4/7 Team Care & Counseling Continued Flashcards
(43 cards)
In terms of taste & smell what does a lary experience?
taste may get a little bit better but smell is always affected!
-diminished taste may be due to radiation (remember, they most often have cancer)
What percentage of larys return to previous enrollment?
70%
what are some things that people experience when going back to work?
- for those that are working, they may potentially need to find some place else to work (e.g., if it’s a dusty/dirty place to work)
- types of work require you to be hands free, so this may potentially affect you going back to work
- You want to encourage people to get back to their normal lives!
Even though some larys have jobs go back to work, what are most larys?
retired. because of this they are more at risk because they don’t have an excuse to get up and talk to people
What are some changes larys experience in terms of physical activity?
they generally experience a change in physical activity, but as much as possible you want them to keep doing the activities they alway shave
the activities involving water are an issue (swimming, sailing, water skiing…)
Will eating be affected for larys?
YES! To some degree food WILL BE AFFECTED..
there is likely to be something else along with the diminished taste and smell
the radiation causes issues, they have to pay attention when they start eating again. they will need to eat slower, take smaller bites, and for some people, they will see an improvement over time, some may not recover, and some may never eat again
-we need to talk to our patients about eating slowly and progressively
In terms of stoma care what must larks do 2x daily?
clean the stoma with soap and water 2x daily
it needs to be cleaned @ least 2x daily. When they leave the hospital, potentially more.
Don’t scrub hard cause you don’t want to have raw tissue but they will be hacking up a lot of mucous
What does the nose do?
it filters, moistens, and warms the air, without it it’s just cold air going into the stoma
What should they never use to clean the stoma?
cotton balls! they should use a really soft cloth
If there is crust around the edges of the stoma, what should the lary do?
it needs to be soaked in water. makes sure they don’t inhale any soap or water!
What may they use for raw skin on the stoma?
k-y jelly.
Don’t use vaseline! it’s a petroleum product, it gets warm and it runs!
-make sure no moisturizer is used that is used to burn raw skin.
Aloe is good for dry skin, not so good for raw skin.
What must we teach larys that is ABSOLUTELY NECESSARY for the stoma?
a cover!
right away, the client MUST cover their stoma! it’s not an option!
try to talk your patient into getting an HME (heat/moisture exchange) it’s just so much better for long term health
** they can’t get an HME quickly before being discharged…
What is something we should warn larys about in terms of mucous?
there may be ALOT of mucous at first
the upper respiratory tract adds 1-2 quarts of water to inspired air every 24 hours
tell them to use an HME!
they could use a humidifier, it’s better for them, and helps the body be more comfortable.
What should we educate larys about in terms of showering?
shower guards are something that they should use
it goes around the neck like a choker, and has a front piece that is just a plastic shelter for the stoma.
What should we teach them about shaving?
most laryngectomees are men, try to talk your client into an electric razor
What should we tell them about sleeping
it’s not a problem, just like other people. when you can’t breathe, you wake up. they won’t have issues with this!
Because natural healing response wants to close the stoma, what is necessary to use?
a canula
Describe the canula
a canula is a tube that is made out of plastic or metal and it puts it in the stoma hole. The device sits around the stoma, with a tube going hroughthe stoma, just a little way to the trachea. It’s something that holds the stoma open while it heals. Some people may have an issue with stenosis (tissue closure) this is not good when you’re breathing through that hole! the canula is placed into every patient
Describe the introducer in the canula
-when a canula is introduced, it is just a tube with edges. They make an introducer that goes down into the canula and is shaped like a bullet so you have a smooth surface. However, when the introducer goes in it, it is plugging the canula, and will cause the patient to suffocate. The inner canula needs to be cleaned multiple times daily, and every now and again the outer canula needs to be taken out to be cleaned.
How can canals be cleaned?
they can be soaked in hydrogen peroxide or warm water, (don’t put soap on the canula–if it doesn’t get completely removed, it’ll burn!)
you can use a small bottle brush to scrape and clean the canula
What may you have to teach the patient in terms of their canula?
you may have to teach the patient how to clean and maintain the canula
Describe the inner canula & the outer canula
the inner canula has a locking mechanism to keep it from falling out when the patient bends over. The outer canula is usually kept on a tie around the neck.
the outer canula stays in, but the patient takes out the inner canula and cleans it
Do we ever have to be a counselor?
yes! in general, as a SLP there are several populations where you need to have a good idea about yourself as a counselor. It is within your purview with limitation!
(e.g., transgender population, people who stutter, or who have parkinson’s or huntington’s or CVA’s. Larys are part of this population)
What should we always find ways to encourage?
encourage them to continue their life as normal as possible!
