Independently caring for the laryngectomy tube indicates that the patient has regained control of personal care and hopelessness is at least partially resolved. Letting the nurse and spouse provide care and requesting no visitors may indicate that the patient is still experiencing hopelessness.
The nurse should clarify that nasal decongestant sprays should be used for no more than 3 days to prevent rebound vasodilation and congestion. The other responses indicate that the teaching has been effective. The nurse has just auscultated coarse crackles bilaterally on a patient with a tracheostomy tube in place.
Prolonged alcohol use and smoking are associated with the development of laryngeal cancer, which the patient's symptoms and history suggest. Family history is not a risk factor for head or neck cancer.
The patient would not remove or reapply nasal packing, which is usually removed by the surgeon on the day after surgery.
In older adults, can present as lower respiratory infection, fever, or pneumonia. In infants, can manifest as a URI, but more likely to progress to pneumonia, bronchiolitis, and tracheobronchiolitis. Aerosolized ribavirin (Virazole) may be prescribed for older adults and immunocompromised patients with RSV pneumonia.
Respiratory Syncytial Virus (RSV) Common cold in older children and adults. Can cause severe illness or death in immune-compromised individuals. Transmission same as other URIs. Incubation period is 4-6 days. Adult manifestations—as with URIs. In older adults, can present as lower respiratory infection, fever, or pneumonia.