You are a 2-year graduate of an accredited AGACNP master's program. You are now a certified AGACNP practicing on a very busy inpatient oncology unit.
Your patient is a 45-year-old male with head/neck cancer. This is a new diagnosis, but the patient has lost over 60 pounds in the past 4 months due to dysphagia, malnutrition, and intractable pain. He is currently NPO due to risk of aspiration.
Explore the types of head and neck carcinomas that you will encounter as an AGACNP on this oncology unit. Describe the following and support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.
Malignancy, cytology results, and type of cancer markers, if available.
How this is cancer diagnosed.
The key complications for which you must be watchful.
How you will manage this unique and very difficult patient with regard to pain management, airway, cosmetics, and psychological concerns.
Which nutritional interventions would be important for this patient?
Full Answer Section
The symptoms of head and neck cancer can vary depending on the type of cancer and the location of the cancer. Some common symptoms include:
- A lump or mass in the head or neck
- Sore throat
- Difficulty swallowing
- Hoarseness
- Ear pain
- Unexplained weight loss
- Fatigue
The diagnosis of head and neck cancer is usually made with a biopsy. A biopsy is a procedure where a small piece of tissue is removed from the tumor and examined under a microscope.
The treatment for head and neck cancer depends on the type of cancer, the location of the cancer, and the stage of the cancer. Treatment options may include surgery, radiation therapy, chemotherapy, or a combination of treatments.
Key complications for which you must be watchful
Some of the key complications that you must be watchful for in a patient with head and neck cancer include:
- Airway obstruction: This can occur if the tumor grows large enough to block the airway.
- Nutritional problems: Patients with head and neck cancer often have difficulty eating and drinking due to pain, dysphagia, or the loss of teeth. This can lead to malnutrition and weight loss.
- Pain: Pain is a common symptom of head and neck cancer. It can be caused by the tumor itself, or by the treatment.
- Psychological problems: Patients with head and neck cancer often experience psychological problems such as anxiety, depression, and fear of death.
Managing this unique and very difficult patient
Managing a patient with head and neck cancer can be challenging. However, there are a number of things that you can do to help improve the patient's quality of life. These include:
- Managing pain: Pain is a major concern for patients with head and neck cancer. You should work with the patient to develop a pain management plan that is effective and tolerable.
- Improving nutrition: Patients with head and neck cancer often have difficulty eating and drinking. You should work with the patient to develop a nutritional plan that meets their needs.
- Addressing psychological problems: Patients with head and neck cancer often experience psychological problems. You should be aware of these problems and offer support and resources to the patient.
- Providing emotional support: Patients with head and neck cancer often need emotional support. You should be available to listen to the patient and offer support.
Nutritional interventions
Nutritional interventions are important for patients with head and neck cancer for a number of reasons. These interventions can help to:
- Improve the patient's quality of life: Patients who are well-nourished are more likely to feel better and have more energy.
- Reduce the risk of complications: Patients who are well-nourished are less likely to develop complications such as infection and malnutrition.
- Improve the patient's response to treatment: Patients who are well-nourished are more likely to respond well to treatment.
There are a number of nutritional interventions that can be used to help patients with head and neck cancer. These interventions include:
- Providing a high-calorie, high-protein diet: Patients with head and neck cancer often need to eat a high-calorie, high-protein diet to maintain their weight and prevent malnutrition.
- Using enteral or parenteral feeding: If the patient is unable to eat or drink, they may need to receive enteral or parenteral feeding. Enteral feeding is the delivery of nutrients through a tube into the stomach or small intestine. Parenteral feeding is the delivery of nutrients through a vein.
Sample Answer
Head and neck cancer is a general term for cancer that starts in the head and neck. This area includes the mouth, throat, larynx, sinuses, and salivary glands. Head and neck cancer is the sixth most
common cancer in the United States.
There are many different types of head and neck cancer, but the most common are:
- Squamous cell carcinoma: This is the most common type of head and neck cancer. It starts in the squamous cells, which are the flat cells that line the inside of the mouth, throat, and larynx.
- Oral cavity cancer: This type of cancer starts in the mouth. It is the most common type of head and neck cancer in men.
- Larynx cancer: This type of cancer starts in the larynx, which is the voice box. It is the second most common type of head and neck cancer in men.
- Nasopharyngeal cancer: This type of cancer starts in the nasopharynx, which is the upper part of the throat. It is more common in people of Asian descent.
- Salivary gland cancer: This type of cancer starts in the salivary glands, which are the glands that produce saliva. It is more common in older adults.