Nursing Care Plan #3 Med Surg 2

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OluwaBusayo (Busayo) Ojo Med Surg #2 Nursing Care Plan #3 8/17/20 1. George Smith, a 55-year-old patient is admitted to the intensive care unit after a thoracotomy approach was used for an esopha... gectomy to remove an early stage adenocarcinoma of the distal esophagus and gastroesophageal junction. The patient has a history of GERD and Barrett’s esophagus. The patient sought medical treatment for dysphagia with solid foods, feeling that there was a lump in his throat and substernal pain with swallowing and subsequent regurgitation of undigested food and the development of hiccups. The patient has no other medical problems. (Learning Objectives 6 and 7) 1. Medical Diagnosis: Esophageal Cancer Definition/etiology/pathophysiology Esophageal cancer can be of two cell types: adenocarcinoma and squamous cell carcinoma. It is found primarily in the distal esophagus and gastroesophageal junction. Risk factors for esophageal cancer include chronic esophageal irritation or GERD. In the U.S, cancer of the esophagus has been associated with ingestion of alcohol and the use of tobacco. There is an apparent association between GERD and adenocarcinoma of the esophagus. People with Barrett’s esophagus (which is caused by chronic irritation of the mucous membranes due to reflux of gastric and duodenal contents) have a higher incidence of esophageal cancer. Tumor cells of adenocarcinoma and squamous cell carcinoma may spread beneath the esophageal mucosa or directly into, through and beyond the muscle layers into the lymphatics. In the latter stages, obstruction of the esophagus is noted, with possible perforation into the mediastinum and erosion into the great vessels. 2. Common signs and symptoms:  Advanced ulcerated lesion of the esophagus  Dysphagia This study source was downloaded by 100000830569446 from CourseHero.com on 08-26-2021 14:50:45 GMT -05:00 https://www.coursehero.com/file/72015438/Med-Surg-2-Nursing-Care-Plan-3docx/ This study resource was shared via CourseHero.com  Sensation of a mass in the throat  Painful swallowing  Substernal pain or fullness  Regurgitation of undigested food with halitosis and hiccups  Progressive loss of weight and strength occurs from inadequate nutrition [Show More]

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