Case Study, Chapter 46, Management of Patients With Oral and Esophageal Disorders
George Smith, a 55-year-old patient is admitted to the intensive care unit after a thoracotomy approach was used for an esophagectomy 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)
a. Describe the esophageal cancer that the patient has and how it relates to his history of GERD and Barrett's esophagus.
b. Explain the rationale for the early symptoms and late symptoms of esophageal cancer.
c. What course of cancer treatment should the nurse anticipate that the patient in this case study would have?
d. What nursing care should be provided for the patient in the intensive care unit in the early postoperative period?
e. Explain the care the nurse should provide when the patient begins to eat.