When teaching a patient about esophageal speech, which technique ...

[mmm]

When teaching a patient about esophageal speech, which technique should the nurse instruct the patient to use first?
 
  a. Coordinate lip and tongue movements with produced sound.
  b. Relax the diaphragm to allow air into the esophagus.
  c. Cough to express air.
  d. Swallow air and force it back up through the esophagus.

Question 2

The nurse is reviewing the plan of care for a patient following a tympanoplasty. Which intervention should the nurse implement in the immediate postoperative period?
 
  a. Keep the patient flat in bed.
  b. Encourage deep breathing and coughing.
  c. Reposition the patient quickly to reduce nausea and vomiting.
  d. Position the patient's head with the af-fected ear touching the mattress.

[izzat]

Answer to Question 1

D
Many people are able to learn esophageal speech. First, the patient should master the art of swallowing air and then moving it forcibly back up through the esophagus. Next, the patient should learn to coordinate lip and tongue movements with the sound produced by the air passing over vibrating folds of the esophagus. The sounds may be somewhat hoarse, but are more natural than the sounds produced by an artificial larynx. Relaxing the diaphragm and coughing to ex-press air are not methods to achieve esophageal speech.

Answer to Question 2

A
Postoperative care involves keeping the patient quiet and flat in bed for at least 12 hours. Coughing and sneezing should be avoided, or if unavoidable, should be accomplished with the mouth open to decrease pressure in the ear. Position changes should be accomplished slowly. The head is turned so that the affected ear is uppermost.