Medical Surgical Esophageal cancer #5

Question

Which will the nurse anticipate following surgery for stage 1 esophageal cancer?

Answers

  1. Jejunal feeding tube
    • Rationale:

      This answer is correct because a jejunal feeding tube will be placed while the client is in surgery to provide nutritional support. The nurse should anticipate this and provide education prior to surgery and anticipate assessment of this site after surgery.

  2. Deep vein thrombosis
    • Rationale:

      This answer is not correct because deep vein thrombosis (DVT) should not occur due to prevention protocol. Nevertheless, the nurse should continue DVT prevention protocol as prescribed and continue to watch for this potential post-surgical complication.

  3. 3+ periorbital edema
    • Rationale:

      This answer is not correct because 3+ periorbital edema is not an expected finding after esophageal surgery. Some swelling may occur but 3+ periorbital edema should be assessed further, including a lung assessment, to rule out heart failure or fluid volume overload. The head of the bed should be elevated for this client due to the need for airway support, decreasing swelling, and for the feeding to be administered.

  4. Hospice consultation
    • Rationale:

      This answer is not correct because stage 1 esophageal cancer is localized and has a good prognosis. Emotional and physical support will be needed due to the extensive surgery, but not due to poor prognosis.

Overview

The nurse should anticipate the client having a jejunal feeding tube following surgery for stage 1 esophageal cancer. The esophagus will not be usable while healing so a feeding tube will be placed to meet the client’s dietary needs and promote healing.

Explanation

Learning Outcomes

Stage 1 esophageal cancer is rarely found at this stage since there are usually no symptoms. It is generally found as a result of another problem being examined and as the result of visualization during an endoscope exam. The esophagus and stomach is generally resected and not usable while healing occurs. Therefore, a jejunal feeding tube will be placed while the client is in surgery to provide nutritional support. The nurse should anticipate this and provide education prior to surgery and anticipate assessment of this site after surgery. Before discharge, the client and caregiver will need to be taught how to prepare and administer tube feedings and fluids.

Test Taking Tip

It is important to understand staging of esophageal cancer and the prognosis.

Video Rationale