Nur-105 Oral cavities/Premalignant/ Malignant Tumors. Part-2

leukoplakia/Erythroplakia, Squamous cell carcinoma, Basal cell carcinoma.

Leukoplakia.

Most common oral lesion.

Least likely to become malignant.

Leukoplakia.

Description of Leukoplakia.

Thickened white, firmly attached patches that are slightly raised and sharply circumscribed. (You can see the borders).

Attached and cannot be scrapped off.

Leukoplakia.

Leukoplakia results from.

Long- term mechanical irritation.

Etiology factors of leukoplakia.

Smokers patch, braces, poor fitting dentures, broken teeth, biting of the inside of the cheek.

Most likely to become malignant and painless.

Erythroplakia.

Description of erythroplakia.

Red velvety mucosal lesions on the surface of the oral mucosa.

Erythroplakia is found.

On the floor of the mouth, tongue, palate, and mandibular mucosa.

Questions asked with erythroplakia.

Do you smoke.

Concerns with erythroplakia.

Nutrition, body image, eating, and talking.

Malignant tumors.

1. Squamous cell carcinoma.

2. Basal cell carcinoma.

Squamous cell carcinoma.

Most malignant.

Description of squamous cell carcinoma.

Red raised eroded area.

Squamous cell carcinoma is found.

on the lips, tongue, buccal mucosa, oral oropharynx.

Etiology factors of squamous cell carcinoma.

Aging, tobacco and alcohol use, poor oral hygiene, HPV.

Questions asked with squamous cell carcinoma.

Do you smoke or use tobacco products?

Basal cell carcinoma.

Does not hurt and will not go away.

Description of basal cell carcinoma.

Asymptomatic, resembles a raised scab/ulcer with pearly borders.

Basal cell carcinoma is found.

On the lip.

Etiology factors of basal cell carcinoma.

Sunlight.

Who is at risk for basal cell carcinoma?

Anyone who is exposed to the sun for long periods.

Farmers, construction workers, athletes, sun bathers.

Assessment for malignant tumors.

1. History- occupation, smoke/alcohol/history, diet, how much sun exposure.

2. Physical- Complete thorough oral assessment, chart specifically, palpate Lym nodes to rule out metastasis.

3. psychosocial- body image, and anxiety.

4. Diagnostic- Biopsy.

Priority nursing diagnosis.

Ineffective airway clearance.

Interventions for airway management.

1. Teach pt’ productive cough method.

2. Elevate the head of the bed.

3. Feed them small amounts of thickened liquids.

4. keep suction at bedside.

Surgical interventions.

Possible tracheostomy. Discuss with pt’ and family before surgery and establish means of communication.

Impaired oral mucous membrane.

Oral cavities that can be treated by surgical excision, nonsurgical treatments such as radiation or chemotherapy, or by a combination of treatments. (Nutritional therapy).

Nonsurgical treatments for impaired oral mucous membranes.

1. Oral care every 2hrs- rinse with saline, consume cool liquids, use soft bristle toothbrush.

2. Radiation.

3. Chemotherapy.

Surgical management of impaired oral mucous membranes.

1. Teach pt’ and family about pain, ADLS-possible physical therapy, NG tube, diet.

2. Establish communication, address anxiety, dressings etc.

3. Suction secretions regularly.

Post- op.

1. Elevate HOB, relieve pain, promote nutrition, assess swallowing, vitals.

Home care management.

Teach pt’ and family about care of incisions, dressings, drainage, feeding, meds, and safety.

Primary risk for oral cancer.

1. Smoking.

2. Drinking.

3. Aging.

Acute Sialadentiis.

Inflammation of the salivary glands.

Concern of acute sialadenitis.

Impediment of salvia flow leads to concerns of dry mouth, swallowing, and aspiration, which leads to lack of nutrition.

Etiology factors of acute sialadenitis.

Radiation-most common, HIV, certain drugs, and infectious agents.

Interventions for acute sialadenitis.

1. Drink plenty of fluids.

2. Apply warm compress, massage glands.

3. use gel substitutes, and hard candy.

Xerostomia.

Post irradiation sialadenitis.

Description of Xerostomia.

Extreme dry mouth, resulting from radiation.

Interventions for xerostomia.

Hydration, drink before you eat to prevent aspiration.

With xerostomia nothing can’t be done until?

Radiation is complete.