Question

you are a nurse providing care for a patient about to undergo a total laryngectomy. Which nursing intervention in a priority?

a. review the use of an artificial larynx

b. schedule a support session for and with the patient

c. explain techniques of esophageal speech

Answer 1

TOTAL LARYNGECTOMY

Total laryngectomy is a surgical procedure in which larynx is totally removed so that the the airway is totally interupted resulting in artificially creation of a tracheal stoma and the respiration can be restored.

nursing care before surgery

1. assess the knowledge level of the client and the family members and teach them regarding the procedure and its effects after the surgery.clarify their doubts as possible
2. before the surgery vital signs should be frequently monitored.
3. assess the anxiety level of the patient.teach them that anxiety can cause variation in their heart rate ,blood pressure etc. teach them that an artificial stoma will be created and respiration can be continued through that passage
4. if possible ,make arrangements to contact a post laryngectomy patient ,so that the client and family members can reduce some sort of anxiety
5. establish an alternative means of communication for the patient like paper and pen non verbal communication methods like hand signals etc

ARTIFICIAL LARYNX

An artificial larynx is also known as electro larynx is a medical device used to produce clearer speech by those people who have lost their larynx .The uses of an electro larynx is that it can be used to vibrate the throat for you ,but your mouth still needs to shape that sound into words.using the electro larynx the patient can later on speak.

TECHNIQUES OF ESOPHAGEAL SPEECH

esophageal speech is a method of speech production that involves oscillation of the esophagus.instead ,air is injected into upper esophagus and released in a controlled manner to create sound used to produce speech.It is a skill that help the patient to communicate with others after the surgery.esophageal speech is produced without an artificial larynx ,and is achieved by pumping air from the mouth into upper esophagus..the esophagus is slightly expanded in this.the air is then released in a regulated manner through the mouth,with simultaneous articulation of words.

support session:

provide support to the patient and family members if they are mentally weak.help them to speak using artificial larynx .help them to use it in a proper manner..teach the family members how to provide food and how much amount can be given and the teach the diet pattern of the patient..teach them regarding Nasogastric tube care and feeding.,how to wash the tube ,how much amount food can be given,how to provide that food .