamines, nasal steroids
-
Foreign body: Protect airway; removal by ENT doctor
-
GERD: H2 blockers (e.g., ranitidine) or proton pump inhibitors (e.g., omeprazole), elevate head of bed, weight loss, small meals
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Dysphagia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Important to assess for adequate nutritional intake and safety of swallow without aspiration
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Underlying inflammatory disorders are addressed
-
The modified barium swallow study may provide guidance and the speech pathologist may provide recommendations regarding position during feeds, consistency, size limitations, temperature of food, appropriate bottles or utensils, bolus size
-
Total oral feeding may not be possible for all children; options include naso- or orogastric feeding or gastrotomy tube feeding
-
Surgery
–Dysphagia associated with tonsillar hypertrophy may require tonsillectomy
–Pharyngeal and esophageal tumors may require resection
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Sore Throat:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Viral causes
–Supportive care including hydration, acetaminophen or ibuprofen, bedrest, salt water rinses
–Steroids may be considered to minimize upper airway obstruction
-
Antibiotics for bacterial etiologies
–For group A β-hemolytic strep: Shortens duration of symptoms and prevents rheumatic fever
-
Consider inpatient admission when there is concern about adequate airway or oral intake
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Airway management: Intubation or tracheotomy
-
When gastroesophageal reflux is suspected, treatment may include dietary changes, antireflux therapy
-
Adenotonsillectomy for recurrent tonsillitis is considered depending on frequency of recurrence, i.e., 6–7 infections/year, or 4–5 infections/year for 2 years, or 3 infections/year for 3 years
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Malignant spinal neoplasms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Throat abscesses:
Treatment
(Professional Guide to Diseases (Eighth Edition))
For early-stage peritonsillar abscess, large doses of penicillin or another broad-spectrum antibiotic are necessary. If the patient is immunocompromised or has been repeatedly hospitalized, antibiotic therapy should include coverage for staphylococci and gram-negative organisms. For late-stage abscess, with cellulitis of the tonsillar space, primary treatment is usually incision and drainage under a local anesthetic, followed by antibiotic therapy for 7 to 10 days. Tonsillectomy, scheduled no sooner than 1 month after healing, prevents recurrence but is recommended only after several episodes.
In acute retropharyngeal abscess, the primary treatment is incision and drainage through the pharyngeal wall. It’s considered a surgical emergency. In chronic retropharyngeal abscess, drainage is performed through an external incision behind the sternomastoid muscle. During incision and drainage, strong, continuous mouth suction is necessary to prevent aspiration of pus, and the head should be kept down. Postoperative drug therapy includes I.V. antibiotics (usually penicillin or clindamycin) and analgesics.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Dysphagia:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient suddenly complains of dysphagia and displays signs of respiratory distress, such as dyspnea and stridor, suspect an airway obstruction and quickly perform abdominal thrusts. Prepare to administer oxygen by mask or nasal cannula or to assist with endotracheal intubation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Mouth lesions:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to avoid irritants, such as highly seasoned foods, citrus fruits, foods that contain salt or vinegar, alcohol, and tobacco. For mouth care, warn against using lemon-glycerin swabs because these can dry and irritate the lesions.
As appropriate, teach the patient proper oral hygiene. If toothbrushing is contraindicated, instruct him to use a mouth rinse, such as normal saline solution or half-strength hydrogen peroxide, and to avoid commercial mouthwashes that contain alcohol. Stress the importance of frequently changing to a new toothbrush. If the patient uses an inhaled steroid, instruct him to rinse his mouth after each use. Also, tell him to report mouth lesions that don’t heal within 2 weeks.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Throat pain:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient is taking antibiotics, stress the importance of completing the 10-day course of treatment, even if symptoms improve after only a few days. Tell the patient that he’s presumed noninfectious after 24 hours of antibiotic coverage. Suggest gargling with salt water to soothe the throat.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Dysphagia:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Stimulate salivation by talking with the patient about food, adding a lemon slice or dill pickle to his tray, and providing mouth care before and after meals. Moisten his food with a little liquid if salivation is decreased. Administer an anticholinergic or antiemetic to control excess salivation. If he has a weak or absent cough reflex, begin tube feedings or esophageal drips of special formulas.
Consult with the dietitian to select foods with distinct temperatures and textures. The patient should avoid sticky foods, such as bananas and peanut butter. If the patient has mucous production, avoid uncooked milk products. Consult a therapist to assess the patient for his aspiration risk and for swallowing exercises to possibly help decrease his risk. At mealtimes, take measures to minimize the patient’s risk of choking and aspiration. Place the patient in an upright position, and have him flex his neck forward slightly and keep his chin at midline. Instruct the patient to swallow multiple times before taking the next bite or sip. Separate solids from liquids, which are harder to swallow.
Prepare the patient for diagnostic tests including endoscopy, esophageal manometry, esophagography, and esophageal acidity test to pinpoint the cause of dysphagia.
Patient teaching
Advise the patient to consume foods that are easy to swallow. Explain measures he can take to reduce the risk of choking and aspiration, such as positioning during eating and after the meal has been consumed. Encourage the patient’s family or caregiver to take a first aid or cardiopulmonary course that provides techniques for managing choking.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Dysphagia:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient suddenly complains of dysphagia and displays signs of respiratory distress, such as dyspnea and stridor, suspect an airway obstruction and quickly perform abdominal thrusts. Prepare to administer oxygen by mask or nasal cannula or to assist with endotracheal intubation.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Mouth lesions:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to avoid irritants, such as highly seasoned foods, citrus fruits, alcohol, tobacco, and foods that contain salt or vinegar. For mouth care, warn against using lemon-glycerin swabs because these can dry and irritate the lesions.
As appropriate, teach the patient proper oral hygiene. If toothbrushing is contraindicated, instruct him to use a mouth rinse, such as normal saline solution or half-strength hydrogen peroxide, and to avoid commercial mouthwashes that contain alcohol. Stress the importance of frequently changing to a new toothbrush. If the patient uses an inhaled steroid, instruct him to rinse his mouth after each use. Also tell him to report any mouth lesions that don’t heal within 2 weeks.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Throat pain:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient is taking antibiotics, stress the importance of completing the full course of treatment, even if symptoms improve after only a few days. Tell the patient that he’s presumed noninfectious after 24 hours of antibiotic coverage. Suggest gargling with salt water to soothe the throat.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Dysphagia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Stimulate salivation by talking with the patient about food, adding a lemon slice or dill pickle to his tray, and providing mouth care before and after meals.
▪ Moisten his food with a little liquid if the patient has decreased salivation.
▪ Administer an anticholinergic or antiemetic to control excess salivation.
▪ If the patient has a weak or absent cough reflex, begin tube feedings.
▪ Consult with the dietitian to select foods with distinct temperatures and textures.
▪ Consult with a speech therapist to assess the patient for his aspiration risk and for swallowing exercises to help decrease his risk.
▪ When feeding the patient, place him in an upright position, and have him flex his neck forward slightly and keep his chin at midline.
▪ Instruct the patient to swallow multiple times before taking the next bite or sip.
▪ Separate solids from liquids, which are harder to swallow.
▪ Prepare the patient for diagnostic evaluation, including endoscopy, esophageal manometry, esophagography, and the esophageal acidity test, to pinpoint the cause of dysphagia.
Patient teaching
▪ Tell the patient which foods and textures he should avoid.
▪ Explain measures to take to reduce the risk of choking and aspiration.
▪ Explain to the patient his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Mouth lesions:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ If the patient's mouth ulcers are painful, provide a topical anesthetic such as lidocaine.
▪ Encourage or provide regular oral hygiene.
Patient teaching
▪ Tell the patient which irritants he should avoid.
▪ Teach proper mouth care and oral hygiene.
▪ Review any prescribed medications.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Throat pain:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide analgesic sprays or lozenges to relieve throat pain.
▪ Prepare the patient for throat culture, complete blood count, and a Monospot test.
Patient teaching
▪ Explain the underlying disorder and treatment plan.
▪ Explain the importance of taking the full course of antibiotics, as ordered.
▪ Discuss ways to soothe the throat.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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