Medical Surgical Esophageal cancer #4

Question

Which nursing action is priority when a client has just been diagnosed with stage 4 esophageal cancer after being inaccurately diagnosed with various conditions over the past 6 months related to symptoms of dysphagia, unintentional weight loss, increasing heartburn, hoarseness or coughing, and chest pain?

Answers

  1. Schedule a swallowing study
    • Rationale:

      This answer is not correct because of the nursing actions listed, consulting hospice care is the priority since the client will need emotional and physiological support that hospice services provide. The other actions should be completed next but contacting hospice care is important to help provide optimal emotional support at this time.

  2. Consult hospice care
    • Rationale:

      This answer is correct because the priority care following a diagnosis of stage 4 esophageal cancer following 6 months of inaccurate diagnosis is contacting hospice care. Unfortunately, once clients have symptoms, the very aggressive cancer is late-stage, with a poor prognosis. Hospice care should be contacted as soon as possible so the client can have the emotional and physical support needed. If desired, pastoral care can be consulted to provide spiritual support.

  3. Plan a dietary consult
    • Rationale:

      This answer is not correct because dietary consultation, education, and support is not the number one priority at this moment. It should be part of the next priority for the client, but due to the information received about stage 4 esophageal cancer and prognosis, hospice care is priority.

  4. Set up a chest x-ray
    • Rationale:

      This answer is not correct because ordering a chest x-ray is not the nursing priority following information received from the physician about stage 4 esophageal cancer and its prognosis. Hospice should be consulted so hospice support can begin as soon as possible. If desired, pastoral care can be consulted to provide spiritual support.

Overview

The priority care following a diagnosis of stage 4 esophageal cancer following 6 months of inaccurate diagnosis is contacting hospice care. Unfortunately, once clients have symptoms, the very aggressive cancer is late-stage, with a poor prognosis.

Explanation

Learning Outcomes

The priority care following a diagnosis of stage 4 esophageal cancer following 6 months of inaccurate diagnosis is contacting hospice care. Unfortunately, once clients have symptoms, the very aggressive cancer is late-stage, with a poor prognosis. Hospice care should be contacted as soon as possible so the client can have the emotional and physical support needed. If desired, pastoral care can be consulted to provide spiritual support. Other prescribed interventions, such as swallowing studies, dietary consults, and a chest x-ray support the physical needs of the client and should be performed, but in this situation, emotional support is priority since the client has just received the stage 4 esophageal cancer diagnosis.

Test Taking Tip

Understanding the symptoms of late-stage esophageal cancer and the prognosis is helpful to answer this question correctly since it points to the immediate need of emotional support.

Video Rationale