Which of the following is a priority psychosocial outcome for a patient who has had a radical neck dissection?
A) He indicates acceptance of altered appearance and demonstrates positive self-image.
B) He freely expresses needs and concerns related to postoperative pain management.
C) He compensates effectively for alteration in ability to communicate related to dysarthria.
D) He demonstrates effective stress management techniques to promote muscle relaxation.
Ans: A
Feedback: Since radical neck dissection involves removal of the sternocleidomastoid muscle, spinal accessory muscles, and cervical lymph nodes on one side of the neck, the patient's appearance is visibly altered. The face generally appears asymmetric with a visible neck depression; shoulder drop also occurs frequently. These changes have the potential to negatively affect self-concept and body image. Facilitating adaptation to these changes is a crucial component of nursing intervention. Patients who have had head and neck surgery generally report less pain as compared with other postoperative patients; however, the nurse must assess each individual patient's level of pain and response to analgesics. Patients may experience transient hoarseness following a radical neck dissection; however, their ability to communicate is not permanently altered. Stress management is beneficial but would not be considered the priority in this clinical situation.
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