Author Question: A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa ... (Read 113 times)

james · **on:** Jun 25, 2018

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?

a. Remove food debris from the teeth and oral mucosa with a stiff toothbrush.
b. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
c. Gargle and rinse the mouth several times a day with an antiseptic mouthwash.
d. Rinse the mouth before and after each meal and at bedtime with a saline solution.

Question 2

A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?

a. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
b. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
c. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
d. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.

batool · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The patient should rinse the mouth with a saline solution frequently. A soft toothbrush is used for oral care. Hydrogen peroxide may damage tissues. Antiseptic mouthwashes may irritate the oral mucosa and are not recommended.

Answer to Question 2

ANS: C
For chronic cancer pain, analgesics should be taken on a scheduled basis, with additional doses as needed for breakthrough pain. Taking the medications only when pain reaches a certain level does not provide effective pain control. Although nonopioid analgesics also may be used, there is no maximum dose of opioid. Opioids are given until pain control is achieved. The IV route is not more effective than the oral route, and usually the oral route is preferred.