In planning postoperative nursing care for a client who has undergone radical neck dissection and total laryngectomy, the nurse would give priority to the fact that
a. esophageal speech is relatively difficult to learn and takes practice.
b. prognosis after treatment is moderate, depending on findings.
c. the stoma should never be covered after this type of surgery.
d. there is a radical change in appearance as a result of this type of surgery.
D
Surgical management of laryngeal tumors often includes neck dissection. Radical neck dissection is the removal of lymphatic drainage channels and nodes, sternocleidomastoid muscle, spinal accessory nerve, jugular vein, and submandibular area. The radical approach to surgery results in a drastic change in appearance. Esophageal speech is not difficult to learn. Laryngeal cancer is potentially curable if caught early enough. Clients often learn to camouflage their stomas by covering them with articles of clothing, such as scarves or turtleneck sweaters.
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