Medical Surgical Esophageal cancer #3

Question

An obese male client has been treated for several months for a cough, hoarseness, and unexplained weight loss of 20 pounds. Despite conservative treatment with GERD medications, cough suppressants, and evaluation of medications, the cough persists. Which diagnostic test does the nurse expect to be prescribed to identify the likely cause for these symptoms?

Answers

  1. A dietary consult
    • Rationale:

      This answer is not correct because a dietary consult is not a diagnostic test. However, if esophageal cancer is ruled out by the endoscopic exam, the client should be educated about various foods to help prevent esophageal cancer and minimize GERD symptoms.

  2. A swallowing study
    • Rationale:

      This answer is not correct because the client has not indicated dysphagia is present. This is a symptom of esophageal cancer but has not been reported by the client. Due to the history and symptoms of the client, an endoscopic examination is indicated.

  3. An endoscopic exam
    • Rationale:

      This answer is correct because an upper endoscopy is an appropriate diagnostic study due to the need to rule out esophageal cancer. Endoscopy is a minimally invasive procedure where a tube with a camera on it is placed in the mouth to observe the tissue and structures of the mouth, esophagus and stomach. Imaging and minor procedures can be accomplished through this procedure. It can help the physician see if GERD or cancerous lesions are present. Unfortunately, when a client has symptoms such as a cough, hoarseness, and unexplained weight loss, if esophageal cancer is found, the cancer tends to be late-stage, with a poor prognosis.

  4. An electrocardiogram
    • Rationale:

      This answer is not correct because an electrocardiogram is not appropriate at this time. If heart failure was suspected, weight gain would be present, not weight loss. Other tests would be more appropriate if heart failure was suspected.

Overview

An endoscopy exam is a minimally invasive procedure where a tube with a camera on it is placed in the mouth to observe the tissue and structures of the mouth, esophagus and stomach. It can help the physician see if GERD or cancerous lesions are present.

Explanation

Learning Outcomes

An upper endoscopy is a minimally invasive procedure where a tube with a camera on it is placed in the mouth to observe the tissue and structures of the mouth, esophagus and stomach. Imaging and minor procedures can be accomplished through this procedure. It can help the physician see if GERD or cancerous lesions are present. Unfortunately, when a client has symptoms such as a cough, hoarseness, and unexplained weight loss, if esophageal cancer is found, the cancer tends to be late-stage, with a poor prognosis. Since GERD and Barrett’s esophagus is a risk factor for esophageal cancer, if a client has a family history or other risk factors, including over the age of 55, male, smoker, and obese, an endoscopy procedure should be considered.

Test Taking Tip

Be sure to answer the question being asked. Also, understand the signs and symptoms of esophageal cancer.

Video Rationale