The nurse is planning care for a patient who has just had a permanent tracheostomy following total laryngectomy

Question

What should the nurse consider when planning this care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The patient will require isolation until the site is healed.
2. The patient will require enteral feedings until healed.
3. Writing will be an important form of communication immediately postoperatively.
4. The patient will be unable to speak normally
5. The family will be unable to communicate with the patient.

Answer 1

2,3,4
Rationale 1: There is no reason for isolation until the site is healed, but meticulous wound care is paramount.
Rationale 2: The patient will not be able to eat orally until the internal incision lines heal, which should take 5 to 7 days.
Rationale 3: Use of an alternative form of communication such as writing will be necessary immediately after surgery. Pantomime and lip reading can also be used, but they are not generally as efficient as writing.
Rationale 4: The patient will be unable to speak normally after the laryngectomy. It will take time to learn an alternate form of speech.
Rationale 5: Alternate forms of communication can allow the family to communicate with the patient.