Exam 19: Otorhinolaryngologic Surgery

During the preoperative assessment and teaching for a patient scheduled for otolaryngologic surgery performed using local anesthetic,the perioperative nurse reviews with the patient normal coping mechanisms that are personally effective and supports and encourages the patient during the surgical intervention.The nurse is preparing the patient to anticipate:

The salivary glands produce saliva,which serves to moisten the mouth and initiate:

The nasal septum is lined with blood vessels and mucus-secreting cells.The proper name of this lining is the:

A nasal polypectomy is the removal of polyps from the nasal cavity.Nasal polyps are benign,grapelike clusters of mucous membrane and connective tissue.When the polyps become large,they obstruct the free passage of air,make breathing difficult,and cause a change in speech quality.Nasal polypectomies are typically performed endoscopically with the use of microdebriders,which remove the polyps by their mechanism of _______________.

A power drill and assorted rotating burrs are essential for middle ear surgery and some sinus procedures.A selection of burrs including assorted sizes of round cutting burrs and diamond polishing burrs should be available.During drill and power saw use,the scrub person keeps irrigation solution on the sterile field to:

Oral malignancies can be linked to specific carcinogens,the most important one being tobacco.Benign or malignant lesions of the tongue,floor of the mouth,alveolar ridge,buccal mucosa,or tonsillar area are excised depending on the extensiveness of disease,involvement of surrounding vessels and nerves,and candidacy for surgery.Benign or small malignant tumors of the oral cavity may be excised without a neck dissection.Which indicator would prompt the surgeon to perform a neck dissection for benign or small malignant tumors?

The palatine and lingual tonsils are situated in the oropharynx,while the adenoids are located in the nasopharynx.Both adenoids and tonsils consist of:

Surgical removal of hypertrophic adenoids to relieve upper airway obstruction is often performed to create a patent nasal airway.The highly vascular adenoids are treated by which method(s)of hemostasis to control bleeding?

Excision of the submandibular gland is performed to remove mixed tumors and calculi associated with extensive chronic inflammation.The submandibular gland lies in close proximity to several important nerves and vessels.Of the following,what is the highest priority perioperative nursing action related to submandibular surgery?

The external ear,which includes the auricle (or pinna)and external auditory canal,is composed of cartilage covered with skin.The primary function of the auricle is to:

Depending on the surgical defect,head and neck surgical procedures to remove malignant tumors may also involve reconstructive procedures.The wound may be closed primarily,or local flaps and split-thickness skin grafts or full-thickness skin grafts may be used to restore function as well as cover defects.An important role of the perioperative nurse in the ongoing assessment of graft integrity includes which assessment tool?

Lasers assist in vaporization of scar tissue,granulomas,and cholesteatomas without damaging surrounding tissue and may be used for select otolaryngologic procedures.Lasers can be secured to the operating microscope and laser energy delivered to the tissue by means of a:

The surgical microscope is often used to provide illumination and magnification for complex procedures to the ear,laryngeal surgery,or reconstructive free flap procedures following neck surgery.A common eyepiece magnification for an otologic microscope is ´12.5,and the usual objective (lens)is ______-mm focal length (f).A _______-mm lens is used for laryngeal surgery.

Myringotomy is often accompanied by the aspiration of fluid under pressure in the tympanum,and the subsequent placement of small,hollow pressure equalization tubes.It is indicated for acute otitis media (AOM)in the presence of an exudate that has not responded to antibiotic therapy.If left untreated,what is the main concern for a child with chronic otitis media?

Microlaryngoscopy facilitates improved diagnosis and allows the laryngologist to view,with relative ease,areas that previously were inaccessible or difficult to visualize.What are the two most common indications for microlaryngoscopy?

Tympanoplasty is the surgical repair of the tympanic membrane and the tympanum and the reconstruction of the ossicular chain.Conductive hearing loss is caused by an obstruction in the external canal or middle ear,which impedes the passage of sound waves to the inner ear.A common cause of conductive hearing loss would be:

During a stapedotomy or stapedectomy procedure,the perioperative nurse manages and controls the environment of care by maintaining a quiet,warm,and comfortable operating room (OR).Energy modality devices and monitor alarms are turned down to the lowest audible setting for the team to hear without startling the patient.The English-speaking,nonanxious patient sedated using local or monitored anesthesia care (MAC)anesthetics is well prepared by the perioperative nurse for sensory and procedural expectations.Which event occurs near the conclusion of the procedure that predicts patient outcome?

When laryngoscopy,bronchoscopy,and esophagoscopy are performed in a single session on a patient,the procedure is termed triple endoscopy or panendoscopy.The purpose of triple endoscopy is usually diagnostic.A procedure-specific perioperative nursing intervention is:

When microlaryngoscopy is performed to remove polyps or nodules from the vocal cords,which important postoperative instruction must the nurse give the patient during discharge teaching?

Several types of diagnostic imaging studies visualize structures by producing serial sections through different anatomic planes,highlighting specific structures,or tissue densities.Examples of these imaging diagnostics would be: