Evidence Based Article

In the article, “Current Management of Advanced Resectable Oral Cavity Squamous Cell Carcinoma”, it is stated that an estimated 24,000 cases of oral squamous cell carcinoma are diagnosed each year, and that this specific cancer is ranked within the top 10 cancers that effect the oral cavity. This type of cancer most commonly starts out as what looks like a scaly red patch, open sores, elevated growth with a central depression or a wart. In the case of my father, it started out as what looked like a scab on his upper lip and by the time the small site was surgically removed, it had metastasized to the lymph nodes in his neck.

The head and neck region is the most common site for squamous cell carcinoma. Surgery is the leading treatment for this cancer, however a new method of treatment is emerging that involves collaborative therapy. Depending on the staging, a combination of: radiation therapy, chemotherapy, and surgical intervention can be used to treat squamous cell carcinoma of the mouth. Nursing care is a part of this collaborative care.

Nursing care starts from the initial assessment of any patient, even before diagnosis of cancer. Considering the most common risk factor for developing oral cancer is tobacco use, it is vital as a nurse to include this in the initial assessment. If the patient denies tobacco use of any kind, the assessment may move along. However, if the patient claims to have used at any time in the past or  present, the nurse must get answers to the following questions: How long has the patient been using tobacco products? How often are the products used? What type of tobacco does the patient use? Nurses should also educate all patients that although the risk is slightly lower than it is with smoking, smokeless tobacco is still a risk factor in developing oral cancer.

Advancements are being made with the use of collaborative care to treat more advanced stage cancer, including the use of radiation, chemotherapy, and surgical resection/reconstruction; but even with these progressive steps forward, there is still the high rate of failure and morbidity that must be overcome to make further advancements. Tobacco use kills, the nurses role of assessment and education plays a vital role in the prevention of unnecessary bodily damage or even death to the patient. 

Bibliography 

Thomas J. Ow, M. a. (2011, March 4). Clinical and Experimental Otorhinolaryngology. Retrieved from US National Library of Medicine National Insitutues of Health : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062220/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062220/

ISTAN Reflective Journal

For my Istan day, my fellow classmates (Julia James, Brooke Edwards, and Alexis White) and I cared for a 85 year old female admitted for dehydration and urinary retention caused by a drug interaction between 2 home medications she had been taking. We completed many task during our simulation and were very efficient in the time we were given. We performed our assessment, identified the absence of an arm band, called admissions and obtained another one, discovered there was no statlock on the patient’s catheter, applied a new one, we discovered the patient had more allergies then were listed, and obtained an allergy band to place on the patient. Morning medication was administered, labs were drawn, and a sterile urine specimen was taken from the Foley catheter to be sent to the lab.

I feel that I learned team work is very important when working with others to provide care for a patient but I also think that next time in simulations, I will not solely rely on the other members of the team to check behind one another, and I will double check things myself.

The main things I learned from watching my peers is that it is key to communicate properly and have a plan before initiating care, even if the plan goes completely upside down, have some sort of ground plan to fall back on and go back to when things get chaotic and you need to evaluate what things are priority, which is another thing I learned from my peers, it is important to step back and assess how high of a priority are the things you are doing at that moment compared to the things that are waiting to be done. Also, I learned that it is important to be able to handle any situation well, no matter how odd or difficult the situation may be, keep your patient’s safety and well-being in mind first and handle the situation with that in mind.

One of my favorite parts of clinical and simulations is when we are able to take the things we have learned in the class room and out then into effect and it all starts coming together and making more sense. In this simulation, we focused on hydration, encouraging fluids and closely monitoring intake and output, we discussed mediation interactions and how certain medications could affect the patient and also how it is important to keep the patient educated about what is being done to them, given to them, and the status of the care they are receiving.

- Victoria Saranthus  

Hi Victoria