When caring for a client who has just had a total laryngectomy, the nurse should plan to:
a) encourage oral feedings as soon as possible.
b) develop an alternative communication method.
c) keep the tracheostomy cuff fully inflated.
d) keep the client flat in bed.
Answer: b) develop an alternative communication method.
Explanation:
A client with a laryngectomy can't speak, but still needs to communicate. Therefore, the nurse should plan to develop an alternative communication method. After a laryngectomy, edema interferes with the ability to swallow and necessitates tube (enteral) feedings. To prevent injury to the tracheal mucosa, the nurse should deflate the tracheostomy cuff or use the minimal leak technique. To decrease edema, the nurse should place the client in semi-Fowler's position. pg.560
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