Discharge diagnoses:

Question

1. (1)________, malignant, laryngeal primary.
2. Alcoholic liver disease.
3. History of alcohol abuse.
4. Chronic obstructive pulmonary disease.
5. (2)________.
6. Malnutrition.

PROCEDURES PERFORMED: Total laryngectomy with right (3) ________ neck dissection.

COMPLICATIONS: None.

HOSPITAL COURSE: The patient was admitted for a total laryngectomy and neck (4)________ for treatment of a laryngeal carcinoma. Preoperatively, this was thought to be a T4N0 transchorionic carcinoma. The procedure was performed without complication. Postoperatively the patient did relatively well and was without significant pulmonary complications, although she did have respiratory therapy treatment throughout her hospital course. She was noted to have a low hematocrit and received 2 units of packed red blood cells. She was also noted to have a low magnesium level, and this was treated with (5)________ magnesium. The drains were removed on the 3rd postoperative day. She was noted to have some redness and erythema of the neck skin and was (6)________ treated with ampicillin and gentamicin for a possible infection. Further signs of infection were not noted other than a low-grade fever. She did not develop any (7)________ and was noted to be feeling well at the time. The nasogastric tube was discontinued on the 11th postoperative day. A (8)________ swallow was obtained prior to discontinuing the nasogastric tube and no (9)________ of the neck was noted. The patient tolerated tube feedings relatively well while the nasogastric tube was in place and once the tube was removed, she tolerated oral feedings well.

DISPOSITION:
1. The patient was discharged home without complications or problems.
2. Her diet and activity level should be as tolerated.

DISCHARGE MEDICATIONS: Tylenol with codeine (10)________ 30 mL p.o. q.4 hours p.r.n. One pint was dispensed.

FOLLOWUP:
1. Followup will be in the ENT clinic for suture removal.
2. The patient will also be followed by Speech Therapy as an outpatient and will receive radiation therapy treatments approximately 1 month postoperatively.

Answer 1

1. Neoplasm
2. Hypomagnesemia
3. radical
4. dissection
5. intramuscular
6. empirically
7. fistulization
8. Hypaque
9. extravasation
10. elixir